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  1. Fulltext A Review on the Role of Denosumab in Fracture Prevention
    Pang KL, Low NY, Chin KY
    Drug Des Devel Ther, 2020;14:4029-4051.
    PMID: 33061307 DOI: 10.2147/DDDT.S270829
    Denosumab is a receptor activator of nuclear factor kappa-Β ligand inhibitor, which suppresses the bone resorption process to preserve bone mass. It is usually recommended to postmenopausal women and men with high fracture risk. With the recent publication of the results from FREEDOM study and its extension, the long-term effect of denosumab in preventing fragility fractures has been put forward. This review aims at summarising the evidence of denosumab in reducing fracture risk and its safety derived from clinical studies. Most of the evidence are derived from FREEDOM trials up to 10 years of exposure. Denosumab is reported to prevent vertebral and non-vertebral fractures. It is also proven effective in Japanese women, patients with chronic kidney diseases and breast cancer patients receiving antineoplastic therapy. Denosumab discontinuation leads to high remodeling, loss of bone mineral density and increased fracture risk. These negative effects might be preventable by bisphosphonate treatment. The safety profile of denosumab is consistent with increased years of exposure. In conclusion, denosumab is a safe and effective option for reducing fracture risk among patients with osteoporosis.
    Matched MeSH terms: Osteoporosis/prevention & control*
  2. Therapeutic effect of Vitamin E in preventing bone loss: An evidence-based review
    Nazrun Shuid A, Das S, Mohamed IN
    Int J Vitam Nutr Res, 2019 Nov;89(5-6):357-370.
    PMID: 30856080 DOI: 10.1024/0300-9831/a000566
    The present review explored the anti-inflammatory and immunomodulatory properties of vitamin E, which has protective action against osteoporosis. A systematic review of the literature was conducted to identify the published bone studies on vitamin E. The studies included inflammatory or immunology-related parameters. Medline and Scopus databases were searched for relevant studies published from 2005 till 2015. Research articles published in English and confined to the effect of vitamin E on bone were included. It is pertinent to mention that these studies took into consideration inflammatory or immunology parameters including interleukin (IL)-1, IL-6, receptor activator of nuclear factor kappa-B ligand (RANKL), inducible nitric oxide synthases (iNOS), serum amyloid A (SAA), e-selection and high-sensitivity C-reactive protein (hs-CRP). An extended literature search yielded 127 potentially relevant articles with seven articles meeting the inclusion and exclusion criteria. Another recent article was added with the total number accounting to eight. All these included literature comprised five animal studies, one in-vitro study and two human studies. These studies demonstrated that vitamin E, especially tocotrienol, was able to alleviate IL-1, IL-6, RANKL, iNOS and hs-CRP levels in relation to bone metabolism. In conclusion, vitamin E exerts its anti-osteoporotic actions via its anti-inflammatory and immunomodulatory effects.
    Matched MeSH terms: Osteoporosis/prevention & control*
  3. The use of selective estrogen receptor modulators on bone health in men
    Wong SK, Mohamad NV, Jayusman PA, Shuid AN, Ima-Nirwana S, Chin KY
    Aging Male, 2019 Jun;22(2):89-101.
    PMID: 29508640 DOI: 10.1080/13685538.2018.1448058
    Selective estrogen receptor modulators (SERMs) represent a class of drugs that act as agonist or antagonist for estrogen receptor in a tissue-specific manner. The SERMs drugs are initially used for the prevention and treatment of osteoporosis in postmenopausal women. Bone health in prostate cancer patients has become a significant concern, whereby patients undergo androgen deprivation therapy is often associated with deleterious effects on bone. Previous preclinical and epidemiological findings showed that estrogens play a dominant role in improving bone health as compared to testosterone in men. Therefore, this evidence-based review aims to assess the available evidence derived from animal and human studies on the effects of SERMs on the male skeletal system. The effects of SERMs on bone mineral density (BMD)/content (BMC), bone histomorphometry, bone turnover, bone strength and fracture risk have been summarized in this review.
    Matched MeSH terms: Osteoporosis/prevention & control*
  4. Fulltext The Effects of Vitamin E from Elaeis guineensis (Oil Palm) in a Rat Model of Bone Loss Due to Metabolic Syndrome
    Wong SK, Chin KY, Suhaimi FH, Ahmad F, Ima-Nirwana S
    Int J Environ Res Public Health, 2018 08 24;15(9).
    PMID: 30149518 DOI: 10.3390/ijerph15091828
    The beneficial effects of vitamin E in improving components of MetS or bone loss have been established. This study aimed to investigate the potential of palm vitamin E (PVE) as a single agent, targeting MetS and bone loss concurrently, using a MetS animal model. Twelve-week-old male Wistar rats were divided into five groups. The baseline group was sacrificed upon arrival. The normal group was given standard rat chow. The remaining three groups were fed with high-carbohydrate high-fat (HCHF) diet and treated with tocopherol-stripped corn oil (vehicle), 60 mg/kg or 100 mg/kg PVE. At the end of the study, the rats were evaluated for MetS parameters and bone density. After euthanasia, blood and femurs were harvested for the evaluation of lipid profile, bone histomorphometric analysis, and remodeling markers. PVE improved blood pressure, glycemic status, and lipid profile; increased osteoblast surface, osteoid surface, bone volume, and trabecular thickness, as well as decreased eroded surface and single-labeled surface. Administration of PVE also significantly reduced leptin level in the HCHF rats. PVE is a potential agent in concurrently preventing MetS and protecting bone loss. This may be, in part, achieved by reducing the leptin level and modulating the bone remodeling activity in male rats.
    Matched MeSH terms: Osteoporosis/prevention & control*
  5. Fulltext Effect of tocotrienol from Bixa orellana (annatto) on bone microstructure, calcium content, and biomechanical strength in a model of male osteoporosis induced by buserelin
    Mohamad NV, Ima-Nirwana S, Chin KY
    Drug Des Devel Ther, 2018;12:555-564.
    PMID: 29588572 DOI: 10.2147/DDDT.S158410
    Background: Patients receiving androgen deprivation therapy experience secondary hypogonadism, associated bone loss, and increased fracture risk. It has been shown that tocotrienol from Bixa orellana (annatto) prevents skeletal microstructural changes in rats experiencing primary hypogonadism. However, its potential in preventing bone loss due to androgen deprivation therapy has not been tested. This study aimed to evaluate the skeletal protective effects of annatto tocotrienol using a buserelin-induced osteoporotic rat model.

