248 research outputs found
Nutrients and Dietary Patterns Related to Osteoporosis
Osteoporosis is a common chronic disease characterized by a decrease in bone mineral
density, impaired bone strength, and an increased risk of fragility fractures. Fragility fractures are
associated with significant morbidity, mortality and disability and are a major public health problem
worldwide. The influence of nutritional factors on the development and progression of this disease
can be significant and is not yet well established. Calcium intake and vitamin D status are considered
to be essential for bone metabolism homeostasis. However, some recent studies have questioned the
usefulness of calcium and vitamin D supplements in decreasing the risk of fractures. The adequate
intake of protein, vegetables and other nutrients is also of interest, and recommendations have been
established by expert consensus and clinical practice guidelines. It is important to understand the
influence of nutrients not only in isolation but also in the context of a dietary pattern, which is a
complex mixture of nutrients. In this review, we evaluate the available scientific evidence for the
effects of the main dietary patterns on bone health. Although some dietary patterns seem to have
beneficial effects, more studies are needed to fully elucidate the true influence of diet on bone fragility.Instituto de Salud Carlos III
PI18/01235European Union (EU
Vitamin D Status, Calcium Intake and Risk of Developing Type 2 Diabetes: An Unresolved Issue
The relationship between vitamin D status, calcium intake and the risk of developing
type 2 diabetes (T2D) is a topic of growing interest. One of the most interesting non-skeletal
functions of vitamin D is its potential role in glucose homeostasis. This possible association is
related to the secretion of insulin by pancreatic beta cells, insulin resistance in different tissues and its
influence on systemic inflammation. However, despite multiple observational studies and several
meta-analyses that have shown a positive association between circulating 25-hydroxyvitamin D
concentrations and the risk of T2D, no randomized clinical trials supplementing with different doses
of vitamin D have confirmed this hypothesis definitively. An important question is the identification
of what 25-hydroxyvitamin D levels are necessary to influence glycemic homeostasis and the risk of
developing T2D. These values of vitamin D can be significantly higher than vitamin D levels required
for bone health, but the currently available data do not allow us to answer this question adequately.
Furthermore, a large number of observational studies show that dairy consumption is linked to
a lower risk of T2D, but the components responsible for this relationship are not well established.
Therefore, the importance of calcium intake in the risk of developing T2D has not yet been established.
Although there is a biological plausibility linking the status of vitamin D and calcium intake with the
risk of T2D, well-designed randomized clinical trials are necessary to answer this important question
Wireless sensor networks and structural health monitoring: Experiences with slab track infrastructures
Slab track systems have the potential to become a more sustainable option for high-speed railway infrastructures than traditional ballasted tracks. Traditionally, the systems that monitor these infrastructures have been costly, but advances in the last few decades have made the use of wireless sensor networks within these infrastructures a feasible solution that can be used to evaluate their degradation for failure detection and prediction. Since the cost of these systems is steadily decreasing, it is now possible to use permanent wireless sensor networks as an integral part of the overall system to pave the way for smart infrastructures that can get real-time information about the structural health of the infrastructure at a relatively low cost. In order to show the suitability of this kind of system to monitor the structural health, three demonstrators, developed in the context of the FASTRACK project, related to the design and construction of a monitoring system for slab track systems that measures vibrations and displacements in the track, are presented. FASTRACK uses an innovative approach where data read by sensors are sent to passing trains, which are used as data mules to upload the information to a remote server. On arrival at the station, the data are stored in a database, which is queried by an application to extract relevant information by means of analysis algorithms to detect and predict failures. The first real scenario tests the limits of the system under stress situations. The second one tests the system in an actual, installed slab track to analyze the suitability of the communication architecture and to study a transition zone between slab tracks to a ballast track. The last scenario deals with the data mule performance tests
Osteoglycin as a Potential Biomarker of Mild Kidney Function Impairment in Type 2 Diabetes Patients
Osteoglycin (OGN) could be a biomarker of mild kidney function impairment in type 2 diabetes (T2D). Our study aimed to determine the association between serum OGN and impaired kidney
function risk in T2D patients and to analyze its potential role as an estimator of kidney disturbances
in this population. This cross-sectional study included 147 T2D patients (65 ± 8 years, 58.5% males),
and 75 healthy controls (63 ± 10 years, 36% males). Circulating OGN levels were determined by
ELISA. Linear regression modeling was performed to determine the variables influencing circulating
OGN, and an ROC curve was plotted to assess the usefulness of OGN as an estimator of diabetic
kidney disease risk. Circulating OGN was significantly increased in T2D patients compared to
controls (18.41 (14.45–23.27) ng/mL vs. 8.74 (7.03–12.35) ng/mL; p < 0.001). We found a progressive
increase in serum OGN according to the severity of kidney impairment in T2D patients (normal
kidney function: 16.14 (12.13–20.48) ng/mL; mildly impaired kidney function: 19.15 (15.78–25.90)
ng/mL; moderate impaired kidney function: 21.80 (15.06–29.22) ng/mL; p = 0.006). Circulating OGN
was an independent estimator of mildly impaired kidney function risk in T2D patients. We suggest
that serum OGN could act as an albuminuria-independent biomarker of incipient kidney dysfunction
in T2D patients.Junta de AndalucĂa grants (PI-0207-2016 and PI0268-2019)Instituto de Salud Carlos III grants (PI18-00803 and PI18-01235)European Regional
Development Fund (FEDER)Instituto de Salud Carlos III (FI19/00118; CD20/00022
Obesity and Bone Health: A Complex Relationship
Recent scientific evidence has shown an increased risk of fractures in patients with obesity,
especially in those with a higher visceral adipose tissue content. This contradicts the old paradigm
that obese patients were more protected than those with normal weight. Specifically, in older subjects
in whom there is a redistribution of fat from subcutaneous adipose tissue to visceral adipose tissue and
an infiltration of other tissues such as muscle with the consequent sarcopenia, obesity can accentuate
the changes characteristic of this age group that predisposes to a greater risk of falls and fractures.
Other factors that determine a greater risk in older subjects with obesity are chronic proinflammatory
status, altered adipokine secretion, vitamin D deficiency, insulin resistance and reduced mobility. On
the other hand, diagnostic tests may be influenced by obesity and its comorbidities as well as by body
composition, and risk scales may underestimate the risk of fractures in these patients. Weight loss
with physical activity programs and cessation of high-fat diets may reduce the risk. Finally, more
research is needed on the efficacy of anti-osteoporotic treatments in obese patients.Instituto de Salud Carlos IIIEuropean Commission CD20/00022
PI18-00803
PI21-01069
PI18-01235European CommissionJunta de Andalucia PI-0268-201
Mechanisms Involved in the Relationship between Vitamin D and Insulin Resistance: Impact on Clinical Practice
This research was funded by the Institute of Health Carlos III grants (PI18-00803 and PI18-01235), co-funded by the European Regional Development Fund (FEDER) and Junta de Andalucia (PI-0268-2019). In addition, V.C.-B. and C.G.-F. are funded by postdoctoral fellowships from the Junta de Andalucia and Institute of Health Carlos III respectively (RH-0141-2020; CD20/00022).Recent evidence has revealed anti-inflammatory properties of vitamin D as well as extraskeletal
activity. In this context, vitamin D seems to be involved in infections, autoimmune diseases,
cardiometabolic diseases, and cancer development. In recent years, the relationship between vitamin
D and insulin resistance has been a topic of growing interest. Low 25-hydroxyvitamin D (25(OH)D)
levels appear to be associated with most of the insulin resistance disorders described to date. In fact,
vitamin D deficiency may be one of the factors accelerating the development of insulin resistance.
Vitamin D deficiency is a common problem in the population and may be associated with the pathogenesis
of diseases related to insulin resistance, such as obesity, diabetes, metabolic syndrome (MS)
and polycystic ovary syndrome (PCOS). An important question is the identification of 25(OH)D levels
capable of generating an effect on insulin resistance, glucose metabolism and to decrease the risk of
developing insulin resistance related disorders. The benefits of 25(OH)D supplementation/repletion
on bone health are well known, and although there is a biological plausibility linking the status of
vitamin D and insulin resistance supported by basic and clinical research findings, well-designed
randomized clinical trials as well as basic research are necessary to know the molecular pathways
involved in this association.Institute of Health Carlos III grants PI18-00803
PI18-01235European Commission
Junta de Andalucia PI-0268-2019Instituto de Salud Carlos III RH-0141-2020
CD20/0002
Cardiorespiratory fitness and bone turnover markers in adults with metabolic syndrome: the mediator role of inflammation
The relationship between inflammatory markers and bone turnover in adults is well known, whilst a negative association between cardiorespiratory fitness (CRF) and inflammatory markers has also been described. Hence, we tested whether the association between CRF and bone turnover markers is mediated by inflammatory markers in adults with metabolic syndrome. A total of 81 adults (58.5±5.0 yrs, 62.7% women) were included in the analysis. CRF was measured by the six-minute walking test. Serum interleukine (IL)-1β, IL-6, IL-10, tumor necrosis factor alpha, high-sensitivity c-reactive protein (hsCRP) and vascular endothelial growth factor, collagen type I cross-linked C-telopeptide, procollagen type I N-terminal propeptide (P1NP) and total osteocalcin were assessed using a sensitive ELISA kit. Body composition was assessed by dual-energy x-ray absorptiometry. Partial correlation was used to test the relationship between CRF, inflammatory markers and bone turnover markers, controlling for sex, lean mass and fat mass. Boot-strapped mediation procedures were performed and indirect effects with confidence intervals not including zero were interpreted as statistically significant. CRF was positively correlated with P1NP levels (r=0.228, p=0.044) and osteocalcin levels (r=0.296, p=0.009). Furthermore, CRF was positively correlated with IL-1β levels (r=0.340, p=0.002) and negatively correlated with hsCRP levels (r=-0.335, p=0.003), whereas IL-1β levels were positively correlated with P1NP levels (r=0.245, p=0.030) and hsCRP levels were negatively correlated with P1NP levels (r=-0.319, p=0.004). Finally, the association between CRF and P1NP levels was totally mediated by hsCRP (PM=39.9). Therefore, CRF benefits on bone formation could be dependent on hsCRP concentrations in this population.Heart and Diseases Foundation (Fondation 234 Coeur et Artères) 59200 Loos, Franc
Circulating Undercarboxylated Osteocalcin as Estimator of Cardiovascular and Type 2 Diabetes Risk in Metabolic Syndrome Patients
Undercarboxylated osteocalcin (ucOC) could be a biomarker of glucose disturbances and cardiovascular
risk. Our study aimed to determine the association between serum levels of ucOC and cardiovascular
risk in metabolic syndrome (MetS) patients and to analyse its potential role as estimator of type 2
diabetes (T2D) risk in this population. This cross-sectional study included 235 patients with MetS,
53.2% women, aged 55–75 years. Circulating ucOC levels were measured by ELISA. Cardiovascular risk
was determined as Z-score of the diagnostic criteria for MetS (CV-ZS). Linear regression model was
performed to analyse the association between circulating ucOC and CV-ZS. A receiver operating curve
(ROC) was performed to analyse the usefulness of ucOC as T2D risk estimator. Patients above the CV-ZS
median showed signifcant lower ucOC levels. We found an inverse association between ucOC levels and
CV-ZS in MetS patients without T2D. Patients with ucOC levels below the 25th percentile showed worse
cardiometabolic profle and higher cardiovascular and T2D risk. The area under the curve performed
better when ucOC levels were included along with the classic T2D risk factors. The measurement of
circulating ucOC could be a useful tool to identify increased cardiovascular and T2D risk in MetS patients
without T2D.Junta de Andalucia
PI-0207-2016European Union (EU)
PI18-00803
PI18-0123
The Influence of the Mediterranean Dietary Pattern on Osteoporosis and Sarcopenia
Diet is a modifiable factor in bone and muscle health. The Mediterranean diet (MedDiet) is
rich in nutrients and contains key bioactive components with probable protective effects on muscle
and bone deterioration. Osteoporosis (OP) and sarcopenia are diseases that increase frailty and
susceptibility to fracture, morbidity and mortality. Therefore, it is necessary to combat them in
the population. In this regard, MedDiet adherence has proven to be beneficial to bone mineral
density (BMD), muscle mass, physical function, OP and sarcopenia. Hence, this diet is proposed as a
therapeutic tool that could slow the onset of osteoporosis and sarcopenia. However, there is doubt
about the interaction between the MedDiet, strength and fracture risk. Perhaps the amount of EVOO
(extra virgin olive oil), fruits, vegetables and fish rich in anti-inflammatory and antioxidant nutrients
ingested has an influence, though the results remain controversiaInstitute of Health Carlos III grants (PI21-01069, PI18-01235
and CIBERFES)European Regional Development Fund (FEDER)Junta de AndalucĂa (PI-
0268-2019)Junta de
AndalucĂa and Institute of Health Carlos III, respectively (RH-0141-2020; CD20/00022
Systematic Review of Therapeutic Physical Exercise in Patients with Amyotrophic Lateral Sclerosis over Time
Background: the main objective of this study was to analyze the potential short-, medium- and long-term effects of a therapeutic physical exercise (TFE) programme on the functionality of amyotrophic lateral sclerosis (ALS) patients, measured with the Revised Amyotrophic Lateral Sclerosis Functional Scale (ALSFRS-R) scale. Methods: a systematic review of the PubMed, SCOPUS, Cochrane, Scientific Electronic Library Online (Scielo), Physiotherapy Evidence Database (PEDro), Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Medical Literature Analysis and Retrieval System Online (MEDline) databases was carried out. The information was filtered using the following Medical Subjects Heading (MeSH) terms: "Amyotrophic lateral sclerosis", "Physical Therapy", and "Physical and Rehabilitation Medicine". The internal validity of the selected documents was evaluated using the PEDro scale. The study included clinical trials published in the last 5 years in which one of the interventions was therapeutic physical exercise in patients with ALS, using the ALSFRS-R as the main outcome variable and functional variables as secondary variables. Results: 10 clinical trials were analyzed, with an internal validity of 5-7 points. The TFE groups showed significant short-, medium- and long-term differences, obtaining a mean difference of 5.8 points compared to the 7.6 points obtained by the control groups, at six months, measured with ALSFRS-R. In addition, the participants showed significant improvements in functional abilities in the short, medium and long terms. Conclusions: Therapeutic physical exercise could contribute to slowing down the deterioration of the musculature of patients with ALS, thus facilitating their performance in activities of daily living, based on the significant differences shown by these individuals in the short, medium and long term both in subjective perception, measured with ALSFRS-R, and functional capacities
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