Saturday, 5 December 2015

Most Common Diseases of elder: The Clinical Trials and Studies of Musculo-Skeletal disorders: Osteoporosis - The Antioxidant Vitamins

Kyle J. Norton (Scholar)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are  medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. According to a community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home, musculoskeletal pain was reported by 57% of those interviewed(1).

      Types of Musculo-Skeletal disorders in elder(2)

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia


Osteoporosis is defined as a condition of thinning of bone and bone tissues as a result of the loss of bone density over a long period of time. It is a widespread degenerative disease of skeletal joints and often associated with senescence in vertebrates due to excessive or abnormal mechanical loading of weight-bearing joints, arising from heavy long-term use or specific injuries(6).

                               The Prevention and Management 
The prevention and management of osteoporosis are always important due to the prevalent of the diseases in  in all populations and all ages(221), especially to elder, causing a significant physical, psychosocial, and financial consequences(220).

Antioxidants and Osteoporosis

Oxidative stress can induce impairment of bone mass and fragility fractures through its effects in causing apoptosis in osteoblasts, due to continuously generated of reactive oxygen species (ROS), such as H2O2-induced oxidative damage-implications(246) involved lipid peroxidation, protein damage, and DNA lesions of that exhibit the increased risk of osteoporosis(245)(248).
Antioxidant enzymes, including superoxide dismutase, glutathione peroxidase, and catalase reduced the excessive production of free radicals in the organism, and the imbalance between the concentrations of these and the antioxidant defenses have found to attenuate the risk of osteoporosis (OP) in postmenopausal women, according to the study by the Adnan Menderes University School of Medicine(247). Further more, decrease antioxidant defenses due to aging may also may contribute to this process(250).
Dietary and endogenous antioxidants were consistently lower in patients with osteoporosis, according to University of Perugia, of that can lead to decrease antioxidant defenses and promoting pathogenesis of osteoporosis(249).

The  Antioxidant Vitamins
1. Vitamin C
The one of free radical scavenger with function in remove or de-activate impurities and unwanted reaction of oxygen species plays an important role in antioxidant defense in reduced risk of osteoporosis, in a study of 75 subjects with osteoporosis and 75 controls(249).
In a 17-year follow-up from the Framingham Osteoporosis Study, dietary vitamin C has found to exhibit a protective effect on bone health in older adults(251), with significantly fewer hip fractures and non-vertebral fractures(251). In oxidative stress, Not orally, administration of vitamin C may prevent osteoporosis in menopausal women at high doses to postmenopausal women throguhplasma antioxidant activity(252).
The The University of Melbourne study insisted that antioxidant vitamin E or C supplements may suppress bone resorption in nonsmoking postmenopausal women, by improved bone formation and resorption(253).

2. Vitamin A
Low retinol concentrations, a derivative of vitamin A may associated to modest fracture risk in adjustment for BMI and serum concentrations of α-tocopherol(254). According to the study by University of Sheffield, serum retinol, retinyl palmitate, and beta-carotene found in multivitamin or cod liver oil supplementation may induce lower risk of fracture depending to age, total hip BMD(255). Dr. Crandall C. said" Retinol intake from diet or supplements is negatively associated with lumbar, femoral neck, and trochanter bone mineral density (BMD),....(But) it is not yet possible to set a specific level of retinol intake above which bone health is compromised" (256).
According to the UMDNJ-Robert Wood Johnson Medical School, deficiency of vitamin A and other dietary factors, such as protein, vitamin K, phytoestrogens, and other nutrients, -might also contribute to the risk for osteoporosis(257).

3. Vitamin D
Vitamin D, found abundantly when exposed your skin on sunlight and played an essential role in the absorption of calcium has been found to have a beneficiary effect on patient with osteoporosis. Dr. Gennari C. said" daily intake of 700-800 mg of calcium and 400-800 IU of vitamin D. This is an effective, safe and cheap means of preventing osteoporotic fractures"(258).
In a cross-sectional study involved 2942 men and 7158 women aged 40-75 years, deficiency of vitamin D (serum 25(OH)D levels below 20ng/mL) found in in 75.2% of the entire study population. is associated to significantly high prevalence of osteoporosis risk(259)(260).
Ovariectomy, corticosteroid therapy and calcium/phosphorus/vitamin D-deficient diet in the aging population, has shown to induce risk of osteoporosis(261).
According to Italian Society for Osteoporosis "The highest tolerated daily dose has been identified as 4,000 IU/day. Vitamin D supplementation should be carefully monitored in patients at higher risk of vitamin D intoxication (granulomatosis) or with primary hyperparathyroidism"(262).