    Methods: Forty-six male Sprague Dawley rats aged 3 months were randomized into six groups. The baseline control (n=6) was sacrificed at the onset of the study. The normal control (n=8) received corn oil (the vehicle of tocotrienol) orally daily and normal saline (the vehicle of buserelin) subcutaneously daily. The buserelin control (n=8) received corn oil orally daily and subcutaneous buserelin injection (75 µg/kg) daily. The calcium control (n=8) was supplemented with 1% calcium in drinking water and daily subcutaneous buserelin injection (75 µg/kg). The remaining rats were given daily oral annatto tocotrienol at 60 mg/kg (n=8) or 100 mg/kg (n=8) plus daily subcutaneous buserelin injection (75 µg/kg) (n=8). At the end of the experiment, the rats were euthanized and their blood, tibia, and femur were harvested. Structural changes of the tibial trabecular and cortical bone were examined using X-ray micro-computed tomography. Femoral bone calcium content and biomechanical strength were also evaluated.

    Results: Annatto tocotrienol at 60 and 100 mg/kg significantly prevented the deterioration of trabecular bone and cortical thickness in buserelin-treated rats (P<0.05). Both doses of annatto tocotrienol also improved femoral biomechanical strength and bone calcium content in buserelin-treated rats (P<0.05). The effects of annatto tocotrienol were comparable to calcium supplementation.

    Conclusion: Annatto tocotrienol supplementation is effective in preventing degeneration of the bone induced by buserelin. Therefore, it is a potential antiosteoporotic agent for men receiving androgen deprivation therapy.

