ascorbic-acid and Osteoporosis

Vitamin C (ascorbic acid), is an important antioxidant that has been applied broadly in the field of orthopaedics. Current research on vitamin C examines the molecule's role in bone and tendon physiology, as well as joint replacement and Postoperative pain. Most laboratory and human studies associate the use of vitamin C with improved bone health and tendon healing. Recent literature moderately supports the use of vitamin C to improve functional outcomes, decreased postoperative pain, and prevent complex regional pain syndrome following orthopaedic procedures. The perioperative use of vitamin C in patients undergoing joint replacement surgery and anterior cruciate ligament reconstruction is still under investigation. Overall, there is need for high-quality human trials to confirm whether vitamin C can potentiate the outcomes of orthopaedic procedures and to determine optimal dosage and means of administration to maximize its proposed benefits. The purpose of this review was to summarize the application of vitamin C in orthopaedic practices and to identify potential areas for future study.

Topics: Animals; Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Antioxidants; Arthroplasty, Replacement; Ascorbic Acid; Bone and Bones; Clinical Trials as Topic; Humans; Orthopedics; Osteoporosis; Pain, Postoperative; Perioperative Period; Randomized Controlled Trials as Topic; Tendons; Treatment Outcome

In animal models it has been shown that ascorbic acid (AA) is an essential cofactor for the hydroxylation of proline in collagen synthesis. However, there are still no precise indications regarding the role of AA in maintaining bone health in humans, so the aim of this narrative review was to consider state of the art on correlation between bone mineral density (BMD), AA dietary intake and AA blood levels, and on the effectiveness of AA supplement in humans. This review included 25 eligible studies. Fifteen studies evaluated correlations between AA intake and BMD: eight studies demonstrated a positive correlation between AA dietary intake and BMD in 9664 menopausal women and one significant interaction between effects of AA intake and hormone therapy. These data were also confirmed starting from adolescence (14,566 subjects). Considering studies on AA blood concentration and BMD, there are four (337 patients) that confirm a positive correlation. Regarding studies on supplementation, there were six (2671 subjects), of which one was carried out with AA supplementation exclusively in 994 postmenopausal women with a daily average dose of 745 mg (average period: 12.4 years). BMD values were found to be approximately 3% higher in women who took supplements.

Topics: Adolescent; Animals; Ascorbic Acid; Bone and Bones; Bone Density; Databases, Factual; Diet; Dietary Supplements; Female; Hormones; Humans; Male; Osteoporosis

Recent research studies have shown that vitamin C (ascorbic acid) may affect bone mineral density and that a deficiency of ascorbic acid leads to the development of osteoporosis. Patients suffering from an inflammatory bowel disease are at a risk of low bone mineral density. It is vital to notice that patients with Crohn's disease and ulcerative colitis also are at risk of vitamin C deficiency which is due to factors such as reduced consumption of fresh vegetables and fruits, i.e., the main sources of ascorbic acid. Additionally, some patients follow diets which may provide an insufficient amount of vitamin C. Moreover, serum vitamin C level also is dependent on genetic factors, such as

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Bone Density; Colitis, Ulcerative; Crohn Disease; Diet; Female; Gastrointestinal Microbiome; Glutathione S-Transferase pi; Glutathione Transferase; Humans; Inflammatory Bowel Diseases; Male; Osteoporosis; Risk Factors; Sodium-Coupled Vitamin C Transporters

Osteoporosis and associated low energy fractures are a significant clinical problem, especially in the elderly population. The occurrence of a hip fracture is associated with significant mortality and a high risk of disability. For this, apart from the treatment of osteoporosis, effective prevention of both the development of the disease and related fractures is extremely important. One aspect of osteoporosis prevention is proper dietary calcium intake and normal vitamin D3 levels. However, there is some evidence for a potential role of vitamin C in osteoporosis and fracture prevention, too. This review aims to summarize the current knowledge about the role of vitamin C in osteoporosis development, prevention and treatment. The PubMed/Medline search on the role of vitamin C in bone metabolism database was performed for articles between 2000 and May 2020. Reports from in vitro and animal studies seem promising. Epidemiological studies also indicate the positive effect of high vitamin C content in the daily diet on bone mineral density. Despite promising observations, there are still few observational and intervention studies and their results do not allow for unequivocal determination of the benefits of high daily intake of vitamin C or its long-term supplementation.

Topics: Animals; Ascorbic Acid; Bone and Bones; Bone Density; Cell Line; Dietary Supplements; Fractures, Spontaneous; Humans; Nutritional Physiological Phenomena; Osteogenesis; Osteoporosis

This study aimed to provide reliable estimates for dietary antioxidant vitamin (vitamins A, C, and E) intake and their effect on fracture risk at various sites.. The PubMed, EMBASE, and Cochrane Library databases were searched to identify prospective cohort studies published throughout October 2019. The pooled relative risk (RR) with its 95% confidence interval (CI) was calculated using a random-effects model.. In total, 13 prospective cohort studies involving 384,464 individuals were selected for this meta-analysis. The summary RR indicated that increased antioxidant vitamin intake was associated with a reduced fracture risk (RR: 0.92; 95% CI: 0.86-0.98; P = .015). When stratified by the vitamin types, increased vitamin E intake was found to be associated with a reduced fracture risk (RR: 0.66; 95% CI: 0.46-0.95; P = .025), whereas increased vitamin A and C intake did not affect this risk. Increased antioxidant vitamin intake was associated with a reduced fracture risk, irrespective of fracture sites (HR: 0.90; 95% CI: 0.86-0.94; P < .001); however, it did not affect hip fracture risk. Furthermore, increased antioxidant vitamin intake was associated with a reduced fracture risk in men (RR: 0.81; 95% CI: 0.68-0.96; P = .017) and combined men and women (RR: 0.83; 95%CI: 0.73-0.93; P = .002); however, it did not affect fracture risk in women.. Fracture risk at any site is significantly reduced with increased antioxidant vitamin intake, especially vitamin E intake and in men.

Topics: Adult; Aged; Aged, 80 and over; Antioxidants; Ascorbic Acid; Dietary Supplements; Female; Fractures, Bone; Hip Fractures; Humans; Male; Middle Aged; Osteoporosis; Prevalence; Prospective Studies; Risk Factors; Vitamin A; Vitamin E; Vitamins

We aimed to systematically review available data on the association between vitamin C intake and bone mineral density (BMD), as well as risk of fractures and osteoporosis, and to summarise this information through a meta-analysis. Previous studies on vitamin C intake in relation to BMD and risk of fracture and osteoporosis were selected through searching PubMed, Scopus, ISI Web of Science and Google Scholar databases before February 2017, using MeSH and text words. To pool data, either a fixed-effects model or a random-effects model was used, and for assessing heterogeneity, Cochran's Q and I 2 tests were used. Subgroup analysis was applied to define possible sources of heterogeneity. Greater dietary vitamin C intake was positively associated with BMD at femoral neck (pooled r 0·18; 0·06, 0·30) and lumbar spine (pooled r 0·14; 95 % CI 0·06, 0·22); however, significant between-study heterogeneity was found at femoral neck: I 2=87·6 %, P heterogeneity<0·001. In addition, we found a non-significant association between dietary vitamin C intake and the risk of hip fracture (overall relative risk=0·74; 95 % CI 0·51, 1·08). Significant between-study heterogeneity was found (I 2=79·1 %, P heterogeneity<0·001), and subgroup analysis indicated that study design, sex and age were the main sources of heterogeneity. Greater dietary vitamin C intake was associated with a 33 % lower risk of osteoporosis (overall relative risk=0·67; 95 % CI 0·47, 0·94). Greater dietary vitamin C intake was associated with a lower risk of hip fracture and osteoporosis, as well as higher BMD, at femoral neck and lumbar spine.

Topics: Ascorbic Acid; Bone Density; Hip Fractures; Humans; Observational Studies as Topic; Osteoporosis; Risk Factors

Osteoporosis and related fractures are a major global health issue, but there are few preventative strategies. Previously reported associations between higher intakes of fruits and vegetables and skeletal health have been suggested to be partly attributable to vitamin C. To date, there is some evidence for a potential role of vitamin C in osteoporosis and fracture prevention but an overall consensus of published studies has not yet been drawn. The present review aims to provide a summary of the proposed underlying mechanisms of vitamin C on bone and reviews the current evidence in the literature, examining a potential link between vitamin C intake and status with osteoporosis and fractures. The Bradford Hill criteria were used to assess reported associations. Recent animal studies have provided insights into the involvement of vitamin C in osteoclastogenesis and osteoblastogenesis, and its role as a mediator of bone matrix deposition, affecting both the quantity and quality of bone collagen. Observational studies have provided some evidence for this in the general population, showing positive associations between dietary vitamin C intake and supplements and higher bone mineral density or reduced fracture risk. However, previous intervention studies were not sufficiently well designed to evaluate these associations. Epidemiological data are particularly limited for vitamin C status and for fracture risk and good-quality randomised controlled trials are needed to confirm previous epidemiological findings. The present review also highlights that associations between vitamin C and bone health may be non-linear and further research is needed to ascertain optimal intakes for osteoporosis and fracture prevention.

Topics: Animals; Ascorbic Acid; Bone and Bones; Diet; Epidemiologic Methods; Fractures, Bone; Humans; Nutritional Status; Osteoporosis

Osteoporosis is a leading cause of morbidity and mortality in the elderly and influences quality of life, as well as life expectancy. Currently, there is a growing interest among the medical scientists in search of specific nutrients and/or bioactive compounds of natural origin for the prevention of disease and maintenance of bone health. Although calcium and vitamin D have been the primary focus of nutritional prevention of osteoporosis, a recent research has clarified the importance of several additional nutrients and food constituents. Based on this review of the literature, supplementation with vitamins B, C, K, and silicon could be recommended for proper maintenance of bone health, although further clinical studies are needed. The results of studies on long-chain polyunsaturated fatty acids, potassium, magnesium, copper, selenium, and strontium are not conclusive, although studies in vitro and in animal models are interesting and promising.

Topics: Amino Acids; Ascorbic Acid; Food; Humans; Minerals; Osteoporosis; Proteins; Vitamin B Complex; Vitamin K

Osteoporosis is a major health disorder associated with an increased risk of fracture. Nutrition is among the modifiable factors that influence the risk of osteoporosis and fracture. Calcium and vitamin D play important roles in improving bone mineral density and reducing the risk of fracture. Other vitamins appear to play a role in bone health as well. In this review, the findings of studies that related the intake and/or the status of vitamins other than vitamin D to bone health in animals and humans are summarized. Studies of vitamin A showed inconsistent results. Excessive, as well as insufficient, levels of retinol intake may be associated with compromised bone health. Deficiencies in vitamin B, along with the consequent elevated homocysteine level, are associated with bone loss, decreased bone strength, and increased risk of fracture. Deficiencies in vitamins C, E, and K are also associated with compromised bone health; this effect may be modified by smoking, estrogen use or hormonal therapy after menopause, calcium intake, and vitamin D. These findings highlight the importance of adequate nutrition in preserving bone mass and reducing the risk of osteoporosis and fractures.

Topics: Animals; Ascorbic Acid; Avitaminosis; Bone and Bones; Female; Fractures, Bone; Humans; Male; Nutritional Status; Osteoporosis; Osteoporosis, Postmenopausal; Vitamin A; Vitamin B Complex; Vitamin E; Vitamin K; Vitamins

Metabolic bone disease (osteodystrophy) is an important complication of patients with chronic liver disease; its etiology is complex and multifactorial. Osteodystrophy is manifested as osteopenia/osteoporosis. Osteoporosis can predispose patients to bone fractures, increasing morbidity and mortality, especially after liver transplantation. Early evaluation, screening, and treatment of bone disorders in patients with liver disease are essential to minimize fracture risk and to improve clinical outcome and quality of life.

