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Types of Musculo-Skeletal disorders in elder(2)
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
7. Low back pain
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).
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).
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).
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