    Matched MeSH terms: Osteoporosis/prevention & control*
  6. The Role of Dietary Compounds in the Therapy of Nicotine-Induced Osteoporosis
    Mohamed N, Muhammad N, Shuid AN, Soelaiman IN
    Curr Drug Targets, 2018;19(12):1424-1430.
    PMID: 28950810 DOI: 10.2174/1389450118666170925154428
    Nicotine is one of the most abused substances worldwide and can cause several harmful effects on health. One of the harmful effects, which is often ignored, is osteoporosis. Smoking has been shown to cause a decrease in bone mineral density in humans. Animal studies have proven that nicotine exerts negative effects on bone. The number of people who smoke increases each day. Those who smoke start at a very young age and they usually smoke for years. This will increase the risk of developing osteoporosis. As the prevalence of osteoporosis increases, the risk of fractures also increases. The major concerns are disability following fractures, mortality due to complications after fractures and the increasing cost of management and therapy. This paper will review the effects of nicotine on bone and the potential natural products which can be used as treatment for nicotine-induced osteoporosis.
    Matched MeSH terms: Osteoporosis/prevention & control
  7. Tocotrienols for bone health: a translational approach
    Shen CL, Klein A, Chin KY, Mo H, Tsai P, Yang RS, et al.
    Ann N Y Acad Sci, 2017 Aug;1401(1):150-165.
    PMID: 28891093 DOI: 10.1111/nyas.13449
    Osteoporosis, a degenerative bone disease, is characterized by low bone mass and microstructural deterioration of bone tissue resulting in aggravated bone fragility and susceptibility to fractures. The trend of extended life expectancy is accompanied by a rise in the prevalence of osteoporosis and concomitant complications in the elderly population. Epidemiological evidence has shown an association between vitamin E consumption and the prevention of age-related bone loss in elderly women and men. Animal studies show that ingestion of vitamin E, especially tocotrienols, may benefit bone health in terms of maintaining higher bone mineral density and improving bone microstructure and quality. The beneficial effects of tocotrienols on bone health appear to be mediated via antioxidant/anti-inflammatory pathways and/or 3-hydroxy-3-methylglutaryl coenzyme A mechanisms. We discuss (1) an overview of the prevalence and etiology of osteoporosis, (2) types of vitamin E (tocopherols versus tocotrienols), (3) findings of tocotrienols and bone health from published in vitro and animal studies, (4) possible mechanisms involved in bone protection, and (5) challenges and future direction for research.
    Matched MeSH terms: Osteoporosis/prevention & control*
  8. Fulltext A qualitative study of community pharmacists' opinions on the provision of osteoporosis disease state management services in Malaysia
    Nik J, Lai PS, Ng CJ, Emmerton L
    BMC Health Serv Res, 2016 08 30;16:448.
    PMID: 27577560 DOI: 10.1186/s12913-016-1686-x
    BACKGROUND: Osteoporosis has significant impact on healthcare costs and quality of life. Amongst the models for collaborative disease state management services published internationally, there is sparse evidence regarding the role of community pharmacists in the provision of osteoporosis care. Hence, the aim of our study was to explore community pharmacists' opinions (including the barriers and facilitators) and scope of osteoporosis disease state management services by community pharmacists in Malaysia, informing a vision for developing these services.

    METHODS: Semi-structured individual interviews and focus groups discussions were conducted with community pharmacists from October 2013 to July 2014. Three trained researchers interviewed the participants. Interviews were recorded and transcribed verbatim. Data were analyzed thematically using an interpretative description approach.

    RESULTS: Nineteen community pharmacists with 1-23 years of experience were recruited (in depth interviews: n = 9; focus group discussions: n = 10). These participants reflected on their experience with osteoporosis-related enquiries, which included medication counseling, bone density screening and referral of at-risk patients. Key barriers were the lack of numerous factors: public awareness of osteoporosis, accurate osteoporosis screening tools for community pharmacists, pharmacists' knowledge on osteoporosis disease and medications, time to counsel patients about bone health, collaboration between pharmacists and doctors, and support from the government and professional body. The pharmacists wanted more continuing education on osteoporosis, osteoporosis awareness campaigns, a simple, unbiased osteoporosis education material, and inter-professional collaboration practices with doctors, and pharmacists' reimbursement for osteoporosis care.

    CONCLUSIONS: The involvement of community pharmacists in the provision of osteoporosis disease state management was minimal. Only ad-hoc counseling on osteoporosis prevention was performed by community pharmacists. Development and trial of collaborative osteoporosis disease state management services in community pharmacy could be facilitated by training, support and remuneration.
    Matched MeSH terms: Osteoporosis/prevention & control
  9. Fulltext Olives and Bone: A Green Osteoporosis Prevention Option
    Chin KY, Ima-Nirwana S
    Int J Environ Res Public Health, 2016 Jul 26;13(8).
    PMID: 27472350 DOI: 10.3390/ijerph13080755
    Skeletal degeneration due to aging, also known as osteoporosis, is a major health problem worldwide. Certain dietary components confer protection to our skeletal system against osteoporosis. Consumption of olives, olive oil and olive polyphenols has been shown to improve bone health. This review aims to summarize the current evidence from cellular, animal and human studies on the skeletal protective effects of olives, olive oil and olive polyphenols. Animal studies showed that supplementation of olives, olive oil or olive polyphenols could improve skeletal health assessed via bone mineral density, bone biomechanical strength and bone turnover markers in ovariectomized rats, especially those with inflammation. The beneficial effects of olive oil and olive polyphenols could be attributed to their ability to reduce oxidative stress and inflammation. However, variations in the bone protective, antioxidant and anti-inflammatory effects between studies were noted. Cellular studies demonstrated that olive polyphenols enhanced proliferation of pre-osteoblasts, differentiation of osteoblasts and decreased the formation of osteoclast-like cells. However, the exact molecular pathways for its bone health promoting effects are yet to be clearly elucidated. Human studies revealed that daily consumption of olive oil could prevent the decline in bone mineral density and improve bone turnover markers. As a conclusion, olives, olive oil and its polyphenols are potential dietary interventions to prevent osteoporosis among the elderly.
    Matched MeSH terms: Osteoporosis/prevention & control*
  10. Bisphosphonates, healthcare professionals and oral health
    Raj DV, Abuzar M, Borromeo GL
    Gerodontology, 2016 Mar;33(1):135-43.
    PMID: 25039439 DOI: 10.1111/ger.12141
    OBJECTIVE: General medical and dental practitioner and pharmacists all encounter patients on bisphosphonates and as such require adequate knowledge regarding osteonecrosis of the jaw, a potential complication associated with its use. The cross-sectional study investigated perceived implications of and attitudes towards bisphosphonate use in oral health among general medical and dental practitioners and pharmacists.
    MATERIALS AND METHODS: Medical and dental practitioners and pharmacists registered in Victoria, Australia, completed an online survey (SurveyMonkey©). Data analysis consisted of chi-square tests with significance as p < 0.05.
    RESULTS: One hundred and thirty six doctors (general medical practitioners, GMPs), 283 dentists (GDPs) and 26 pharmacists (PHs) participated. 70, 38 and 80%, respectively, reviewed patients prescribed bisphosphonates (BPs). GMPs (88%), GDPs (76%) and PHs (85%) were aware of osteonecrosis of the jaws (ONJ). GMPs (76%) and PHs (100%) advised patients to inform dentists. GMPs (45%) referred patients for dental assessments prior to commencing BPs with 71.9% of GDPs received such referrals. In terms of available information on oral health and BPs, GMPs (56%), GDPs (50%) and PH (53.8%) were either unsure any existed or reported receiving sufficient information.
    CONCLUSIONS: Discrepancies exist amongst different healthcare professionals in terms of BP use and oral health, and common consensus guidelines are warranted.
    KEYWORDS: bisphosphonates; clinical guidelines; drug therapy; oral health; osteonecrosis.
    Matched MeSH terms: Osteoporosis/prevention & control
  11. Fulltext The effects of α-tocopherol on bone: a double-edged sword?
    Chin KY, Ima-Nirwana S
    Nutrients, 2014 Apr 10;6(4):1424-41.
    PMID: 24727433 DOI: 10.3390/nu6041424
    Recent studies have found conflicting evidence on the role of α-tocopherol (αTF) on bone health. This nonsystematic review aimed to summarize the current evidence on the effects of αTF on bone health from cell culture, animal, and human studies in order to clarify the role of αTF on bone health. Our review found that αTF exerted beneficial, harmful or null effects on bone formation cells. Animal studies generally showed positive effects of αTF supplementation on bone in various models of osteoporosis. However, high-dose αTF was possibly detrimental to bone in normal animals. Human studies mostly demonstrated a positive relationship between αTF, as assessed using high performance liquid chromatography and/or dietary questionnaire, and bone health, as assessed using bone mineral density and/or fracture incidence. Three possible reasons high dosage of αTF can be detrimental to bone include its interference with Vitamin K function on bone, the blocking of the entry of other Vitamin E isomers beneficial to bone, and the role of αTF as a prooxidant. However, these adverse effects have not been shown in human studies. In conclusion, αTF may have a dual role in bone health, whereby in the appropriate doses it is beneficial but in high doses it may be harmful to bone.
    Matched MeSH terms: Osteoporosis/prevention & control
  12. Novel agents in the treatment of osteoporosis
    Shuid AN, Ima Nirwana S, Das S
    Curr Drug Targets, 2013 Dec;14(14):1631.
    PMID: 24383964
    Matched MeSH terms: Osteoporosis/prevention & control
  13. Can soy prevent male osteoporosis? A review of the current evidence
    Chin KY, Ima-Nirwana S
    Curr Drug Targets, 2013 Dec;14(14):1632-41.
    PMID: 24354587
    The Asian population whose soy intake is higher compared to Western populations shows a significantly lower incidence of osteoporotic fracture. Several meta-analyses have revealed that supplementation of soy isoflavones improve bone health status in women. This review examined the current evidence as to whether soy could exhibit similar bone protective effects on the male population. In vivo studies revealed that supplementation of soy protein or soy isoflavones improved bone health in both normal and osteoporotic male rodents. Cell culture studies showed that soy isoflavones influenced osteogenesis and osteoclastogenesis through mechanisms such as estrogen receptor binding activity, antiinflammatory activity and anti-parathyroid hormone activity. Soy isoflavones also affected calcium channel signaling and might exhibit direct effects on the osteoblastogenesis modulator, core binding factor 1. However, limited clinical trials involving soy intervention in males generally showed insignificant results. This could be attributed to the short duration of intervention, characteristics of the subjects or method of bone health assessment. More well-planned clinical trials are required to establish possible bone protective effects of soy in men.
    Matched MeSH terms: Osteoporosis/prevention & control*
  14. Psychometric properties and osteoprotective behaviors among type 2 diabetic patients: osteoporosis self-efficacy scale Malay version (OSES-M)
    Abdulameer SA, Syed Sulaiman SA, Hassali MA, Subramaniam K, Sahib MN
    Osteoporos Int, 2013 Mar;24(3):929-40.
    PMID: 22790611 DOI: 10.1007/s00198-012-2071-1
    In type 2 diabetic patients (T2DM), only 22 % have normal bone mineral density and almost three quarters of the sample population had low self-efficacy towards osteoporosis. These results reflect the need for screening and educational programs to increase the awareness of T2DM towards osteoporosis.
    INTRODUCTION: Our aim was to translate and examine the psychometric properties of the Malay version of the osteoporosis self-efficacy scale (OSES-M) among T2DM and to determine the best cut-off value with optimum sensitivity and specificity. In addition, to assess factors that affects diabetic patients' osteoporosis self-efficacy.
    METHODS: A standard "forward-backward" procedure was used to translate the OSES into Malay language, which was then validated with a convenience sample of 250 T2DM. The sensitivity and specificity of the OSES-M was calculated using receiver operating characteristic curve analysis. Bivariate and multivariate approaches were used to examine multiple independent variables on each dependent variable.
    RESULTS: The mean score of OSES-M was 731.74 ± 197.15. Fleiss' kappa, content validity ratio range, and content validity index were 0.99, 0.75-1, and 0.96, respectively. Two factors were extracted from exploratory factor analysis and were confirmed through confirmatory factor analysis. Internal consistency and test-retest reliability were 0.92 and 0.86, respectively. The optimum cut-off point of OSES-M to predict osteoporosis/osteopenia was 858. Regression analysis revealed that knowledge, health belief, and some demographic data had an impact on OSES-M.
    CONCLUSIONS: The results show that the OSES-M is a reliable and valid instrument for measuring osteoporosis self-efficacy in the Malaysian clinical setting.
    Matched MeSH terms: Osteoporosis/prevention & control*
  15. Fulltext Bone mineral density loss, osteoporosis, and fractures in HIV
    Labarga P
    AIDS Rev, 2013 Jul-Sep;15(3):189-90.
    PMID: 24002203
    The link between HIV and reduced bone mineral density, including osteopenia and the more severe osteoporosis, is well established. HIV infection has also been associated with an increased risk of fractures. It is so far unclear whether this is due to HIV itself, resulting inflammatory and metabolic changes, antiretroviral toxicity, or some combination of factors. This topic was the focus of major debate at the 7th IAS Conference held in Kuala Lumpur, Malaysia, in early July 2013.
    Matched MeSH terms: Osteoporosis/prevention & control
  16. Protective effects of Tualang honey on bone structure in experimental postmenopausal rats
    Zaid SS, Sulaiman SA, Othman NH, Soelaiman IN, Shuid AN, Mohamad N, et al.
    Clinics (Sao Paulo), 2012 Jul;67(7):779-84.
    PMID: 22892923
    OBJECTIVE: The objective of this study was to evaluate the effects of Tualang honey on trabecular structure and compare these effects with those of calcium supplementation in ovariectomized rats.

    METHODS: Forty female, Sprague-Dawley rats were randomly divided into five groups (n =8): four controls and one test arm. The control arm comprised a baseline control, sham-operated control, ovariectomized control, and ovariectomized calcium-treated rats (receiving 1% calcium in drinking water ad libitum). The test arm was composed of ovariectomized, Tualang honey-treated rats (received 0.2 g/kg body weight of Tualang honey). Both the sham-operated control and ovariectomized control groups received vehicle treatment (deionized water), and the baseline control group was sacrificed without treatment.

    RESULTS: All rats were orally gavaged daily for six weeks after day one post-surgery. The bone structural analysis of rats in the test arm group showed a significant increase in the bone volume per tissue volume (BV/TV), trabecular thickness (Tb.Th) and trabecular number (Tb.N) and a significant decrease in inter-trabecular space (Tb.Sp) compared with the ovariectomized control group. The trabecular thickness (Tb.Th) in the test arm group was significantly higher compared with the ovariectomized-calcium treated group, and the inter-trabecular space (Tb.Sp) in the test arm group was significantly narrower compared with the ovariectomized-calcium treated group.

    CONCLUSION: In conclusion, ovariectomized rats that received Tualang honey showed more improvements in trabecular bone structure than the rats that received calcium.

    Matched MeSH terms: Osteoporosis/prevention & control
  17. Labisia pumila protects the bone of estrogen-deficient rat model: a histomorphometric study
    Fathilah SN, Nazrun Shuid A, Mohamed N, Muhammad N, Nirwana Soelaiman I
    J Ethnopharmacol, 2012 Jun 26;142(1):294-9.
    PMID: 22542643 DOI: 10.1016/j.jep.2012.04.029
    Labisia pumila var. alata (LP) is a phytoestrogenic herb with potential as an alternative to Estrogen Replacement Therapy (ERT) in the treatment of postmenopausal osteoporosis. LP has been reported to produce similar effects to ERT on the bone markers, but could not match ERT in terms of maintaining the bone calcium in postmenopausal osteoporosis rat model. This study aimed to examine in detail the effects of LP on the bone of postmenopausal osteoporosis rat model using bone histomorphometry.
    Matched MeSH terms: Osteoporosis/prevention & control
  18. Vitamin D levels: its relationship to bone mineral density response and disease activity in premenopausal Malaysian systemic lupus erythematosus patients on corticosteroids
    Yeap SS, Othman AZ, Zain AA, Chan SP
    Int J Rheum Dis, 2012 Feb;15(1):17-24.
    PMID: 22324943 DOI: 10.1111/j.1756-185X.2011.01653.x
    AIM: To determine if baseline vitamin D levels would influence the gain in bone mineral density (BMD) in female systemic lupus erythematosus (SLE) patients on corticosteroids (CS) taking bone-active medication.

    METHOD: Premenopausal SLE patients participating in a trial assessing the efficacy of calcium alone, calcitriol and calcium, and alendronate and calcium, on BMD in patients on CS, were studied. Patients were randomly allocated to the treatment groups at the start of the study and followed up for 2 years. Serum 25-hydroxy vitamin D [25(OH)D] was measured at baseline.

    RESULTS:   Thirty-eight patients were studied. One (2%) patient had osteoporosis, nine (24%) had osteopenia and all others had normal BMD. The mean baseline 25(OH)D levels were 21.6 ± 4.6 ng/mL (± 1 SD). Twelve (32%) patients had vitamin D deficiency [25(OH)D < 20 ng/mL]. There was a significant negative correlation between SLEDAI scores and 25(OH)D levels, that is, patients with high SLEDAI scores had significantly lower 25(OH)D levels (P = 0.033). Left femoral neck BMD was significantly lower in the deficient compared to insufficient group (P = 0.042). There was a trend toward better BMD gain at 2 years in the vitamin D insufficient compared to the deficient group, which did not reach statistical significance.

    CONCLUSION: This study showed that in female SLE patients, low vitamin D levels are associated with higher disease activity and suggests that patients who have higher vitamin D levels have a better BMD response during treatment with bone-active agents.
    Matched MeSH terms: Osteoporosis/prevention & control
  19. Piper sarmentosum prevents glucocorticoid-induced osteoporotic bone resorption by increasing 11β-hydroxysteroid dehydrogenase type 1 activity
    Suhana MR, Farihah HS, Faizah O, Nazrun SA, Norazlina M, Norliza M, et al.
    Clin Ter, 2011;162(4):313-8.
    PMID: 21912818
    Osteoporosis is a proven complication of long-term glucocorticoid therapy. Concern on glucocorticoid induced osteoporosis has increased dramatically in recent years with the widespread use of synthetic glucocorticoids. Glucocorticoid action in bone depends upon the activity of 11βhydroxysteroid dehydrogenase type 1 enzyme (11βHSD1). This enzyme plays an important role in regulating corticosteroids by locally interconverting cortisone into active cortisol. This has been demonstrated in primary cultures of human, mouse or rat osteoblasts. Therefore, inhibition of this enzyme may reduce bone resorption markers. Piper sarmentosum (Ps) is a potent inhibitor of 11βHSD1 in liver and adipose tissue. In this study we determined the effect of Ps on 11βHSD1 activity in bones of glucocorticoid-induced osteoporotic rats.
    Matched MeSH terms: Osteoporosis/prevention & control*
  20. Vitamin E exhibits bone anabolic actions in normal male rats
    Shuid AN, Mehat Z, Mohamed N, Muhammad N, Soelaiman IN
    J. Bone Miner. Metab., 2010 Mar;28(2):149-56.
    PMID: 19779668 DOI: 10.1007/s00774-009-0122-2
    Recently, vitamin E has been found to promote the bone structure of nicotine-treated rats well above their baseline values, thus suggesting that vitamin E may have some anabolic action. A bone anabolic agent acts by improving the bone structure leading to stronger bone. To assess the possible anabolic action vitamin E on bone, we supplemented alpha-tocopherol (ATF) or gamma-tocotrienol (GTT) at 60 mg/kg or vehicle [normal control (NC) group] for 4 months to normal male rats and measured their bone structure and biomechanical properties. Histomorphometric analysis revealed that vitamin E-supplemented rats have better trabecular volume, thickness, number, and separation than rats receiving vehicle only. For the first time we reported that GTT improves all the parameters of bone biomechanical strength, while ATF only improved some of the parameters compared to the NC group. Vitamin E supplementation, especially with the gamma isomer, improves bone structure, which contributed to stronger bone. Therefore, vitamin E has the potential to be used as an anabolic agent to treat osteoporosis or as bone supplements for young adults to prevent osteoporosis in later years.
    Matched MeSH terms: Osteoporosis/prevention & control
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