vitamin-b-12 and Bone-Diseases--Metabolic

Chronic vitamin D deficiency, inadequate calcium intake, and secondary hyperparathyroidism are common in obese individuals, placing them at risk for low bone mass and metabolic bone disease. After bariatric surgery, they are at even higher risk, owing to malabsorption and decreased oral intake. Meticulous preoperative screening, judicious use of vitamin and mineral supplements, addressing modifiable risk factors, and monitoring the absorption of key nutrients postoperatively are essential in preventing metabolic bone disease in bariatric surgery patients.

Topics: Absorptiometry, Photon; Bariatric Surgery; Bone Diseases, Metabolic; Calcium Compounds; Dietary Proteins; Health Status Indicators; Humans; Magnesium Compounds; Nutritional Status; Obesity; Perioperative Care; Risk Factors; Vitamin B 12; Vitamin D

Young Indian women may be at risk of poor bone health due to malnutrition. The aim of this study was to examine the effects on bone metabolism of a nutritional supplement in women aged 25 to 44. The nutritional supplement was a protein-rich beverage powder fortified with multi-micronutrients including calcium (600 mg), vitamin D (400 IU), and vitamin K (55 mcg) per daily serving, while a placebo supplement was low-protein non-fortified isocaloric beverage powder. This 6-month randomised, controlled trial showed favorable changes in bone turnover markers (decreased) and calcium homeostasis; such changes in older adults have been associated with slowing of bone loss and reduced fracture risk. For example, serum CTX decreased by about 30% and PINP by about 20% as a result of the increase in calcium intake. There were also changes in the ratio of carboxylated to undercarboxylated osteocalcin and such changes have been linked to a slowing of bone loss in older subjects. For example, the ratio increased by about 60% after 3 months as a result in the improvement in vitamin K status. Finally, there were improvements in the status of B vitamins, and such changes have been associated with reductions in homocysteine, but it is uncertain whether this would affect fracture risk. The product was generally well tolerated. This study shows the nutritional supplement holds promise for improved bone health among young Indian women.

Topics: Adult; Bone Diseases, Metabolic; Bone Remodeling; Calcium; Calcium, Dietary; Dietary Supplements; Double-Blind Method; Female; Folic Acid; Fractures, Bone; Homeostasis; Humans; India; Osteocalcin; Osteoporosis; Premenopause; Vitamin B 12; Vitamin D; Vitamin K

To investigate diet and nutrition-related factors associated with bone loss in a group of postmenopausal (PM) women. Nutritional intake, inflammatory markers and body composition (weight, body mass index, fat/lean mass) were analysed for associations with bone mineral density (BMD).. A cross sectional study examining correlations between BMD (Duel-energy X ray absorptiometry; (DXA) and dietary intake (3-day diaries), body composition and plasma bone and inflammatory markers: C-terminal telopeptide of type I collagen (CTX) and procollagen type I N propeptide (P1NP), C- reactive protein (CRP), interleukin 6 and 10 (IL-6, IL-10), tumour necrosis factor (TNF) and osteoprotegerin (OPG).. Community dwelling women from the Auckland, Hawke's Bay and Manawatu regions in New Zealand.. 142 healthy, PM women aged 50-70 years.. OPG (per kilogram fat mass) was increased in women with osteoporosis (p<0.001) compared to groups classified with normal BMD and osteopenia. Protein, vitamin B12, zinc, potassium and dairy intake were all positively correlated with higher BMD while dairy and potassium intakes also inversely correlated with CTX. Body composition (weight, BMI and fat/lean mass) had strong positive associations with BMD. Multiple regression analysis showed body weight, potassium and dairy intake were predictors of increased BMD in PM women and explained 39% (r2=0.39, p< 0.003) of variance.. BMD was negatively correlated with OPG and positively with weight, dairy and potassium intake. This study highlights the importance of maintaining adequate body weight and emphasising dairy and potassium predominantly sourced from fruit/vegetables to reduce bone loss at midlife.