4. Vitamin E
Lower serum of vitamin E  and  vitamin E:lipid ratio levels are associated with osteoporosis in early postmenopausal women through reduced bone mineral density(BMD)(263). In acommunity-dwelling elderly people in Taiwan and in postmenopausal women of Northwest India studies, vitamin D receptor (VDR) variability such as gene polymorphism and physical activity are associated to low handgrip strength (LHS) and osteoporosis (OST)(264)(265).
In fact, the imbalance of osteoclastic and osteoblastic activities in osteoporosis, may be prevented with with prolonged intake of antioxidant vitamin supplementation(266), the study Patil Medical College and Hospital suggested.

5. Vitamin K
Synthetic vitamin K2  found to associate to the inverse correlation between the changes of lumbar bone mineral density and serum undercarboxylated osteocalcin in children treated with glucocorticoid and alfacalcidol(268) has been used in therapy for treatment of osteoporosis, especially in the prevention of fractures in postmenopausal women, as it modestly increased lumbar spine BMD, and reduced the incidence of fractures (mainly vertebral fracture),..(267). Short-term effect of vitamin K administration improved BMD of the lumbar spine associated with suppression of both bone formation and bone resorption(269) and dietary of synthetic vitamins K2 and D3 induced protective effects through decreased bone mineral density(270) in patients with chronic glomerulonephritis, the Hamamatsu University School of Medicine suggested

