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New Perspectives on Osteopenia, Osteoporosis, and Vitamin D

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Endocrinology & Metabolism".

Deadline for manuscript submissions: closed (25 October 2022) | Viewed by 11105

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Special Issue Editors

Dr. Gerrit Steffen Maier

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Guest Editor

Rehazentrum am Meer, Bad Zwischenahn, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
Interests: vitamin D; osteoporosis; bone metabolism

Dr. Konstantin Horas

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Guest Editor

Department of Orthopaedic Surgery, König Ludwig Haus, Julius-Maximilians University Würzburg, Würzburg, Germany
Interests: vitamin D; osteoporosis; bone metabolism
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Osteopenia and osteoporosis are major clinical problems affecting the population globally. The fragility fractures caused by this disease have a significant socioeconomic impact, leading to high healthcare costs, reduced quality of life, and increased mortality. The pathogenesis of osteopenia and osteoporosis is multifactorial and associated with several risk factors, including vitamin D deficiency.

Vitamin D is a steroid hormone responsible for the regulation of calcium and phosphate metabolism and for maintaining a healthy mineralized skeleton. In addition, it is known to exert various non-skeletal actions due to the presence of the vitamin D receptor (VDR) in most tissues, including the skin, adipose tissue, skeletal muscle, endocrine pancreas, immune cells, breast, blood vessels, and brain. Vitamin D deficiency may modify the function of these organs. Vitamin D deficiency increases the risk of osteoporosis and several other diseases and complications characterized by impaired bone metabolism.

We invite contributions from experts on the treatment and diagnosis of osteopenia and /or osteoporosis. Furthermore, contributions on the newest achievements on vitamin D are invited in order to present recent scientific achievements and update the scientific literature on this topic.

This Special Issue welcomes randomized controlled trials (RCT), cohort studies, and practice-based/real-world evidence/registry studies together with different types of systematic reviews.

Dr. Gerrit Steffen Maier
Dr. Konstantin Horas
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

osteopenia
osteoporosis
vitamin D
bone metabolism
vitamin D deficiency
frailty

Published Papers (6 papers)

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Research

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12 pages, 1244 KiB

Open AccessArticle

Bone Metastases of Diverse Primary Origin Frequently Express the VDR (Vitamin D Receptor) and CYP24A1

by Jonas Seiler, Regina Ebert, Maximilian Rudert, Marietta Herrmann, Ellen Leich, Manuela Weißenberger and Konstantin Horas

J. Clin. Med. 2022, 11(21), 6537; https://doi.org/10.3390/jcm11216537 - 3 Nov 2022

Viewed by 1535

Abstract

Active vitamin D (1,25(OH)2D3) is known to exert direct anti-cancer actions on various malignant tissues through binding to the vitamin D receptor (VDR). These effects have been demonstrated in breast, prostate, renal and thyroid cancers, which all have a high propensity to metastasise to bone. In addition, there is evidence that vitamin D catabolism via 24-hydroxylase (CYP24A1) is altered in tumour cells, thus, reducing local active vitamin D levels in cancer cells. The aim of this study was to assess VDR and CYP24A1 expression in various types of bone metastases by using immunohistochemistry. Overall, a high total VDR protein expression was detected in 59% of cases (39/66). There was a non-significant trend of high-grade tumours towards the low nuclear VDR expression (p = 0.07). Notably, patients with further distant metastases had a reduced nuclear VDR expression (p = 0.03). Furthermore, a high CYP24A1 expression was detected in 59% (39/66) of bone metastases. There was a significant positive correlation between nuclear VDR and CYP24A1 expression (p = 0.001). Collectively, the VDR and CYP24A1 were widely expressed in a multitude of bone metastases, pointing to a potential role of vitamin D signalling in cancer progression. This is of high clinical relevance, as vitamin D deficiency is frequent in patients with bone metastases. Full article

(This article belongs to the Special Issue New Perspectives on Osteopenia, Osteoporosis, and Vitamin D)

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11 pages, 736 KiB

Open AccessArticle

Triglyceride Glucose–Body Mass Index Is a Reliable Indicator of Bone Mineral Density and Risk of Osteoporotic Fracture in Middle-Aged and Elderly Nondiabetic Chinese Individuals

by Zhangxin Wen, Yongfang Li, Lulu Xu, Chun Yue, Qinyi Wang, Rong Chen, Na Ding, Xiaoli Qu, Yangna Ou, Yanyi Yang, Zhifeng Sheng and Hong Liu

J. Clin. Med. 2022, 11(19), 5694; https://doi.org/10.3390/jcm11195694 - 26 Sep 2022

Cited by 7 | Viewed by 1984

Abstract

(1) Background: This study aimed to investigate the relationship of triglyceride glucose–body mass index (TyG-BMI) with bone mineral density (BMD), femoral neck geometry, and risk of fracture in middle-aged and elderly Chinese individuals. (2) Methods: A total of 832 nondiabetic individuals were selected from the prospective population-based HOPE cohort. All individuals underwent DXA for assessment of BMD at the lumbar spine, femoral neck, and total hip, as well as femoral neck geometry. The 10-year probabilities of both major osteoporotic (MOFs) and hip fractures (HFs) were calculated. (3) Results: Cortical thickness, compression strength index, cross-sectional moment of inertia, cross-sectional area, section modulus, and 25(OH)D levels were significantly lower in women (all p < 0.001). The presence of osteoporosis was related to age, BMI, BMD and femoral neck geometry, TyG-BMI, MOF, and HF. TyG-BMI was positively correlated with BMD. In men, TyG-BMI showed significant negative correlation with HF but not with MOF, the correlation exists only after adjusting for other variables in women. Femoral neck geometries were significantly impaired in individuals with low TyG-BMI. (4) Conclusion: TyG-BMI is positively associated with BMD and geometry, and negatively associated with risk of fracture in nondiabetic middle-aged and elderly Chinese men and women. Full article

(This article belongs to the Special Issue New Perspectives on Osteopenia, Osteoporosis, and Vitamin D)

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13 pages, 2046 KiB

Open AccessArticle

Decrease in Bone Formation and Bone Resorption during Intravenous Methylprednisolone Pulse Therapy in Patients with Graves’ Orbitopathy

by Joanna Rymuza, Klaudia Gutowska, Dagmara Kurpios-Piec, Marta Struga and Piotr Miśkiewicz

J. Clin. Med. 2022, 11(17), 5005; https://doi.org/10.3390/jcm11175005 - 26 Aug 2022

Cited by 1 | Viewed by 1168

Abstract

Background: Treatment with glucocorticoids (GCs) is associated with side effects. In contrast to the well-known negative impact on bone tissue exerted by oral GCs, few data are available regarding intravenous GCs. We investigated the influence of intravenous methylprednisolone (IVMP) on bone turnover markers (BTM): amino-terminal propeptide of type I procollagen (P1NP) and the C-terminal telopeptide of type I collagen (CTX), and on calcium metabolism parameters: 1,25-dihydroxyvitamin D (1,25(OH)₂D), 25-hydroxyvitamin D (25(OH)D), calcium (Ca), phosphate (P), and intact parathormone (iPTH). Methods: In a prospective study, 23 consecutive subjects with Graves’ orbitopathy were included and treated with IVMP according to the European Group on Graves’ Orbitopathy recommendations. We evaluated effects on BTM occurring during the first 7 days after 0.5 g IVMP, and after the therapy with 12 IVMP pulses with a cumulative dose of 4.5 g. Results: We observed prompt but transient decrease of P1NP (p < 0.001) and the reduction of CTX (p = 0.02) after the first IVMP pulse. Following the full course of IVMP therapy, both P1NP and CTX were found decreased (p < 0.05 and p < 0.01, respectively). Conclusions: A single pulse of 0.5 g IVMP already decreases bone formation and resorption; however, this change is transient. The full therapy is associated with suppression of bone turnover. Full article

(This article belongs to the Special Issue New Perspectives on Osteopenia, Osteoporosis, and Vitamin D)

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10 pages, 947 KiB

Open AccessArticle

Long-Term Sex-Specific Effects of Cadmium Exposure on Osteoporosis and Bone Density: A 10-Year Community-Based Cohort Study

by Seung Min Chung

J. Clin. Med. 2022, 11(10), 2899; https://doi.org/10.3390/jcm11102899 - 20 May 2022

Cited by 8 | Viewed by 1674

Abstract

This study explored the long-term effects of cadmium (Cd) exposure on osteoporosis incidence and bone mineral density (BMD). This retrospective cohort study included men aged ≥50 years and post-menopausal women from the 2001–2002 Korea Genome and Epidemiology Study. Participants previously diagnosed with osteoporosis were excluded. Blood Cd concentrations were measured and categorized as <0.5, 0.5–1.0, and >1.0 μg/L. BMD was measured using quantitative ultrasound. Osteoporosis was diagnosed when the T-score was ≤−2.5. Confounders that affect exposure and outcome were controlled. Osteoporosis incidence and differences in BMD (ΔBMD) were assessed until 2012. The osteoporosis incidence among 243 participants who were followed up for an average of 6.3 years was 22.2%. In all the participants, a dose–response relationship was observed between blood Cd and incident osteoporosis and ΔBMD (both p-for-trend < 0.01). After adjusting for age, sex, smoking, physical activity, body mass index, creatinine, and baseline BMD, a blood Cd concentration of >1.0 μg/L was an independent risk factor for incident osteoporosis and decrements in ΔBMD. In women, blood Cd concentrations of >0.5 μg/L increased the risk for osteoporosis. Exposure to Cd prospectively increases the risk for osteoporosis and decrements of ΔBMD, particularly in women, even in lower doses of Cd. Full article

(This article belongs to the Special Issue New Perspectives on Osteopenia, Osteoporosis, and Vitamin D)

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Review

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16 pages, 524 KiB

Open AccessReview

Influence of Vitamin D and C on Bone Marrow Edema Syndrome—A Scoping Review of the Literature

by Annette Eidmann, Marius Eisert, Maximilian Rudert and Ioannis Stratos

J. Clin. Med. 2022, 11(22), 6820; https://doi.org/10.3390/jcm11226820 - 18 Nov 2022

Cited by 4 | Viewed by 1826

Abstract

Bone marrow edema syndrome (BMES) is a rare disease with a largely unknown etiology. The aim of this scoping review is to systematically evaluate and combine the available evidence about vitamin D and C and BMES. The analysis of the manuscripts was based on country of origin, number of patients, gender, study type, epidemiology, localization, bone mineral density measurements, vitamin status and therapy. Sixty studies were included. The overall number of patients was 823 with a male-to-female ratio of 1.55:1 and a mean age of 40.9 years. Studies were very heterogeneous and of diverging scientific scope with a weak level of evidence. The hip was the most affected joint, followed by the foot and ankle and the knee; 18.3% of patients suffered from multifocal BMES. Sixteen studies reported on vitamin D levels, resulting in a high prevalence of vitamin D deficiency (47%) and insufficiency (17.9%) among BMES patients. Three BME manuscripts were associated with vitamin C deficiency. Current therapeutic interventions include conservative measures (mainly unloading), various osteoactive drugs and iloprost. In summary, data about BMES in association with vitamin status is limited. A causal relationship between vitamin D or vitamin C status, osteopenia, and BMES cannot be determined from the existing literature. Full article

(This article belongs to the Special Issue New Perspectives on Osteopenia, Osteoporosis, and Vitamin D)

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23 pages, 1666 KiB

Open AccessReview

Pleiotropic Effects of Vitamin D in Patients with Inflammatory Bowel Diseases

by Aleksandra Szymczak-Tomczak, Alicja Ewa Ratajczak, Marta Kaczmarek-Ryś, Szymon Hryhorowicz, Anna Maria Rychter, Agnieszka Zawada, Ryszard Słomski, Agnieszka Dobrowolska and Iwona Krela-Kaźmierczak

J. Clin. Med. 2022, 11(19), 5715; https://doi.org/10.3390/jcm11195715 - 27 Sep 2022

Cited by 3 | Viewed by 2216

Abstract

The multifaceted activity of vitamin D in patients with inflammatory bowel disease (IBD) presents a challenge for further research in this area. Vitamin D is involved in the regulation of bone mineral metabolism, it participates in the regulation of the immune system, and it is an underlying factor in the pathogenesis of IBD. Additionally, vitamin D affects Th1 and Th2 lymphocytes, influencing the release of cytokines and inhibiting tumor necrosis factor (TNF) expression and the wnt/β-catenin pathway. As far as IBDs are concerned, they are associated with microbiota dysbiosis, abnormal inflammatory response, and micronutrient deficiency, including vitamin D hypovitaminosis. In turn, the biological activity of active vitamin D is regulated by the vitamin D receptor (VDR) which is associated with several processes related to IBD. Therefore, in terms of research on vitamin D supplementation in IBD patients, it is essential to understand the metabolic pathways and genetic determinants of vitamin D, as well as to identify the environmental factors they are subject to, not only in view of osteoporosis prevention and therapy, but primarily concerning modulating the course and supplementation of IBD pharmacotherapy. Full article

(This article belongs to the Special Issue New Perspectives on Osteopenia, Osteoporosis, and Vitamin D)

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