Topics: Ascorbic Acid; Bone and Bones; Bone Diseases, Metabolic; Calcium; Chronic Disease; Humans; Liver Diseases; Nutrition Therapy; Osteoporosis; Vitamin D; Vitamin K

Subclinical vitamins deficiency is common in the elderly, especially in osteoporotic patients. However, most physicians in this area are just focused on drugs for the treatment of osteoporosis. It is already established that several vitamins influence bone turnover, bone mineral density, or even the risk of hip fractures. Improving these vitamins status may help to treat and prevent osteoporosis in elderly people. Recently higher vitamin D intake is recognized to be needed to keep not only bone health but also muscle strength. More sun exposure might be needed for improved bone health in the elderly. Deficiency of Vitamin K, C, or B(12) may be also important modifiable risk factors for osteoporosis and bone fracture. Excessive retinal supplementation may become associated with higher bone loss. Thus such diet rich in fruit and vegetables together with fish and meat could fulfill a balance among these vitamins and should be recommended for prevention or treatment of osteoporosis.

Topics: Aged; Ascorbic Acid; Humans; Osteoporosis; Vitamin D; Vitamin K; Vitamins

For early prevention or inhibition of postmenopausal and age-related bone loss, nutritional interventions might be a first choice. For some vitamins and minerals an important role in bone metabolism is known or suggested. Calcium and vitamin D support bone mineral density and are basic components in most preventive strategies. Magnesium is involved in a number of activities supporting bone strength, preservation, and remodeling. Fluorine and strontium have bone-forming effects. However, high amounts of both elements may reduce bone strength. Boron is especially effective in case of vitamin D, magnesium, and potassium deficiency. Vitamin K is essential for the activation of osteocalcin. Vitamin C is an important stimulus for osteoblast-derived proteins. Increasing the recommended amounts (US RDA 1989), adequate intakes (US DRI 1997), or assumed normal intakes of mentioned food components may lead to a considerable reduction or even prevention of bone loss, especially in late postmenopausal women and the elderly.

Topics: Ascorbic Acid; Bone Density; Boron; Calcium; Female; Humans; Magnesium; Middle Aged; Minerals; Osteoporosis; Osteoporosis, Postmenopausal; Strontium; Vitamin D; Vitamin K; Vitamins

This papers summarizes the main role vitamins are believed to play in the prevention of osteoporosis, a common disease which is anticipated to rapidly increase because of the aging of the population. Vitamin D, the classical vitamin related to bone health, improves bone strength mainly by increasing intestinal calcium absorption and reabsorption of calcium by the kidney. Several intervention studies demonstrated in humans that vitamin D can improve bone status as measured by bone density. Vitamin C is considered an essential cofactor of collagen formation. Epidemiological studies report a positive association between vitamin C intake and bone density. Intervention studies on the effect of vitamin C on bone status are missing. Vitamin B6 could function as a cofactor to build up cross-links. In humans, however, there is little evidence to support this. Vitamin K is required for the biological activity of several coagulation factors; the classical function of vitamin K. Recent research also points to a role of vitamin K in bone metabolism. Vitamin K mediates the <--carboxylation of glutamyl residues on several bone proteins, notably osteocalcin. Epidemiological studies and results from first intervention trials are consistently suggesting that vitamin K may improve bone health.

Topics: Adult; Aged; Ascorbic Acid; Humans; Middle Aged; Osteoporosis; Pyridoxine; Vitamin D; Vitamin K; Vitamins

Health authorities are concerned about community exposure to nutritional misinformation. Adequate education of health professionals in nutritional matters has been proposed as an important strategy for counteracting such misinformation. This paper provides an example of how the undergraduate chiropractic curriculum may be used to facilitate the development of a framework which enables discrimination between nutritional sense and nonsense. It also discusses how student awareness of discrepancies between personal belief, nutritional science and clinical practice reality may be enhanced.

Topics: Ascorbic Acid; Calcium; Chiropractic; Curriculum; Health Education; Humans; Naturopathy; Nutritional Requirements; Nutritional Sciences; Osteoporosis; Wound Healing

Vitamins are a group of organic compounds occurring naturally in food and are necessary for good health. Lack of a vitamin may lead to a specific deficiency syndrome, which may be primary (due to inadequate diet) or secondary (due to malabsorption or to increased metabolic need), and it is rational to use high-dose vitamin supplementation in situations where these clinical conditions exist. However, pharmacological doses of vitamins are claimed to be of value in a wide variety of conditions which have no, or only a superficial, resemblance to the classic vitamin deficiency syndromes. The enormous literature on which these claims are based consists mainly of uncontrolled clinical trials or anecdotal reports. Only a few studies have made use of the techniques of randomisation and double-blinding. Evidence from such studies reveals a beneficial therapeutic effect of vitamin E in intermittent claudication and fibrocystic breast disease and of vitamin C in pressure sores, but the use of vitamin A in acne vulgaris, vitamin E in angina pectoris, hyperlipidaemia and enhancement of athletic capacity, of vitamin C in advanced cancer, and niacin in schizophrenia has been rejected. Evidence is conflicting or inconclusive as to the use of vitamin C in the common cold, asthma and enhancement of athletic capacity, of pantothenic acid in osteoarthritis, and folic acid (folacin) in neural tube defects. Most of the vitamins have been reported to cause adverse effects when ingested in excessive doses. It is therefore worthwhile to consider the risk-benefit ratio before embarking upon the use of high-dose vitamin supplementation for disorders were proof of efficacy is lacking.

Topics: Acne Vulgaris; Ascorbic Acid; Asthma; Cardiovascular Diseases; Common Cold; Fibrocystic Breast Disease; Humans; Neoplasms; Osteoporosis; Vitamin A; Vitamin B Complex; Vitamin D; Vitamin E; Vitamin K; Vitamins

Topics: Adolescent; Adult; Aged; Ascorbic Acid; Calcium; Child; Child, Preschool; Dietary Proteins; Energy Intake; Female; Humans; Infant; Infant, Newborn; Iron; Male; Middle Aged; Nutritional Physiological Phenomena; Nutritional Requirements; Osteoporosis; Pregnancy; Trace Elements; Vitamin D

Topics: Adolescent; Aging; Animals; Ascorbic Acid; Bone Development; Calcitonin; Calcium; Collagen; Diphosphates; Female; Glucocorticoids; Gonadal Steroid Hormones; Growth Hormone; Hormones; Humans; Insulin; Osteogenesis; Osteoporosis; Parathyroid Hormone; Phosphates; Potassium; Pregnancy; Rats; Thyroxine; Triiodothyronine; Vitamin A; Vitamin D

Topics: Adult; Age Factors; Aged; Aging; Ascorbic Acid; Bone and Bones; Calcium; Diet; Dietary Carbohydrates; Dietary Fats; Dietary Proteins; Female; Humans; Iron; Male; Middle Aged; Nutritional Physiological Phenomena; Nutritional Requirements; Osteoporosis; Radiography; Sex Factors; Vitamin D

Topics: Age Factors; Aged; Ascorbic Acid; Black People; Bone and Bones; Bone Regeneration; Bone Resorption; Calcium; Calcium Isotopes; Carbon Isotopes; Female; Fluorides; Glucocorticoids; Humans; Hydroxyproline; Insulin; Male; Middle Aged; Osteoporosis; Parathyroid Hormone; Sex Factors; Skin; Thyroid Hormones

Topics: Adrenal Glands; Ascorbic Acid; Breast Neoplasms; Calciphylaxis; Calcium; Growth Hormone; Humans; Osteogenesis; Osteomalacia; Osteoporosis; Parathyroid Glands; Phosphates; Retinoids; Vitamin A; Vitamin D; Vitamin E; Vitamin K; Vitamins

To determine the effect of ascorbic acid and alpha-tocopherol on oxidative stress and bone mineral density (BMD) in elderly people.. A double-blind, controlled clinical assay was carried out in a sample of 90 elderly subjects divided into three age-paired random groups with 30 subjects in each group. Group Tx0 received placebo, group Tx1 received 500 mg of ascorbic acid and 400 IU of alpha-tocopherol, whereas group Tx2 received 1,000 mg of ascorbic acid and 400 IU of alpha-tocopherol, for a 12-month period.. We measured thiobarbituric acid reactive substances (TBARS), total antioxidant status (TAS), superoxide dismutase (SOD), and glutation peroxidase (GPx); BMD was obtained on DXA of hip and spine before and after the 12-month treatment period with supplementation of vitamins C and E.. We found a positive correlation between hip-BMD and SOD (r = 0.298, p < 0.05) and GPx (r = 0.214, p < 0.05). Also, a significantly lower decrease of LPO (p < 0.05) was observed as linked with hip bone loss in the Tx2 group than in the Tx0 group.. Our findings suggest that that administration of 1,000 mg of ascorbic acid together with 400 IU of alpha-tocopherol could be useful in preventing or aiding in the treatment of age-related osteoporosis.

Topics: Aged; alpha-Tocopherol; Antioxidants; Ascorbic Acid; Bone Density; Dietary Supplements; Double-Blind Method; Female; Glutathione Peroxidase; Humans; Male; Osteoporosis; Oxidative Stress; Superoxide Dismutase; Thiobarbituric Acid Reactive Substances

The effect of active absorbable algal calcium (AAA Ca) with collagen and other matrix components on aging-associated skin changes and backache and joint pain was tested in a case-controlled study of 40 test subjects and 40 age-matched control subjects (mean age, 65 years) complaining of backache and knee joint pain due to osteoarthritis, spondylosis deformans, and/or osteoporosis. Supplementation with 900 mg calcium (given as AAA Ca) and 3.5 g collagen and other matrix components, including glucosamine, daily for 4 months resulted in a marked alleviation of subjective pain, assessed by the face scale. A fall of skin impedance in response to exercise loads, such as standing up, walking, squatting, and climbing up and down stairs, reported as an objective manifestion of pain, was also alleviated. The basal skin impedance, which increases with age, was significantly reduced in response to the Ca-collagen-matrix supplementation, suggesting a change of skin properties similar to rejuvenation, along with subjective smoothening and moistening of the skin. Urinary excretion of N-terminal crosslinking telopeptide of type I collagen (NTx) was decreased in the Ca-collagen-matrix supplementation group, but not in the control group. In addition to calcium suppression of parathyroid hormone, preventing bone resorption, collagen, acting on the intestinal lymphatic system, may protect collagen from degradation through the inhibition of cytokine-induced release of metalloproteinases, including collagenase.

Topics: Absorption; Aged; Ascorbic Acid; Bone Density; Calcium; Case-Control Studies; Collagen; Collagen Type I; Electric Impedance; Extracellular Matrix; Female; Glucosamine; Glycosaminoglycans; Humans; Joint Diseases; Knee Joint; Male; Middle Aged; Osteoarthritis; Osteoporosis; Pain; Peptides; Skin Physiological Phenomena

Ascorbic acid is a required cofactor in the hydroxylations of lysine and proline necessary for collagen formation; its role in bone cell differentiation and formation is less well characterized. This study examines the cross-sectional relation between dietary vitamin C intake and bone mineral density (BMD) in women from the Postmenopausal Estrogen/Progestin Interventions Trial. BMD (spine and hip) was measured using dual energy X-ray absorptiometry (DXA). The PEPI participants (n = 775) included in this analysis were Caucasian and ranged in age from 45 to 64 years. At the femoral neck and total hip after adjustment for age, BMI, estrogen use, smoking, leisure physical activity, calcium and total energy intake, each 100 mg increment in dietary vitamin C intake, was associated with a 0. 017 g/cm2 increment in BMD (P = 0.002 femoral neck; P = 0.005 total hip). After adjustment, the association of vitamin C with lumbar spine BMD was similar to that at the hip, but was not statistically significant (P = 0.08). To assess for effect modification by dietary calcium, the analyses were repeated, stratified by calcium intake (>500 mg/day and

Topics: Ascorbic Acid; Body Mass Index; Bone Density; Cross-Sectional Studies; Double-Blind Method; Estrogens, Conjugated (USP); Female; Femur Neck; Humans; Linear Models; Middle Aged; Osteoporosis; Pelvic Bones; Postmenopause; Progestins

The population showed eating habits that do not meet the intake levels recommended by the L.A.R.N. Regarding the relationship between nutrient intake and plaque index, it appears that in the population, the higher the intake of vitamin C through food, the lower the plaque index value is. This result could reinforce the scientific evidence that there is a protective factor in the onset of periodontal disease by the consumption of vitamin C which to date is still the subject of investigation. In addition, the same type of trend would also have been observed for calcium intake, but a larger sample size would be required to make this effect significant.. The relationship between osteoporosis and periodontitis and the role of nutrition in influencing the evolution of these pathologies still seems to be deeply explored. However, the results obtained seem to consolidate the idea that there is a relationship between these two diseases and that eating habits play an important role in their prevention.

Topics: Ascorbic Acid; Bone Density; Calcium; Cross-Sectional Studies; Eating; Humans; Osteoporosis; Periodontal Diseases; Vitamins

Osteoporosis is a skeletal disease characterized by low bone mass, reduced bone strength, and increased fracture risk. We aimed to investigate the association between combined dietary antioxidant intake and the likelihood of osteoporosis in premenopausal and postmenopausal women, based on data from the National Health and Nutrition Examination Survey.. Nutrient intake data were obtained using two 24-hour recalls. Composite dietary antioxidant index (CDAI), which refers to the intake amounts of β-carotene, vitamin A, vitamin C, vitamin E, selenium, zinc, copper, and iron, was then constructed. Prevalent osteoporosis was defined according to bone mineral density T scores of ≤ -2.5 and self-reports. Multiple logistic and Poisson regression models were used for association analyses.. A total of 3,418 participants (1,157 premenopausal and 2,261 postmenopausal women) 40 years or older were included, 776 (22.70%) of whom had prevalent osteoporosis. In terms of individual nutrients, postmenopausal women in the highest CDAI quartiles for dietary β-carotene, vitamin A, vitamin C, and iron intakes had a low likelihood of osteoporosis. Regarding the CDAI-osteoporosis association, postmenopausal women in the highest quartile were less likely to have osteoporosis (OR Q3 vs Q1 , 0.64; 95% CI, 0.43-0.96; OR Q4 vs Q1 , 0.56; 95% CI, 0.35-0.89; P for trend = 0.013), after controlling for covariates.. CDAI was negatively associated with the likelihood of osteoporosis in postmenopausal women. Our findings suggest that the combined intake of antioxidant nutrients can help reduce the likelihood of osteoporosis in women.

Topics: Antioxidants; Ascorbic Acid; beta Carotene; Bone Density; Diet; Eating; Female; Humans; Iron; Nutrition Surveys; Osteoporosis; Osteoporosis, Postmenopausal; Postmenopause; United States; Vitamin A; Vitamins

Population studies have shown a trend in decreasing vitamin C status and increasing prevalence of osteoporosis in patients with diabetes and non-diabetic people. Dietary vitamin C consumption is linked to improvement in bone mineral density (BMD) in epidemiological studies. VCAM-1 and adiponectin are known to activate osteoclasts, which increase bone loss.. This study examined whether there is any association between the circulating level of vitamin C and BMD and whether the beneficial effect of vitamin C on BMD was linked to a simultaneous decrease in circulating levels of adiponectin and VCAM-1 in subjects with diabetes.. Patients with diabetes (T2D,. Patients with diabetes had lower levels of vitamin C and higher levels of VCAM-1 and inflammatory cytokines. There was a significant positive association between vitamin C blood levels and lumbar spine BMD as well as a significant negative association between total adiponectin and VCAM-1 levels with that of vitamin C and lumbar BMD in patients with diabetes. Total adiponectin and VCAM-1 also showed a negative association with BMD of both the right and left femurs. The inter-relationship among the circulating levels of vitamin C and VCAM-1 and BMD was strong and is a novel finding.. This study reports a positive association of circulating vitamin C levels and the BMD and that the beneficial effects of vitamin C on BMD could be linked to a simultaneous lowering in circulating VCAM-1 and total adiponectin levels. Thus, dietary vitamin C consumption has potential to lower inflammation and the risk of osteoporosis in subjects with diabetes.

Topics: Absorptiometry, Photon; Adiponectin; Ascorbic Acid; Biomarkers; Bone Density; Cytokines; Diabetes Mellitus; Humans; Inflammation; Lumbar Vertebrae; Osteoporosis; Vascular Cell Adhesion Molecule-1; Vitamins

Coatomer complexes function in the sorting and trafficking of proteins between subcellular organelles. Pathogenic variants in coatomer subunits or associated factors have been reported in multi-systemic disorders, i.e., coatopathies, that can affect the skeletal and central nervous systems. We have identified loss-of-function variants in COPB2, a component of the coatomer complex I (COPI), in individuals presenting with osteoporosis, fractures, and developmental delay of variable severity. Electron microscopy of COPB2-deficient subjects' fibroblasts showed dilated endoplasmic reticulum (ER) with granular material, prominent rough ER, and vacuoles, consistent with an intracellular trafficking defect. We studied the effect of COPB2 deficiency on collagen trafficking because of the critical role of collagen secretion in bone biology. COPB2 siRNA-treated fibroblasts showed delayed collagen secretion with retention of type I collagen in the ER and Golgi and altered distribution of Golgi markers. copb2-null zebrafish embryos showed retention of type II collagen, disorganization of the ER and Golgi, and early larval lethality. Copb2

Topics: Animals; Ascorbic Acid; Bone and Bones; Brain; Child; Child, Preschool; Coat Protein Complex I; Coatomer Protein; Collagen Type I; Developmental Disabilities; Embryo, Nonmammalian; Endoplasmic Reticulum; Female; Fibroblasts; Gene Expression Regulation, Developmental; Golgi Apparatus; Haploinsufficiency; Humans; Intellectual Disability; Male; Mice; Osteoporosis; RNA, Small Interfering; Severity of Illness Index; Zebrafish

This study evaluated the effects of vitamin C on osteogenic differentiation and osteoclast formation, and the effects of vitamin C concentration on bone microstructure in ovariectomized (OVX) Wistar rats. Micro-computed tomography analysis revealed the recovery of bone mineral density and bone separation in OVX rats treated with vitamin C. Histomorphometrical analysis revealed improvements in the number of osteoblasts, osteoclasts, and osteocytes; the osteoblast and osteoclast surface per bone surface; and bone volume in vitamin C-treated OVX rats. The vitamin C-treated group additionally displayed an increase in the expression of osteoblast differentiation genes, including bone morphogenetic protein-2, small mothers against decapentaplegic 1/5/8, runt-related transcription factor 2, osteocalcin, and type I collagen. Vitamin C reduced the expression of osteoclast differentiation genes, such as receptor activator of nuclear factor kappa-B, receptor activator of nuclear factor kappa-B ligand, tartrate-resistant acid phosphatase, and cathepsin K. This study is the first to show that vitamin C can inhibit osteoporosis by promoting osteoblast formation and blocking osteoclastogenesis through the activation of wingless-type MMTV integration site family/β-catenin/activating transcription factor 4 signaling, which is achieved through the serine/threonine kinase and mitogen-activated protein kinase signaling pathways. Therefore, our results suggest that vitamin C improves bone regeneration.

Topics: Activating Transcription Factor 4; Animal Feed; Animals; Ascorbic Acid; beta Catenin; Bone Density; Diet; Female; Gene Expression Regulation; Osteoblasts; Osteoclasts; Osteoporosis; Ovariectomy; Rats; Rats, Sprague-Dawley; Signal Transduction; Wnt Proteins

Senescence marker protein-30 (SMP30) decreases androgen-independently with aging and is a lactone-hydrolyzing enzyme gluconolactonase (GNL) that is involved in vitamin C biosynthesis. In the present study, bone properties of SMP30/GNL knockout (KO) mice with deficiency in vitamin C synthesis were investigated to reveal the effects of SMP30/GNL and exogenous vitamin C supplementation on bone formation. Mineral content (BMC) and mineral density (BMD) of the mandible and femur of SMP30/GNL KO and wild-type mice at 2 and 3 months of age with or without vitamin C supplementation were measured by dual-energy X-ray absorptiometry. Body and bone weight of both age groups decreased and became significantly lower than those of wild-type mice. The bones of SMP30/GNL KO mice were rough and porous, with BMC and BMD significantly below wild-type. Oral supplementation with vitamin C eliminated differences in body weight, bone weight, BMC, and BMD between SMP30/GNL KO and wild-type mice at each age. These results indicate that bone degeneration in SMP30/GNL KO mice was caused by lack of vitamin C, and that this mouse strain is an appropriate model for bone metabolism in humans, which have no ability to synthesize vitamin C.

Topics: Absorptiometry, Photon; Aging; Animals; Ascorbic Acid; Ascorbic Acid Deficiency; Body Weight; Bone Density; Bone Diseases, Metabolic; Calcium-Binding Proteins; Carboxylic Ester Hydrolases; Dietary Supplements; Disease Models, Animal; Female; Femur; Intracellular Signaling Peptides and Proteins; Male; Mandible; Mice, Inbred C57BL; Mice, Knockout; Osteoporosis

The AKR1A1 protein is a member of the aldo-keto reductase superfamily that is responsible for the conversion of D-glucuronate to L-gulonate in the ascorbic acid (vitamin C) synthesis pathway. In a pCAG-eGFP transgenic mouse line that was produced by pronuclear microinjection, the integration of the transgene resulted in a 30-kb genomic DNA deletion, including the Akr1A1 gene, and thus caused the knockout (KO) of the Akr1A1 gene and targeting of the eGFP gene. The Akr1A1 KO mice (Akr1A1eGFP/eGFP) exhibited insufficient serum ascorbic acid levels, abnormal bone development and osteoporosis. Using micro-CT analysis, the results showed that the microarchitecture of the 12-week-old Akr1A1eGFP/eGFP mouse femur was shorter in length and exhibited less cortical bone thickness, enlargement of the bone marrow cavity and a complete loss of the trabecular bone in the distal femur. The femoral head and neck of the proximal femur also showed a severe loss of bone mass. Based on the decreased levels of serum osteocalcin and osteoblast activity in the Akr1A1eGFP/eGFP mice, the osteoporosis might be caused by impaired bone formation. In addition, administration of ascorbic acid to the Akr1A1eGFP/eGFP mice significantly prevented the condition of osteoporotic femurs and increased bone formation. Therefore, through ascorbic acid administration, the Akr1A1 KO mice exhibited controllable osteoporosis and may serve as a novel model for osteoporotic research.

Topics: Aldehyde Reductase; Animals; Ascorbic Acid; Ascorbic Acid Deficiency; Disease Models, Animal; Female; Femur; Gene Knockout Techniques; Genetic Predisposition to Disease; Mice, Knockout; Osteoblasts; Osteocalcin; Osteogenesis; Osteoporosis; Phenotype; Time Factors; X-Ray Microtomography

Topics: Absorptiometry, Photon; Ascorbic Acid; Bone Density Conservation Agents; Calcium, Dietary; Denosumab; Female; Humans; Life Style; Magnesium; Male; Osteoporosis; Phosphorus; Phytoestrogens; Risk Factors; Teriparatide; Vitamin A; Vitamin D; Vitamin K

Bone loss has been established as a major extra-intestinal complication of short bowel syndrome (SBS). The purpose of this study was to correlate bone mineral density (BMD) with body mass index (BMI), serum vitamin and mineral levels in patients with SBS.. The study was conducted on 13 patients (8 male and 5 female, 54.7 ± 11.4 years) with SBS (residual small bowel length of 10 to 100 cm). We determined the food ingestion, anthropometry, serum levels of vitamins C, A, D, E and K, as well as serum and urinary levels of phosphorus and calcium. BMD was measured by dual-energy x-ray absorptiometry (DXA).. Osteopenia and osteoporosis was diagnosed in all but one SBS patient. Serum levels of vitamin D were low in all volunteers. Sixty-one percent of patients had vitamin E deficiency; hypovitaminosis A and C occurred in one subject. BMI and C, E and K vitamin serum levels correlated with T-score of BMD.. Osteopenia and osteoporosis were common in SBS patients. There was a correlation between BMD and the serum levels of vitamins C, E and K, an indicative that such vitamins may influence bone health.

Topics: Absorptiometry, Photon; Adult; Aged; Ascorbic Acid; Avitaminosis; Body Mass Index; Bone Density; Bone Diseases, Metabolic; Calcium; Cross-Sectional Studies; Energy Intake; Female; Hospitalization; Humans; Male; Middle Aged; Osteoporosis; Phosphorus; Reference Values; Short Bowel Syndrome; Time Factors; Vitamin E; Vitamin K

Vitamin C sufficiency may help prevent osteoporosis and fractures by mediating osteoclastogenesis, osteoblastogenesis, and bone collagen synthesis.. We determined whether dietary intakes and plasma concentrations of vitamin C were associated with a heel ultrasound and hip and spine fracture risks in older men and women.. Participants were recruited from the European Prospective Investigation into Cancer in Norfolk study with 7-d diet diary estimates of vitamin C intake and plasma concentrations. A random subset (4000 of 25,639 subjects) was available for the cross-sectional (ultrasound) study of broadband ultrasound attenuation (BUA) and velocity of sound (VOS), which were determined during the second health examination. The prospective (fracture) study was a case-cohort sample of all participants with a fracture up to March 2009 and the random subset (n = 5319). ANCOVA-determined associations between quintiles of vitamin C intake and plasma status with adjusted BUA and VOS and adjusted Prentice-weighted Cox proportional HRs were calculated for fracture risk.. Women were 58% of the population (39-79 y old), and the median follow-up was 12.6 y (range: 0-16 y). Positive associations across all quintiles of vitamin C intake but not plasma status were significant for VOS in men (β = 2.47 m/s, P = 0.008) and BUA in women (β = 0.82 dB/MHz, P = 0.004). Vitamin C intake was not associated with fracture risk, but there was an inverse association with plasma concentrations in men, with quintile 4 having significantly lower risks of hip fractures (HR: 0.35; 95% CI: 0.16, 0.80) and spine fractures (HR: 0.26; 95% CI: 0.10, 0.69) than quintile 1.. Higher vitamin C intake was significantly associated with higher heel ultrasound measures in men and women, and higher plasma vitamin C concentrations were significantly associated with reduced fracture risk in men only. Our findings that vitamin C intake and status were inconsistently associated with bone health variables suggest that additional research is warranted.

Topics: Adult; Aged; Ascorbic Acid; Ascorbic Acid Deficiency; Bone Density; Case-Control Studies; Cohort Studies; Cross-Sectional Studies; Diet; Diet Records; England; Female; Hip Fractures; Humans; Longitudinal Studies; Male; Middle Aged; Nutritional Status; Osteoporosis; Osteoporotic Fractures; Proportional Hazards Models; Prospective Studies; Risk Factors; Spinal Fractures

The role of oxidative stress in skeletal health is unclear. The present study investigated whether a high dietary intake of antioxidant nutrients (vitamins C and E, β-carotene, animal-derived vitamin A, retinol equivalents, Zn and Se) is associated with a reduced risk of hip fracture in elderly Chinese. This 1:1 matched case-control study involved 726 elderly Chinese with hip fracture and 726 control subjects, recruited between June 2009 and May 2013. Face-to-face interviews were conducted to determine habitual dietary intakes of the above-mentioned seven nutrients based on a seventy-nine-item FFQ and information on various covariates, and an antioxidant score was calculated. After adjustment for potential covariates, dose-dependent inverse associations were observed between the dietary intake of vitamin C, vitamin E, β-carotene, and Se and antioxidant score and the risk of hip fracture (P for trend ≤ 0·005). The OR of hip fracture for the highest (v. lowest) quartile of intake were 0·39 (95 % CI 0·28, 0·56) for vitamin C, 0·23 (95 % CI 0·16, 0·33) for vitamin E, 0·51 (95 % CI 0·36, 0·73) for β-carotene, 0·43 (95 % CI 0·26, 0·70) for Se and 0·24 (95 % CI 0·17, 0·36) for the antioxidant score. A moderate-to-high dietary intake of retinol equivalents in quartiles 2-4 (v. 1) was found to be associated with a lower risk of hip fracture (OR range: 0·51-0·63, P< 0·05). No significant association was observed between dietary Zn or animal-derived vitamin A intake and hip fracture risk (P for trend >0·20). In conclusion, a higher dietary intake of vitamins C and E, β-carotene, and Se and a moderate-to-high dietary intake of retinol equivalents are associated with a lower risk of hip fracture in elderly Chinese.

Topics: Aged; Antioxidants; Ascorbic Acid; Asian People; beta Carotene; Case-Control Studies; China; Female; Hip Fractures; Humans; Middle Aged; Odds Ratio; Osteoporosis; Oxidative Stress; Risk; Risk Factors; Selenium; Trace Elements; Vitamin A; Vitamin E; Vitamins; Zinc

Epidemiologic studies correlate low vitamin C intake with bone loss. The genetic deletion of enzymes involved in de novo vitamin C synthesis in mice, likewise, causes severe osteoporosis. However, very few studies have evaluated a protective role of this dietary supplement on the skeleton. Here, we show that the ingestion of vitamin C prevents the low-turnover bone loss following ovariectomy in mice. We show that this prevention in areal bone mineral density and micro-CT parameters results from the stimulation of bone formation, demonstrable in vivo by histomorphometry, bone marker measurements, and quantitative PCR. Notably, the reductions in the bone formation rate, plasma osteocalcin levels, and ex vivo osteoblast gene expression 8 weeks post-ovariectomy are all returned to levels of sham-operated controls. The study establishes vitamin C as a skeletal anabolic agent.

Topics: Animals; Ascorbic Acid; Bone Density; Female; Mice; Mice, Inbred C57BL; Osteoporosis; Ovariectomy; Radiography

Our recent animal and human studies revealed that chronic hyponatremia is a previously unrecognized cause of osteoporosis that is associated with increased osteoclast numbers in a rat model of the human disease of the syndrome of inappropriate antidiuretic hormone secretion (SIADH). We used cellular and molecular approaches to demonstrate that sustained low extracellular sodium ion concentrations ([Na(+)]) directly stimulate osteoclastogenesis and resorptive activity and to explore the mechanisms underlying this effect. Assays on murine preosteoclastic RAW 264.7 cells and on primary bone marrow monocytes both indicated that lowering the medium [Na(+)] dose-dependently increased osteoclast formation and resorptive activity. Low [Na(+)], rather than low osmolality, triggered these effects. Chronic reduction of [Na(+)] dose-dependently decreased intracellular calcium without depleting endoplasmic reticulum calcium stores. Moreover, we found that reduction of [Na(+)] dose-dependently decreased cellular uptake of radiolabeled ascorbic acid, and reduction of ascorbic acid in the culture medium mimicked the osteoclastogenic effect of low [Na(+)]. We also detected downstream effects of reduced ascorbic acid uptake, namely evidence of hyponatremia-induced oxidative stress. This was manifested by increased intracellular free oxygen radical accumulation and proportional changes in protein expression and phosphorylation, as indicated by Western blot analysis from cellular extracts and by increased serum 8-hydroxy-2'-deoxyguanosine levels in vivo in rats. Our results therefore reveal novel sodium signaling mechanisms in osteoclasts that may serve to mobilize sodium from bone stores during prolonged hyponatremia, thereby leading to a resorptive osteoporosis in patients with SIADH.

Topics: 8-Hydroxy-2'-Deoxyguanosine; Animals; Ascorbic Acid; Calcium; Cell Line; Deoxyguanosine; Endoplasmic Reticulum; Humans; Hyponatremia; Inappropriate ADH Syndrome; Mice; Osmosis; Osteoclasts; Osteoporosis; Oxidative Stress; Rats; Rats, Sprague-Dawley; Sodium

Antioxidant nutrient intake and the lesser formation of free radicals seem to contribute to chronic diseases. The aim of the present study was to evaluate the intake profile of the main dietary antioxidants in a representative sample of the adult Brazilian population and discuss the main consequences of a low intake of these micronutrients on overall health.. The sample comprised 2344 individuals aged 40 years or older from 150 cities and was based on a probabilistic sample from official data. The research was conducted through in-home interviews administered by a team trained for this purpose. Dietary intake information was obtained through 24-h recall. The Nutrition Data System for Research software program was used to analyze data on the intake of vitamins A, C and E, selenium and zinc, which was compared to Dietary Reference Intakes (DRIs). Differences in intake according to sex, anthropometrics, socioeconomic status and region were also evaluated. The SPSS statistical package (version 13) was used for the statistical analysis. P-values < 0.05 were considered significant.. Higher proportions of low intake in relation to recommended values were found for vitamin E (99.7%), vitamin A (92.4%) and vitamin C (85.1%) in both genders. Intake variations were found between different regions, which may reflect cultural habits.. These results should lead to the development of public health policies that encourage educational strategies for improving the intake of micronutrients, which are essential to overall health and prevention of non-communicable diseases.

Topics: Adult; Aged; Antioxidants; Ascorbic Acid; Brazil; Cross-Sectional Studies; Energy Intake; Feeding Behavior; Female; Humans; Interviews as Topic; Male; Middle Aged; Osteoporosis; Selenium; Surveys and Questionnaires; Vitamin A; Vitamin E; Vitamins; Zinc

The aging process correlates with the accumulation of cellular and tissue damage caused by oxidative stress. Although previous studies have suggested that oxidative stress plays a pathologic role in the development of bone fragility, little direct evidence has been found. In order to investigate the pathologic significance of oxidative stress in bones, we analyzed the bone tissue of mice deficient in cytoplasmic copper/zinc superoxide dismutase (CuZn-SOD, encoded by the Sod1 gene; Sod1(-/-)). In this study, we showed for the first time that in vivo cytoplasmic superoxide caused a distinct weakness in bone stiffness and decreased BMD, aging-like changes in collagen cross-linking, and transcriptional alterations in the genes associated with osteogenesis. We also showed that the surface areas of osteoblasts and osteoclasts were decreased significantly in the lumbar vertebrae of Sod1(-/-) mice, indicating the occurrence of low-turnover osteopenia. In vitro experiments demonstrated that intracellular oxidative stress induced cell death and reduced the proliferation in primary osteoblasts but not in osteoclasts, indicating that impaired osteoblast viability caused the decrease in osteoblast number and suppressed RANKL/M-CSF osteoclastogenic signaling in bone. Furthermore, treatment with an antioxidant, vitamin C, effectively improved bone fragility and osteoblastic survival. These results imply that intracellular redox imbalance caused by SOD1 deficiency plays a pivotal role in the development and progression of bone fragility both in vivo and in vitro. We herein present a valuable model for investigating the effects of oxidative stress on bone fragility in order to develop suitable therapeutic interventions.

Topics: Aging; Animals; Ascorbic Acid; Bone and Bones; Bone Resorption; Cell Count; Cell Survival; Collagen; Cross-Linking Reagents; Cytoplasm; Macrophage Colony-Stimulating Factor; Mice; Organ Size; Osteoblasts; Osteoclasts; Osteogenesis; Osteoporosis; Oxidation-Reduction; Phenotype; RANK Ligand; Signal Transduction; Superoxide Dismutase; Superoxides

The aim of this study was to evaluate the possible variations in antioxidant enzymes, lipid peroxidation and erythrocyte deformability in experimentally induced osteoporosis in female rats and to assess the effects of vitamin C supplementation on those variations.. A total of 20 female Wistar Albino Rats were randomized into the three groups as controls (Group C, n = 6), ovariectomized rats (Group O, n = 7) and ovariectomized rats receiving vitamin C supplementation (Group OVC, n = 7). After the surgical procedure of ovariectomy, group OVC received 1 g ascorbic acid in 500 mL water daily. After 100 days following the ovariectomy, bone mineral density (BMD) was measured by using dual-energy X-ray absorptiometry.. BMD was significantly lower in the group O than in the group C (p = 0.015), whereas it was significantly higher in the group OVC than in the group O (p = 0.003). MDA activity was significantly higher in the group O than in the group C (p = 0.032), whereas it was significantly lower in the group OVC than in the group O (p = 0.025). SOD activity was significantly higher in the group O than in the group C (p = 0.032). Erythrocyte deformability was significantly higher in the group O than in the group C and OVC (p = 0.008, p = 0.021, respectively).. Erythrocyte deformability may show negative variations, suggesting a causative role in disruption of blood flow and tissue perfusion, which also negatively affect bone metabolism. Vitamin C supplementation seems to reverse those negative effects of variations in erythrocyte deformability. However, our preliminary results should be confirmed in more experimental studies and clinical trials (Tab. 3, Ref. 28).

Topics: Animals; Antioxidants; Ascorbic Acid; Bone Density; Erythrocyte Deformability; Female; Lipid Peroxidation; Osteoporosis; Ovariectomy; Rats; Rats, Wistar

Complex regional pain syndrome (CRPS) is the complication of some injuries, such as a fracture, which affects the distal end of the injured extremity characterized by pain, allodynia, hyperalgesia, edema, abnormal vasomotor and sudomotor activity, movement disorders, joint stiffness, regional osteoporosis, and dystrophic changes in soft tissue. Exact pathogenic mechanism of CRPS is still unclear. Suggested pathogenic mechanisms of CRPS are evaluated in four major groups consist of classic inflammation, hypoxic changes and chronic ischemia, neurogenic inflammation and sympathetic dysregulation. All of these suggested pathogenic mechanisms produced by inflammatory cytokines mediated by nuclear factor kappaB. Vitamin K is a family of structurally similar, fat-soluble, 2-methyl-1,4-naphthoquinones. Vitamin K exerts a powerful influence on bone formation, especially in osteoporosis. Fat in bone stores some vitamin K. Gamma-carboxylation of the glutamic acid in osteocalcin is vitamin K dependent. Osteocalcin plays a role in calcium uptake and bone mineralization. Osteocalcin, the most abundant non-collagenous protein in bone, is produced by osteoblasts during bone matrix formation. Because osteocalcin is not carboxylated in case of vitamin K deficiency at the distal site of fracture or injury, it cannot bind to hydroxyapatite causing osteoporosis. Fracture starts a local inflammatory process in the fracture site and adjacent tissues as seen in CRPS. Vitamin K was shown to suppress the inflammatory cytokines and NF-kappaB and prevent oxidative, hypoxic, ischemic injury (which have key role in both initiation and progression of CRPS) to oligodendrocytes and neurons. We hypothesized that vitamin K has a key role and modulatory effect in CRPS pathogenesis. Vitamin K deficiency at the distal site of fracture occurs because of diminished and slowed circulation, local immobilization after extremity fracture or injury and use of vitamin K store at the distal site of the injured extremity and in the circulation for fracture healing and bone remodelling. In case of vitamin K deficiency at the distal site of fracture, classic inflammation starts with fracture at the distal tissues could not be restricted and classic inflammation, hypoxic changes, chronic ischemia, neurogenic inflammation, sympathetic dysregulation, which are the pathogenic mechanisms of CRPS, and patchy osteoporosis which occur due to high level of under-carboxylated osteocalcin could not be prevented. Br

Topics: Ascorbic Acid; Blood Coagulation; Complex Regional Pain Syndromes; Cytokines; Fracture Healing; Fractures, Bone; Humans; Intestinal Absorption; NF-kappa B; Osteocalcin; Osteogenesis; Osteoporosis; Vitamin K

Using mouse gene knock-out models, we identify aldehyde reductase (EC 1.1.1.2, Akr1a4 (GR)) and aldose reductase (EC 1.1.1.21, Akr1b3 (AR)) as the enzymes responsible for conversion of D-glucuronate to L-gulonate, a key step in the ascorbate (ASC) synthesis pathway in mice. The gene knock-out (KO) mice show that the two enzymes, GR and AR, provide approximately 85 and approximately 15% of L-gulonate, respectively. GRKO/ARKO double knock-out mice are unable to synthesize ASC (>95% ASC deficit) and develop scurvy. The GRKO mice ( approximately 85% ASC deficit) develop and grow normally when fed regular mouse chow (ASC content = 0) but suffer severe osteopenia and spontaneous fractures with stresses that increase ASC requirements, such as pregnancy or castration. Castration greatly increases osteoclast numbers and activity in GRKO mice and promotes increased bone loss as compared with wild-type controls and additionally induces proliferation of immature dysplastic osteoblasts likely because of an ASC-sensitive block(s) in early differentiation. ASC and the antioxidants pycnogenol and resveratrol block osteoclast proliferation and bone loss, but only ASC feeding restores osteoblast differentiation and prevents their dysplastic proliferation. This is the first in vivo demonstration of two independent roles for ASC as an antioxidant suppressing osteoclast activity and number as well as a cofactor promoting osteoblast differentiation. Although humans have lost the ability to synthesize ASC, our mouse models suggest the mechanisms by which suboptimal ASC availability facilitates the development of osteoporosis, which has important implications for human osteoporosis.

Topics: Animals; Antioxidants; Ascorbic Acid; Bone and Bones; Cell Proliferation; Flavonoids; Homeostasis; Male; Mice; Mice, Inbred C57BL; Mice, Knockout; Mice, Transgenic; Models, Biological; Osteoblasts; Osteoporosis; Plant Extracts; Resveratrol; Stilbenes

Vitamin C may play a role in bone health. In the Framingham Study, subjects with higher total or supplemental vitamin C intake had fewer hip fractures and non-vertebral fractures as compared to subjects with lower intakes. Therefore, vitamin C may have a protective effect on bone health in older adults.. Dietary antioxidants such as vitamin C may play a role in bone health. We evaluated associations of vitamin C intake (total, dietary, and supplemental) with incident hip fracture and non-vertebral osteoporotic fracture, over a 15- to 17-year follow-up, in the Framingham Osteoporosis Study.. Three hundred and sixty-six men and 592 women (mean age 75 +/- 5 years) completed a food frequency questionnaire (FFQ) in 1988-1989 and were followed for non-vertebral fracture until 2003 and hip fracture until 2005. Tertiles of vitamin C intake were created from estimates obtained using the Willett FFQ, after adjusting for total energy (residual method). Hazard ratios were estimated using Cox-proportional hazards regression, adjusting for covariates.. Over follow-up 100 hip fractures occurred. Subjects in the highest tertile of total vitamin C intake had significantly fewer hip fractures (P trend = 0.04) and non-vertebral fractures (P trend = 0.05) compared to subjects in the lowest tertile of intake. Subjects in the highest category of supplemental vitamin C intake had significantly fewer hip fractures (P trend = 0.02) and non-vertebral fractures (P trend = 0.07) compared to non-supplement users. Dietary vitamin C intake was not associated with fracture risk (all P > 0.22).. These results suggest a possible protective effect of vitamin C on bone health in older adults.

Topics: Aged; Aged, 80 and over; Ascorbic Acid; Bone Density; Confounding Factors, Epidemiologic; Diet; Dietary Supplements; Epidemiologic Methods; Female; Hip Fractures; Humans; Male; Massachusetts; Middle Aged; Osteoporosis; Osteoporotic Fractures; Potassium, Dietary

Oxidative stress and inflammation have been linked to bone loss. We evaluated the effects of feeding orange pulp (OP), a source of vitamin C and flavonoids, on bone quality in a rat model of male osteoporosis. One-year-old retired breeder rats (n = 43) were orchidectomized (ORX) or sham-operated (SHAM). Three days postsurgery, ORX rats were randomly assigned to treatments: ORX or ORX with 2.5% OP, 5% OP, or 10% OP. Diets were isonitrogenous, isocaloric, modified AIN-93M diets with equal fiber content. All ORX rats were fed for 4 months to the mean food intake of the SHAM group. At the end of the study blood, urine and bone samples were collected. Plasma antioxidant capacity and urinary deoxypyridinoline (DPD) were determined. Bone density, structure, and strength were assessed using dual energy X-ray absorptiometry, microcomputed tomography, and finite element analyses. ORX decreased (P < .05) antioxidant status, while OP as low as 2.5% maintained the antioxidant capacity of ORX rats comparable to that of the SHAM group. Cortical thickness at the tibial midshaft was significantly decreased by ORX and increased by OP, and urinary DPD was significantly increased by ORX and decreased by OP. In fourth lumbar trabecular cores, ORX rats had significantly reduced bone volume fraction, connectivity density, and trabecular number and increased trabecular separation. OP significantly increased bone volume fraction and trabecular number and decreased trabecular separation in ORX rats. Improvements due to OP in microarchitectural properties of vertebral bones and in cortical thickness of long bones were subtle but significant. The consistently negative impacts of ORX on bone density, structure, and strength parameters confirm the previously reported importance of testosterone for bone.

Topics: Animals; Ascorbic Acid; Bone and Bones; Bone Density; Bone Density Conservation Agents; Citrus sinensis; Disease Models, Animal; Flavonoids; Fruit; Male; Orchiectomy; Osteoporosis; Plant Preparations; Rats; Rats, Sprague-Dawley; Spine; Tibia; Vitamins

To examine the daily intake of bone health-related nutrients and to explore the association between diet composition and estimated net endogenous acid production (estimated NEAP) in Hong Kong Chinese adolescents.. In total, 171 boys and 180 girls aged 10-12 years of Chinese origin from nine primary schools from the Hong Kong Adolescent Bone Health Cohort Study. The study design used food frequency questionnaire. Mean daily intakes of foods and selected nutrients were estimated. Mean percentage of nutrient intake contributed by different food groups was presented. Frassetto's method was used to calculate the estimated NEAP from the diet's protein to potassium ratio.. There was no significant difference in the energy-adjusted intakes of most nutrients between boys and girls, except for intakes of vitamins C and D. Mean protein, sodium and potassium intakes were higher than the Chinese dietary reference intake (DRI), whereas mean intakes of magnesium, calcium and vitamin D were lower than the DRI. Boys had significantly higher estimated NEAP than girls (P=0.0051). Estimated NEAP was significantly positively correlated with meat intake and negatively associated with the consumption of fruits, vegetables, legumes, beverages and dairy products.. The results highlight the importance of considering whole diet quality when interpreting the effects of single nutrient or diet's net acid load on bone. The effect on high protein intake and low fruit and vegetable intake on the long-term bone health of Hong Kong Chinese adolescents warrants attention.

Topics: Acids; Ascorbic Acid; Asian People; Calcium, Dietary; Child; Child Nutritional Physiological Phenomena; Diet; Diet Surveys; Dietary Proteins; Female; Hong Kong; Humans; Magnesium; Male; Osteoporosis; Potassium, Dietary; Sex Factors; Sodium, Dietary; Vitamins

Vitamin C is essential for collagen formation and normal bone development. We evaluated associations of total, supplemental, and dietary vitamin C intake with bone mineral density (BMD) at the hip [femoral neck, trochanter], spine, and radial shaft and 4-y BMD change in elderly participants from the Framingham Osteoporosis Study. Energy-adjusted vitamin C intakes were estimated from the Willett FFQ in 1988-89. Mean BMD and 4-y BMD change was estimated, for men and women, by tertile/category of vitamin C intake, adjusting for covariates. We tested for interaction with smoking, calcium, and vitamin E intake. Among 334 men and 540 women, the mean age was 75 y and mean vitamin D intake was 8.25 mug/d (women) and 8.05 mug/d (men). We observed negative associations between total and supplemental vitamin C intake and trochanter-BMD among current male smokers (P-trend = 0.01). Among male nonsmokers, total vitamin C intake was positively associated with femoral neck BMD (P-trend = 0.04). Higher total vitamin C intake was associated with less femoral neck and trochanter-BMD loss in men with low calcium (all P-trend

Topics: Aged; Aged, 80 and over; Ascorbic Acid; Body Mass Index; Cohort Studies; Dose-Response Relationship, Drug; Female; Fruit; Humans; Male; Massachusetts; Middle Aged; Osteoporosis; Seasons; Vegetables

Water-soluble vitamins influence the development of an adequate structure of bone tissue, but there is scant information relating them with osteoporotic fractures. We analyze whether serum vitamin C, vitamin B12, and erythrocyte folate, or dietary intake of vitamin C and folate, are related with osteoporotic fractures in the elderly. A hospital-based case-control study was carried out at the Hospital of Jaén (167 cases, 167 controls), Spain. Cases were defined as patients aged 65 or more years with a low-energy fracture. Controls were people without fracture, matched for age and sex with cases. Diet was assessed by a semi-quantitative food frequency questionnaire. Serum vitamin C was measured using high-performance liquid chromatography (HPLC). Folic acid and vitamin B12 were measured using procedures of competitive or immunometric immunoassay. Multivariable analyses were also fitted to adjust for confounding using analysis of covariance (for the comparison of adjusted means) and conditional logistic regression (for estimating adjusted odds ratios). A statistically significant difference between cases and controls for vitamin C blood levels was found, being higher for controls (p = 0.01). Analysis of the association between serum vitamin C and fracture risk showed a linear trend (p = 0.03) with a significantly reduced risk for the upper quartile (OR = 0.31; 95% CI 0.11-0.87). The intake of vitamin C, folic acid, and B12 was not related to fracture risk, nor was there any association with erythrocyte folate or serum vitamin B12. In conclusion, serum vitamin C levels were lower in cases with osteoporotic fractures than in controls.

Topics: Aged; Aging; Ascorbic Acid; Case-Control Studies; Causality; Chromatography, High Pressure Liquid; Diet; Diet Records; Female; Folic Acid; Fractures, Bone; Geriatric Assessment; Humans; Immunoassay; Male; Multivariate Analysis; Odds Ratio; Osteoporosis; Risk Factors; Spain; Surveys and Questionnaires; Vitamin B 12

We describe the clinical presentation and diagnostic tests of a patient with regional transient osteoporosis (RTO) of the foot. This patient presented with a 4-month history of left-foot pain, nonpitting edema, and brownish discolorations of both feet. He had a history of tobacco abuse, alcohol abuse, and malnutrition. Radiological studies revealed severe osteopenia in the feet, and a MRI revealed bone marrow edema. The bone biopsy was consistent with RTO. This patient also had vitamin C deficiency. This case suggests a link between vitamin C deficiency and RTO, a hypothesis supported by our review of relevant literature on osteoporosis and vitamin C.

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Bone Diseases, Metabolic; Dietary Supplements; Foot Bones; Humans; Male; Middle Aged; Osteoporosis; Radiography

The objectives of this work were to: (1) establish methodology for pretreating osteoblast-like cells in vitro with dexamethasone to cause glucocorticoid-induced osteoporosis, (2) perform quantitative and qualitative assessments of cellular attachment of osteoporosis-like osteoblasts when grown on implant surfaces of differing roughness, (3) and explore the hypothesis that dexamethasone-treated osteoblasts have altered cell attachment properties by focal adhesion disassembly and decreased tyrosine phosphorylation of the focal adhesion tyrosine kinase.. Osteoblasts were cultured with dexamethasone (10(-7) and 10(-6) M) for up to 4 days of incubation to induce osteoporosis-like conditions. Cellular attachment assays demonstrated the effect of dexamethasone treatments on cellular attachment properties of osteoblasts. Qualitative data were obtained utilizing immunofluorescent microscopy and Western blotting. Focal adhesion kinase (FAK) immunoprecipitation and tyrosine-phosphorylation Western blots were obtained from dexamethasone-treated human embryonic palatal mesenchymal- 1486 osteoblast cultures supplemented with ascorbate and beta-glycerol phosphate medium.. Cellular attachment was significantly greater (P < 0.05) with non-dexamethasone-treated osteoblasts (92%) as compared to dexamethasone-treated osteoblasts after 1 (72%), 2 (63%), and 4 days (53%) of exposure. Dexamethasone-treated osteoblasts were viable and capable of proliferation, suggesting that the reduction of cellular attachment may be related to these cell adhesion processes. Immunofluorescent microscopy of both dexamethasone-treated osteoblasts and non-dexamethasone-treated osteoblasts failed to show any relative difference in the disassembly of focal adhesions and actin filaments. Extended dexamethasone treatment periods (up to 3 weeks) showed changes in the levels of FAK and FAK-phosphotyrosine in human embryonic palatal mesenchymal-1486 osteoblasts.. The protocol used in this study demonstrated a glucocorticoid-induced osteoporosis-like suppression of osteoblasts. FAK disassembly was not a significant factor in short period; however, FAK protein levels and phosphotyrosine signaling on FAK were affected after 1-week exposure to dexamethasone. Phosphorylated FAK was not associated with the rise in the level of FAK, further indicating the possibility of FAK involvement in reduced cell attachment.

Topics: 3T3 Cells; Animals; Antioxidants; Ascorbic Acid; Blotting, Western; Cell Adhesion; Cell Line; Cell Proliferation; Dental Implants; Dexamethasone; Focal Adhesion Protein-Tyrosine Kinases; Glucocorticoids; Glycerophosphates; Humans; Immunoprecipitation; Mice; Microscopy, Electron, Scanning; Osteoblasts; Osteoporosis; Phosphorylation; Surface Properties; Titanium; Tyrosine

Osteoporosis and femoral neck fractures (FNF) are uncommon in black Africans although osteoporosis accompanying iron overload (from traditional beer brewed in iron containers) associated with ascorbic acid deficiency (oxidative catabolism by iron) has been described from sub-Saharan Africa. This study describes histomorphometric findings of iliac crest bone biopsies and serum biochemical markers of iron overload and of alcohol abuse and ascorbic acid levels in 50 black patients with FNFs (29 M, 21 F), age 62 years (40-95) years (median [min-max]), and in age- and gender-matched black controls. We found evidence of iron overload in 88% of patients and elevated markers of alcohol abuse in 72%. Significant correlations between markers of iron overload and of alcohol abuse reflect a close association between the two toxins. Patients had higher levels of iron markers, i.e., siderin deposits in bone marrow (P < 0.0001), chemical non-heme bone iron (P = 0.012), and serum ferritin (P = 0.017) than controls did. Leukocyte ascorbic acid levels were lower (P = 0.0008) than in controls. The alcohol marker mean red blood cell volume was elevated (P = 0.002) but not liver enzymes or uric acid. Bone volume, trabecular thickness, and trabecular number were lower, and trabecular separation was greater in patients than in controls, all at P < 0.0005; volume, surface, and thickness of osteoid were lower and eroded surface was greater, all at P < 0.0001. There was no osteomalacia. Ascorbic acid deficiency accounted significantly for decrease in bone volume and trabecular number, and increase in trabecular separation, osteoid surface, and eroded surface; iron overload accounted for a reduction in mineral apposition rate. Alcohol markers correlated negatively with osteoblast surface and positively with eroded surface. Relative to reported data in white FNF patients, the osteoporosis was more severe, showed lower osteoid variables and greater eroded surface; FNFs occurred 12 years earlier and were more common among men. We conclude that the osteoporosis underlying FNFs in black Africans is severe, with marked uncoupling of resorption and formation in favor of resorption. All three factors--ascorbic acid deficiency, iron overload, and alcohol abuse--contributed to the osteoporosis, in that order.

Topics: Adult; Aged; Aged, 80 and over; Alcoholism; Ascorbic Acid; Ascorbic Acid Deficiency; Biomarkers; Black People; Bone Marrow; Female; Femoral Neck Fractures; Humans; Ilium; Iron Overload; Leukocytes; Male; Middle Aged; Osteoporosis; Siderosis

Using a mouse mutant that fractures spontaneously and dies at a very young age, we identified that a deletion of the GULO gene, which is involved in the synthesis of vitamin C, is the cause of impaired osteoblast differentiation, reduced bone formation, and development of spontaneous fractures.. A major public health problem worldwide, osteoporosis is a disease characterized by inadequate bone mass necessary for mechanical support, resulting in bone fracture. To identify the genetic basis for osteoporotic fractures, we used a mouse model that develops spontaneous fractures (sfx) at a very early age.. Skeletal phenotype of the sfx phenotype was evaluated by DXA using PIXImus instrumentation and by dynamic histomorphometry. The sfx gene was identified using various molecular genetic approaches, including fine mapping and sequencing of candidate genes, whole genome microarray, and PCR amplification of candidate genes using cDNA and genomic DNA as templates. Gene expression of selected candidate genes was performed using real-time PCR analysis. Osteoblast differentiation was measured by bone marrow stromal cell nodule assay.. Femur and tibial BMD were reduced by 27% and 36%, respectively, in sfx mice at 5 weeks of age. Histomorphometric analyses of bones from sfx mice revealed that bone formation rate is reduced by >90% and is caused by impairment of differentiated functions of osteoblasts. The sfx gene was fine mapped to a 2 MB region containing approximately 30 genes in chromosome 14. By using various molecular genetic approaches, we identified that deletion of the gulonolactone oxidase (GULO) gene, which is involved in the synthesis of ascorbic acid, is responsible for the sfx phenotype. We established that ascorbic acid deficiency caused by deletion of the GULO gene (38,146-bp region) contributes to fractures and premature death because the sfx phenotype can be corrected in vivo by treating sfx mice with ascorbic acid and because osteoblasts derived from sfx mice are only able to form mineralized nodules when treated with ascorbic acid. Treatment of bone marrow stromal cells derived from sfx/sfx mice in vitro with ascorbic acid increased expression levels of type I collagen, alkaline phosphatase, and osteocalcin several-fold.. The sfx is a mutation of the GULO gene, which leads to ascorbic acid deficiency, impaired osteoblast cell function, and fractures in affected mice. Based on these and other findings, we propose that ascorbic acid is essential for the maintenance of differentiated functions of osteoblasts and other cell types.

Topics: Animals; Ascorbic Acid; Ascorbic Acid Deficiency; Bone and Bones; Bone Marrow Cells; Cell Differentiation; Chromosome Mapping; Densitometry; DNA Primers; DNA, Complementary; Femur; Fracture Healing; Fractures, Bone; Gene Deletion; Genome; Genotype; L-Gulonolactone Oxidase; Mice; Mice, Inbred BALB C; Models, Genetic; Mutation; Oligonucleotide Array Sequence Analysis; Osteoblasts; Osteoporosis; Phenotype; Reverse Transcriptase Polymerase Chain Reaction; RNA; Stromal Cells; Tibia; X-Rays

The role of protein intake in osteoporosis is unclear. In a case-control study in Utah (n = 2501), increasing level of protein intake was associated with a decreased risk of hip fracture in men and women 50-69 years of age but not in those 70-89 years of age. Protein intake may be important for optimal bone health.. Protein is an important component of bone, but the role of dietary protein intake in osteoporosis and fracture risk remains controversial.. The role of dietary protein intake in osteoporotic hip fracture was evaluated in a statewide case-control study in Utah. Patients, 50-89 years of age, with hip fracture (cases) were ascertained through surveillance of 18 Utah hospitals during 1997-2001. Age- and gender-matched controls were randomly selected. Participants were interviewed in their place of residence, and diet was assessed using a picture-sort food frequency questionnaire previously reported to give a useful measure of usual dietary intake in the elderly Utah population. The association between protein intake and risk of hip fracture was examined across quartiles of protein intake and stratified by age group for 1167 cases (831 women, 336 men) and 1334 controls (885 women, 449 men).. In logistic regression analyses that controlled for gender, body mass index, smoking status, alcohol use, calcium, vitamin D, potassium, physical activity, and estrogen use in women, the odds ratios (OR) of hip fracture decreased across increasing quartiles of total protein intake for participants 50-69 years of age (OR: 1.0 [reference]; 0.51 [95% CI: 0.30-0.87]; 0.53 [0.31-0.89]; 0.35 [0.21-0.59]; p < 0.001). No similar associations were observed among participants 70-89 years of age. Results from analyses stratified by low and high calcium and potassium intake did not differ appreciably from the results presented above.. Higher total protein intake was associated with a reduced risk of hip fracture in men and women 50-69 years of age but not in men and women 70-89 years of age. The association between dietary protein intake and risk of hip fracture may be modified by age. Our study supports the hypothesis that adequate dietary protein is important for optimal bone health in the elderly 50-69 years of age.

Topics: Age Factors; Aged; Aged, 80 and over; Ascorbic Acid; Body Mass Index; Bone and Bones; Calcium, Dietary; Case-Control Studies; Diet; Dietary Proteins; Female; Hip Fractures; Humans; Male; Middle Aged; Motor Activity; Osteoporosis; Potassium; Prospective Studies; Regression Analysis; Risk Factors; Sex Factors; Smoking; Utah; Vitamin D

Although recent epidemiological studies found a positive correlation between dietary vitamin C intake and bone mineral density, data on plasma levels of vitamin C or other antioxidants in osteoporotic subjects are scanty. The aim of this study was to evaluate whether antioxidant defenses are decreased in elderly osteoporotic women and, if this is the case, to understand whether osteoporosis is a condition characterized by increased oxidative stress. To answer these questions, plasma vitamins C, E, and A; uric acid; and the enzymatic activities of superoxide dismutase in plasma and erythrocytes and of glutathione peroxidase in plasma were measured in 75 subjects with osteoporosis and 75 controls. Dietary and endogenous antioxidants were consistently lower in osteoporotic than in control subjects. On the other hand, plasma levels of malondialdehyde, a byproduct of lipid peroxidation, did not differ between groups. Our results reveal that antioxidant defenses are markedly decreased in osteoporotic women. The mechanisms underlying antioxidant depletion and its relevance to the pathogenesis of osteoporosis deserve further investigation.

Topics: Activities of Daily Living; Aged; Aging; Antioxidants; Ascorbic Acid; Body Mass Index; Bone and Bones; Cross-Sectional Studies; Diet; Erythrocytes; Female; Fractures, Bone; Glutathione Peroxidase; Humans; Lipid Peroxidation; Malondialdehyde; Middle Aged; Osteoporosis; Superoxide Dismutase; Uric Acid; Vitamin A; Vitamin E

We measured the impact of diet, anthropometry, physical activity and lifestyle variables on rates of hip bone mineral density (BMD) loss in 470 white men and 474 white women aged 67-79 years at recruitment dwelling in the community. The subjects were recruited from a prospective population-based diet and cancer study (EPIC-Norfolk) in Eastern England. Dietary intake was measured at baseline using 7-day food diaries and used to calculate intakes of some 31 nutrients and 22 food groups. Standardised questionnaires were used to collect data on anthropometry, physical activity and lifestyle variables. BMD loss (percent per annum; % p.a.) was measured using dual-energy X-ray absorptiometry performed on two occasions an average of 3 years apart (range 2-5 years). The mean rate of BMD change at the total hip region was -0.17% p.a. (SD 1.3% p.a.) in men and -0.41% p.a. (SD 1.2% p.a.) in women. In both men and women, weight gain protected against (and weight loss promoted) BMD loss ( P<0.0001). Markers of current physical activity were protective. In men, an increase of 1 l/s in FEV(1) was associated with an increase in BMD at an average rate of 0.25% p.a. ( P=0.013). In women, for every ten trips made per day climbing a flight of stairs, BMD increased at a rate of 0.22% p.a. ( P=0.005) and additionally a 10% increase in activities of daily living score was associated with BMD increasing at a rate of 0.12% p.a. ( P=0.011) in women. Nutritional variation appeared to have less impact on BMD loss. In men there was no evidence of an effect of any of the nutrients evaluated. However, in women, low intake of vitamin C was associated with faster rate of BMD loss. Women in the lowest tertile (7-57 mg/day) of vitamin C intake lost BMD at an average rate of -0.65% p.a., which was significantly faster compared to loss rates in the middle (58-98 mg/day) and upper (99-363 mg/day) tertiles of intake, which were -0.31% p.a. and -0.30% p.a., respectively ( P=0.016). There was no effect of fruits and vegetables, combined or separately, on rate of BMD loss. The results confirm that weight maintenance (or gain) and commonly practiced forms of physical activity appear to protect against BMD loss in this age group. Measures such as ensuring good general nutrition to guard against weight loss in the non-overweight elderly and maintenance of physical fitness could be valuable in protecting against BMD loss. The protective effect of vitamin C in women needs to be further investigated in

Topics: Aged; Ascorbic Acid; Bone Density; Diet; Exercise; Female; Femur; Fruit; Humans; Life Style; Male; Osteoporosis; Physical Fitness; Sex Factors; Weight Loss

The aim of this study was to investigate the effect of heparin on osteoporosis initiation, and the effect of selenium plus vitamins E and C, and the sole combination of vitamins E and C on the progress of osteoporosis induced by heparin through histologic means. Adult female New Zealand white rabbits were divided into three experimental and three control groups. The experimental rabbits were injected with 1000 IU/kg/day heparin (Liquemine) for 4 weeks. These six groups were administered deionized water (CI and EI), 100 mg/kg/day L-ascorbic acid plus 100 mg/kg/day alpha-tocopherol acetate (CII and EII), and 0.05 mg/kg/day sodium selenite, plus these vitamins orally, with a gastric catheter (CIII and EIII), respectively. At the end of the experimental period, the femurs of the animals were collected and investigated under a light photomicroscope. Heparin caused important alterations in bone, such as an improper lamellar structure and a large uncalcified bone matrix. These findings implied the early phase of osteoporosis induced by heparin use. The combination of vitamins E and C given to the experimental rabbits partially prevented this bone tissue destruction. When sodium selenite was given together with vitamins E and C to the osteoporosis model rabbits, the long bone tissue had almost the same structure as in normal rabbits, for example the development of numerous bone trabeculae. Our results suggest that a combination of sodium selenite with vitamins E and C was more effective than combinations of single vitamins to prevent structural alterations in these model bones.

Topics: Animals; Ascorbic Acid; Bone and Bones; Bone Remodeling; Disease Models, Animal; Drug Therapy, Combination; Female; Heparin; Osteoporosis; Probability; Rabbits; Random Allocation; Reference Values; Sensitivity and Specificity; Sodium Selenite; Vitamin E

We have demonstrated that the habitual intake of chitosan can decrease bone mass in ovariectomized (OVX) SHRSP rats fed a low-Ca diet (0.1%). In the present study, we examined both the etiology of bone loss induced by dietary chitosan and the preventive effect of vitamin C supplementation. Rats were OVX and maintained on one of the following diets for 6 wk: 10% cellulose (CE). 10% chitosan (CH) or 10% chitosan with sodium ascorbate (CHVC). CH caused a significant reduction in bone mineral density (BMD) and stiffness in femurs and the fourth lumbar vertebrae (L4). There was no significant difference in intestinal Ca absorption between CH and CE, whereas CH intake significantly reduced intestinal P absorption. The bone loss in CH rats was accompanied with an increase in urinary Ca excretion and a decrease in serum Ca as well as a significant increment In serum PTH and 1,25(OH)2D3. The vitamin D receptor and calcium binding protein D9K mRNAs were also significantly increased in the duodenum of CH rats. Vitamin C supplementation to CH caused an increase in the Ca and P contents of femurs as well as BMD of the L4, with a decrease in urinary Ca excretion. These results indicate that dietary chitosan with low Ca intake possibly induces the loss of bone mass by enhancing urinary Ca excretion rather than by inhibiting Ca absorption, and that vitamin C supplementation could prevent bone loss caused by chitosan through the increment of retained Ca followed by suppression of urinary Ca excretion.

Topics: Analysis of Variance; Animals; Anticholesteremic Agents; Antioxidants; Ascorbic Acid; Biomarkers; Bone Density; Chitin; Chitosan; Duodenum; Female; Osteoporosis; Ovariectomy; Rats; Rats, Inbred SHR; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; S100 Calcium Binding Protein G; Time Factors

Topics: Ascorbic Acid; Body Mass Index; Bone Density; Case-Control Studies; Cohort Studies; Data Collection; Fractures, Bone; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypolipidemic Agents; Osteoporosis; Prospective Studies; Randomized Controlled Trials as Topic; Retrospective Studies; Risk Factors; Time Factors

Rates of vitamin-mineral supplement use by US female physicians are unknown but are of particular interest for several epidemiologic and clinical reasons.. The objective was to determine rates of and variations in vitamin-mineral supplement use among US female physicians.. We used data from the Women Physicians' Health Study, a large (n = 4501) national, randomly sampled mail survey of female physicians aged 30-70 y.. Half of the physicians took a multivitamin-mineral supplement; 35.5% of these did so regularly. However,

Topics: Adult; Aged; Ascorbic Acid; Calcium; Cohort Studies; Coronary Disease; Diabetes Mellitus; Dietary Supplements; Female; Humans; Marital Status; Middle Aged; Minerals; Neoplasms; Osteoporosis; Physicians, Women; Social Class; Surveys and Questionnaires; Vitamin A; Vitamin E; Vitamins

Topics: Adult; Antioxidants; Ascorbic Acid; beta Carotene; Diet; Dietary Supplements; Female; Folic Acid; Humans; Male; Middle Aged; Osteoporosis; Vitamin A; Vitamin B 12; Vitamin D; Vitamin E; Vitamins

1. A modern hybrid strain of laying hen (Hisex) was fed from point of lay to 68 weeks on a control diet and diets containing oystershell, fluoride, 1,25-dihydroxycholecalciferol, ascorbic acid, a lower concentration of phosphorus and a combination of a lower concentration of crude protein and higher concentration of vitamin K. Hens from a much older strain (Brown Leghorn J-line) were fed on the control diet. 2. Plasma variables were measured during lay. End-of-lay trabecular and medullary bone volumes in the proximal tarsometatarsus and free thoracic vertebra were measured by histomorphometry. 3. The majority of Hisex hens were considered to be osteoporotic by the end of lay. In contrast, none of the J-line were osteoporotic. 4. None of the nutritional treatments affected trabecular bone volumes. Medullary bone volumes were increased significantly by feeding oystershell or fluoride. 5. There was no phenotypic correlation between egg production and trabecular bone volume in the Hisex hens. 6. The experiment provided evidence that osteoporosis in laying hens, as assessed by trabecular bone volumes, is not caused by calcium deficiency and could not be prevented by any of the nutritional treatments studied.

Topics: Animal Nutritional Physiological Phenomena; Animals; Ascorbic Acid; Bone Density; Calcitriol; Chickens; Dietary Proteins; Dietary Supplements; Female; Fluorides; Osteoporosis; Ostreidae; Oviposition; Phosphorus; Poultry Diseases; Species Specificity; Vitamin K

This paper aims to examine the relative contributions made by alcohol and iron overload and hypovitaminosis C to the osteoporosis associated with African hemosiderosis. To characterize this bone disorder, we examined double-tetracycline-labeled iliac crest bone biopsies and serum biochemistry in 53 black male drinkers, 38 with (Fe+) and 15 without (Fe-) iron overload, and in controls. We reasoned that abnormalities found in both patient groups were likely to be caused by alcohol abuse and those found only in the Fe+ group to be caused by iron overload and hypovitaminosis C (iron/C-). The patient groups differed only with respect to greater erosion depth (p < 0.05) and abnormal markers of iron overload in the Fe+ group. Ascorbic acid levels were lower in the Fe+ group than in controls (p < 0.001). Bone volume and trabecular thickness were significantly lower in both patient groups compared with controls and therefore likely caused by alcohol. There were no positive correlations between formation and erosion variables in either patient group, which suggests uncoupling of formation from erosion, possibly as a result of alcohol abuse. Prolonged mineralization lag time associated with thin osteoid seams was found in 32% of patients, affecting both groups. This rules out osteomalacia and suggests osteoblast dysfunction, probably caused by alcohol. The number of iron granules in the marrow correlated with erosion depth (r = 0.373, p < 0.01), trabecular number (r = -0.295, p < 0.05), and trabecular separation (r = 0.347, p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Africa; Aged; Alcoholism; Ascorbic Acid; Bone Density; Hemosiderosis; Humans; Ilium; Iron; Male; Middle Aged; Osteoporosis; Primary Myelofibrosis

Topics: Aged; Ascorbic Acid; Female; Humans; Male; Middle Aged; Osmolar Concentration; Osteoporosis; Outpatients

Traumatic sacral fractures are most often due to motor vehicle or industrial accidents and are commonly associated with pelvic, urogenital, and neurological injuries. In recent years, a more subtle type of sacral fracture, not associated with major trauma, has been described. It is an osteoporotic insufficiency fracture that presents as low back pain in elderly patients, especially postmenopausal Caucasian women. It may escape detection unless radionuclide bone scans, tomograms, or computed tomograms are obtained. The radiographic features have been detailed in various publications, but little has been reported about the clinical features, treatment, or ultimate outcome of patients with osteoporotic sacral fractures. We have reviewed the charts and radiological studies of 13 women and 3 men who sustained this type of fracture between 1983 and 1986. All of these patients were Caucasian. The average age was 71 years. The most common presenting symptom complex was diffuse low back pain accompanied by hip, buttock, or thigh pain. Pertinent physical findings were limited to tenderness on palpation of the sacrum and a decreased range of low back motion. The osteoporotic fractures were seldom noted on plain roentgenograms of the sacrum, but were readily defined by sacral tomography or computed tomography. Radionuclide bone scanning also proved helpful in making the diagnosis by localizing the process. Treatment was medical and consisted of therapies designed to reduce pain and to combat the associated osteopenia. Of our 16 patients, 11 had complete pain relief, 2 had substantial pain relief, 2 noted decreasing pain before they died of other causes, and 1 was followed less than 1 month.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Aged; Aged, 80 and over; Ascorbic Acid; Estrogens; Female; Fracture Fixation; Fractures, Bone; Humans; Male; Middle Aged; Osteoporosis; Palliative Care; Radionuclide Imaging; Sacrum; Tomography, X-Ray Computed; Vitamin D

Topics: Adult; Aged; Aging; Ascorbic Acid; Calcium; Child; Diet; Dietary Proteins; Energy Metabolism; Female; Humans; Male; Nutritional Requirements; Osteoporosis; Vitamin K

Throughout adult life, there is progressive alteration in body composition and tissue function. There is loss of lean body mass, notably by muscle, with a gain in body fat. We do not know whether nutritional factors affect these gross changes. In the case of loss of bone density (osteoporosis), however, there is evidence that the process is retarded by raising the intake of calcium and by exercise. Aging also adversely affects tissue function at the level of the whole organ and tissue as well as at the cellular and subcellular level. Animal models show similar age-related changes, and demonstrate further that alterations in nutrient intake or exercise can alter the rate of loss of tissue and cellular function. In addition to the effects of adult aging on tissue function, certain chronic diseases and disabilities are related to aging. These conditions include atherosclerosis, hypertension, coronary thrombosis, cancer, etc. Both human epidemiological studies and animal experiments on aging suggest strongly that nutrition plays a role in the onset and development of these conditions. There is a need for more accurate assessments of the nutrient needs of people over 65 years of age. A few selected nutrients are discussed. Studies of energy intake during adult life show a progressive reduction with increasing age, due mainly to reduced physical activity. Vitamin C levels in the white blood cells of elderly women can be half those of young adults; these respond to supplementary vitamin C without evidence of clinical benefit. Nitrogen balance studies suggest that the allowance of protein for older adults is not less than for young. Finally, surveys of elderly in whole populations and in selected groups show that, by the nutritional standards of young adults, there may exist a significant amount of malnutrition in people as they grow old, though we do not know whether this affects rate of loss of tissue function with age.

Topics: Aged; Ascorbic Acid; Body Composition; Chronic Disease; Dietary Proteins; Disease Models, Animal; Energy Metabolism; Female; Humans; Male; Nutritional Physiological Phenomena; Osteoporosis; Sex Factors

Specialized "nutritional insurance" supplementation may reduce the risk of many important complications of long-term corticosteroid treatment. Supplementation with calcium, fluoride, activated vitamin D metabolites, and GTF, should help prevent osteoporosis. GTF, vitamin C, zinc and fluoride might help offset the inhibitory effect of corticosteroids on fibroblast and osteoblast function. Diabetic, hyperlipidemic and protein-losing effects might be compensated with supplementary GTF. Antioxidant nutrients could support humoral immunity and neutrophil function, while complementing the anti-inflammatory actions of corticosteroids. Supplementary magnesium could reduce the risk of nephrocalcinosis and nephrolithiasis.

Topics: Adrenal Cortex Hormones; Amino Acids; Ascorbic Acid; Chromium; Diabetes Mellitus; Double-Blind Method; Fluorides; Food, Fortified; Humans; Hydroxycholecalciferols; Hyperlipidemias; Immunologic Deficiency Syndromes; Nephrocalcinosis; Nicotinic Acids; Nutritional Requirements; Osteoporosis; Selenium; Silicon

The regulatory functions of vitamins are described with particular reference to their importance in the metabolic processes of ageing. Although clear hypovitaminosis is uncommon, slight vitamin deficiencies are often encountered in the clinical practice. They cause a speed up of the organism deterioration. The nutritional requirement and the effect of vitamin A, B1, B6, B12, are rapidly reviewed. More attention is paid to the data about vitamin C, D and E. Vitamin C deficiency in elderly, especially in the hospitalized ones; whereas a high content of ascorbic acid in necessary in order to extend the life length and to achieve a good self-sufficiency. Also the deficiency of vitamin D and of its metabolites is frequent in the aged due to both a lower uptake and a scarce exposure to the sunlight. Low levels of vitamin D cause a worsening of bone tissue and consequent demineralization (osteomalacia and osteoporosis). Some aspects of ageing can be prevented by the supply of vitamin E, particularly the impaired bone trophism. The anti-oxidant power of tocopherol could also interfere some pathogenetic processes of ageing.

Topics: Adolescent; Adult; Aged; Aging; Ascorbic Acid; Ascorbic Acid Deficiency; C-Peptide; Calcifediol; Child; Child, Preschool; Humans; Hydroxycholecalciferols; Insulin; Middle Aged; Osteomalacia; Osteoporosis; Prediabetic State; Vitamin D Deficiency; Vitamin E

Many edentulous patients are "sick patients." Often geriatric considerations are involved, as well obesity and postmenopausal problems. These patients have deficient tissues on which to build dentures. The degenerative processes which initiate the loss of teeth continue after extraction and cause further shrinkage of supporting tissues. Repeated relining and rebuilding of dentures can be avoided and happier and healthier patients maintained by (1) saturating patients with therapeutic dosages of vitamins and minerals prior to surgical intervention, (2) using scientifically evaluated liquid and semisolid diets containing the maximum quantities of nutrients and the minimum number of calories during the preoperative and postoperative periods, and (3) thereafter maintaining the patient on a high-protein, high-vitamin, high-mineral diet.

Topics: Aged; Aging; Ascorbic Acid; Calcium; Denture, Complete; Dietary Carbohydrates; Female; Humans; Menopause; Middle Aged; Mouth Mucosa; Mouth, Edentulous; Nutritional Physiological Phenomena; Obesity; Osteoporosis; Protein Deficiency; Proteins; Salivary Glands; Stress, Physiological; Vitamin A; Vitamin B Complex; Vitamin D

Topics: Age Determination by Skeleton; Aged; Alkaline Phosphatase; Ascorbic Acid; Body Height; Body Weight; Bone and Bones; Calcium; Calcium, Dietary; Diet; Dietary Proteins; Female; Humans; Male; Osteoporosis; Phosphates; Sex Factors; Vitamin D Deficiency

Topics: Adult; Age Factors; Animals; Ascorbic Acid; Ascorbic Acid Deficiency; Black or African American; Black People; Bone and Bones; Bone Resorption; Humans; Iron; Liver; Male; Middle Aged; Minerals; Osteoporosis; Siderosis; South Africa

Topics: Aged; Alkaptonuria; Ascorbic Acid; Diagnosis, Differential; Female; Femoral Neck Fractures; Humans; Methandrostenolone; Ochronosis; Osteoporosis; Phenylacetates; Polymyalgia Rheumatica; Radiography; Skull; Vitamin D

Topics: Ascorbic Acid; Humans; Infant; Knee; Male; Osteoporosis; Radiography; Scurvy; Spinal Diseases; Spine; Wrist

Topics: Ascorbic Acid; Birth Weight; Breast Feeding; Diagnosis, Differential; Humans; Infant; Infant Nutritional Physiological Phenomena; Infant, Newborn; Milk, Human; Osteoporosis; Prognosis; Radiography; Rickets; Scurvy; Syphilis, Congenital

Topics: Adult; Ascorbic Acid; Ascorbic Acid Deficiency; Beer; Black or African American; Black People; Diet; Humans; Iron; Male; Middle Aged; Osteoporosis; Siderosis; South Africa

Topics: Ascorbic Acid; Bone and Bones; Child, Preschool; Epiphyses, Slipped; Female; Humans; Humeral Fractures; Muscular Dystrophies; Osteoporosis; Radiography; Scurvy

Topics: Anabolic Agents; Ascorbic Acid; Calcium; Humans; Osteoporosis; Vitamin D

Topics: Ascorbic Acid; Bone Diseases; Calcinosis; Diagnosis, Differential; Ergocalciferols; Fractures, Bone; Humans; Infant; Osteoporosis; Radiography; Rickets; Scurvy; Streptomycin; Vitamin A

Topics: Anemia; Anemia, Macrocytic; Anemia, Megaloblastic; Ascorbic Acid; Humans; Osteoporosis; Scurvy

Topics: Ascorbic Acid; Calcium; Calcium, Dietary; Humans; Iodine; Joint Diseases; Osteomalacia; Osteoporosis; Spinal Diseases; Vitamins

Topics: Anabolic Agents; Animals; Ascorbic Acid; Bone and Bones; Fractures, Bone; Humans; Lordosis; Metabolism; Osteoporosis; Pseudarthrosis; Steroids

Topics: Anemia; Anemia, Aplastic; Ascorbic Acid; Bilirubin; Blood Cell Count; Blood Chemical Analysis; Blood Transfusion; Bone Marrow Examination; Child; Flavonoids; Folic Acid; Hematopoietic System; Humans; Infant; Infant, Newborn; Leukopenia; Osteoporosis; Prednisolone; Prednisone; Pyridoxine; Radiography; Riboflavin; Testosterone; Thiamine; Thrombocytopenia; Vitamin B 12

Topics: Ascorbic Acid; Calcium; Calcium, Dietary; Classification; Geriatrics; Gonadal Steroid Hormones; Humans; Osteoporosis; Vitamin A

Topics: Aged; Aged, 80 and over; Ascorbic Acid; Calcium; Female; Humans; Hypercalcemia; Osteoporosis; Osteoporosis, Postmenopausal; Vitamin D; Vitamins

Topics: Adenine Nucleotides; Ascorbic Acid; Humans; Osteoporosis; Polyphosphates; Syndrome; Testosterone; Vitamins