Ovarian Cysts And PCOS Elimination

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(1) Prevalence of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China: a COPCORD study by Dai SM1, Han XH, Zhao DB, Shi YQ, Liu Y, Meng JM.(PubMed)
(2) Musculoskeletal Disorders in the Elderly by Ramon Gheno, Juan M. Cepparo, Cristina E. Rosca,1 and Anne Cotten(PMC)
(3) Osteoporosis(Life extension)
(5) Growth hormone and bone by Ohlsson C1, Bengtsson BA, Isaksson OG, Andreassen TT, Slootweg MC.(PubMed)
(6) GH and bone--experimental and clinical studies by Isaksson OG1, Ohlsson C, Bengtsson BA, Johannsson G.(PubMed)
(205) New advances in imaging osteoporosis and its complications by Griffith JF1, Genant HK.(PubMed)
(207) Severe osteoporosis: diagnosis of non-hip non-vertebral (NHNV) fractures by Giovanni D’Elia,1 Giuliana Roselli,1 Loredana Cavalli,2 Paolo Innocenti,1 and Maria Luisa Brandi2(PubMed)
(208) Whole bone geometry and bone quality in distal forearm fracture by Parkinson IH1, Fazzalari NL.(PubMed)
(209) Vitamin K2 (menatetrenone) effectively prevents fractures and sustains lumbar bone mineral density inosteoporosis by Shiraki M1, Shiraki Y, Aoki C, Miura M.(PubMed)
(210) Short-term menatetrenone therapy increases gamma-carboxylation of osteocalcin with a moderate increase ofbone turnover in postmenopausal osteoporosis: a randomized prospective study by Shiraki M1, Itabashi A.(PubMed)
(211) Association of Body Weight and Body Mass Index with Bone Mineral Density in Women and Men from Kosovo by Rexhepi S1, Bahtiri E2, Rexhepi M1, Sahatciu-Meka V3, Rexhepi B1.(PubMed)
(212) Should we prescribe calcium or vitamin D supplements to treat or prevent osteoporosis? by Bolland MJ1, Grey A1, Reid IR1.(PubMed)
(246) Hydrogen sulfide protects MC3T3-E1 osteoblastic cells against H2O2-induced oxidative damage-implications for the treatment of osteoporosis by Xu ZS1, Wang XY, Xiao DM, Hu LF, Lu M, Wu ZY, Bian JS.(PubMed)
(247) Antioxidant status in patients with osteoporosis: a controlled study by Sendur OF1, Turan Y, Tastaban E, Serter M.(PubMed)
(248) Role of antioxidant systems, lipid peroxidation, and nitric oxide in postmenopausal osteoporosis by Ozgocmen S1, Kaya H, Fadillioglu E, Aydogan R, Yilmaz Z.(PubMed)
(249) Marked decrease in plasma antioxidants in aged osteoporotic women: results of a cross-sectional study by Maggio D1, Barabani M, Pierandrei M, Polidori MC, Catani M, Mecocci P, Senin U, Pacifici R, Cherubini A.(PubMed)
(250) Alterations of antioxidant enzymes and oxidative stress markers in aging by Kasapoglu M1, Ozben T.(PubMed)
(251) Protective effect of total and supplemental vitamin C intake on the risk of hip fracture--a 17-year follow-up from the Framingham Osteoporosis Study by Sahni S1, Hannan MT, Gagnon D, Blumberg J, Cupples LA, Kiel DP, Tucker KL.(PubMed)
(252) Exploiting the antioxidant potential of a common vitamin: could vitamin C prevent postmenopausal osteoporosis? by Talaulikar VS1, Chambers T, Manyonda I.(PubMed)
(253) Antioxidant vitamin supplements and markers of bone turnover in a community sample of nonsmoking women by Pasco JA1, Henry MJ, Wilkinson LK, Nicholson GC, Schneider HG, Kotowicz MA.(PubMed)
(254) No increase in risk of hip fracture at high serum retinol concentrations in community-dwelling older Norwegians: the Norwegian Epidemiologic Osteoporosis Studies by Holvik K1, Ahmed LA2, Forsmo S3, Gjesdal CG4, Grimnes G5, Samuelsen SO6, Schei B7, Blomhoff R8, Tell GS9, Meyer HE10.(PubMed)
(255) Serum retinoids and beta-carotene as predictors of hip and other fractures in elderly women by Barker ME1, McCloskey E, Saha S, Gossiel F, Charlesworth D, Powers HJ, Blumsohn A.(PubMed)
(256) Vitamin A intake and osteoporosis: a clinical review by Crandall C1.(PubMed)
(257) Bones and nutrition: common sense supplementation for osteoporosis by Advani S1, Wimalawansa SJ.(PubMed)
(258) Calcium and vitamin D nutrition and bone disease of the elderly by Gennari C1(PubMed)
(259) High prevalence of vitamin D deficiency among middle-aged and elderly individuals in northwestern China: its relationship to osteoporosis and lifestyle factors by Zhen D1, Liu L2, Guan C3, Zhao N4, Tang X5.(PubMed)
(259) Vitamin D deficiency in northern Vietnam: prevalence, risk factors and associations with bone mineral density by Nguyen HT1, von Schoultz B, Nguyen TV, Dzung DN, Duc PT, Thuy VT, Hirschberg AL.(PubMed)
(260) Vitamin D deficiency and aging: implications for general health and osteoporosis by Eriksen EF1, Glerup H(PubMed)
(261) The standardized creation of a lumbar spine vertebral compression fracture in a sheep osteoporosis model induced by ovariectomy, corticosteroid therapy and calcium/phosphorus/vitamin D-deficient diet by Eschler A1, Röpenack P2, Herlyn PK2, Roesner J3, Pille K2, Büsing K4, Vollmar B5, Mittlmeier T2, Gradl G6.(PubMed)
(262) [Guidelines on prevention and treatment of vitamin D deficiency. Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS)].[Article in Italian] by Adami S1, Romagnoli E, Carnevale V, Scillitani A, Giusti A, Rossini M, Gatti D, Nuti R, Minisola S; Italian Society for Osteoporosis, Mineral Metabolism and Bone Diseases (SIOMMMS).(PubMed)
(263) Lower vitamin E serum levels are associated with osteoporosis in early postmenopausal women: a cross-sectional study by Mata-Granados JM1, Cuenca-Acebedo R, Luque de Castro MD, Quesada Gómez JM.(PubMed)
(264) Vitamin D receptor variability and physical activity are jointly associated with low handgrip strength andosteoporosis in community-dwelling elderly people in Taiwan: the Taichung Community Health Study for Elders (TCHS-E) by Wu FY1, Liu CS, Liao LN, Li CI, Lin CH, Yang CW, Meng NH, Lin WY, Chang CK, Hsiao JH, Li TC, Lin CC.(PubMed)
(265) Vitamin D receptor (VDR) gene polymorphism influences the risk of osteoporosis in postmenopausal women of Northwest India by Singh M1, Singh P, Singh S, Juneja PK, Kaur T.(PubMed)
(266) Effect of supplementation of vitamin C and E on oxidative stress in osteoporosis by Chavan SN1, More U, Mulgund S, Saxena V, Sontakke AN.(PubMed)
(267) Vitamin K₂ therapy for postmenopausal osteoporosis by Iwamoto J1.(PubMed)
(268) Inverse correlation between the changes of lumbar bone mineral density and serum undercarboxylated osteocalcin after vitamin K2 (menatetrenone) treatment in children treated with glucocorticoid and alfacalcidol by Inoue T1, Sugiyama T, Matsubara T, Kawai S, Furukawa S.(PubMed)
(269) Short-term effect of vitamin K administration on prednisolone-induced loss of bone mineral density in patients with chronic glomerulonephritis by Yonemura K1, Kimura M, Miyaji T, Hishida A.(PubMed)
(270) Protective effect of vitamins K2 and D3 on prednisolone-induced loss of bone mineral density in the lumbar spine by Yonemura K1, Fukasawa H, Fujigaki Y, Hishida A.(PubMed)

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