Topics: Absorptiometry, Photon; Aged; Body Composition; Body Mass Index; Body Weight; Bone Density; Bone Diseases, Metabolic; C-Reactive Protein; Collagen Type I; Cross-Sectional Studies; Cytokines; Dairy Products; Diet; Dietary Proteins; Female; Health; Humans; Inflammation; Interleukin-10; Interleukin-6; Middle Aged; New Zealand; Osteoporosis, Postmenopausal; Osteoprotegerin; Peptide Fragments; Peptides; Postmenopause; Potassium; Procollagen; Tumor Necrosis Factor-alpha; Vitamin B 12; Zinc

To test whether in Moroccan healthy postmenopausal women, levels of plasma total homocysteine (tHcy), folate, and vitamin B12 are related to BMD. A total of 188 volunteer postmenopausal women were recruited from our blood taking center between April 2008 and December 2008. Each subject completed a standardized questionnaire designed to document putative risk factors of osteoporosis. Bone mineral density was determined by a Lunar Prodigy Vision DXA system, and blood samples for plasma tHcy, folate, vitamin B12, and serum parathyroid hormone (PTH) were taken. Comparison between women with osteoporosis, osteopenia and normal BMD showed that the osteoporotic women were significantly older, had lower weight and height than the women of the other groups. Plasma tHcy was significantly higher in the osteoporotic group. Levels of tHcy were inversely related to BMD at the lumbar spine, at the total hip and plasma vitamin B12 and positively related to age and creatinine. Multiple regression analysis showed that age and BMI were the main predictors of BMD at the lumbar spine, whereas the main predictors of BMD at the total hip were age, BMI, plasma tHcy, and plasma vitamin B(12). tHcy and vitamin B12 are independent risk factors for osteoporosis in Moroccan healthy postmenopausal women.

Topics: Absorptiometry, Photon; Age Factors; Aged; Body Mass Index; Bone Density; Bone Diseases, Metabolic; Cross-Sectional Studies; Female; Folic Acid; Homocysteine; Humans; Lumbar Vertebrae; Middle Aged; Morocco; Osteoporosis, Postmenopausal; Parathyroid Hormone; Postmenopause; Retrospective Studies; Risk Factors; Vitamin B 12

Genetic hyperhomocysteinemia is associated with skeletal abnormalities and osteoporosis. We tested whether levels of homocysteine and critical co-enzymes of homocysteine metabolism, such as vitamin B12 and folate, are related to lumbar spine bone mineral density (BMD) measured by DEXA in 161 postmenopausal women. Folate but not homocysteine or vitamin B12, was lower in osteoporotic than normal women (7.2 +/- 0.9 ng/L vs 11.4 +/- 0.7 ng/L, P < 0.003). Folate, but not homocysteine or vitamin B12, was independently related to BMD (r = 0.254, P < 0.011). BMD progressively increased from the lowest to the highest folate quartile (1.025 +/- 0.03 g/cm2 vs 1.15 +/- 0.03 g/cm2, P < 0.01) even when covaried for weight, which was the only other variable related to BMD. The present data suggest a major association between folate and bone mineralization.

Topics: Absorptiometry, Photon; Bone Density; Bone Diseases, Metabolic; Feeding Behavior; Female; Folic Acid; Homocysteine; Humans; Linear Models; Lumbar Vertebrae; Middle Aged; Osteoporosis, Postmenopausal; Patient Selection; Postmenopause; Risk Factors; Vitamin B 12

1. The mechanisms underlying gastrectomy osteopenia are not yet clear. The gastrectomy-associated cobalamin (vitamin B12) deficiency may favour osteopenia and skeletal fractures. Also, the exclusion of the duodenum from the food passage may contribute to gastrectomy osteopenia. To investigate this, rats were gastrectomized and the passage of nutrients restored either with the duodenum excluded (Roux Y) or included (Longmire). Sham-operated rats served as controls. In half of the rats in each gastrectomy group the serum B12 levels were normalized by parenteral administration of B12.2. Four months post operation, both gastrectomy groups showed a similar degree of osteopenia. There was normal bone mineralization; serum levels of parathyroid hormone were normal, but decreased for 25-hydroxyvitamin D, and elevated for 1,25-dihydroxyvitamin D; in urine there was decreased pH and excessive hyperphosphaturia.3.B12 therapy had no influence on any of the essential bone and mineral metabolic parameters.4. We conclude that osteopenia in the gastrectomized rat (i) is not due to B12 or folic acid deficiency, calcium deficiency or secondary hyperparathyroidism; (ii) is independent of the type of anatomic reconstruction of the digestive tract; (iii) appears to be related to disturbed vitamin D, phosphorus and acid-base metabolism.

Topics: Acid-Base Imbalance; Animals; Bone Diseases, Metabolic; Calcium; Duodenum; Gastrectomy; Male; Phosphorus; Random Allocation; Rats; Rats, Sprague-Dawley; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin D