Medical Forum / General / Nutrition / July 2006
vitamin D versus sarcopenia
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Doug Skrecky - 29 Jul 2006 03:22 GMT Mol Aspects Med. 2005 Jun;26(3):203-19. Vitamin D in the aging musculoskeletal system: an authentic strength preserving hormone. Until recently, vitamin D was only considered as one of the calciotrophic hormones without major significance in other metabolic processes in the body. Several recent findings have demonstrated that vitamin D plays also a role as a factor for cell differentiation, function and survival. Two organs, muscle and bone, are significantly affected by the presence, or absence, of vitamin D. In bone, vitamin D stimulates bone turnover while protecting osteoblasts of dying by apoptosis whereas in muscle vitamin D maintains the function of type II fibers preserving muscle strength and preventing falls. Furthermore, two major changes associated to aging: osteoporosis and sarcopenia, have been also linked to the development of frailty in elderly patients. In both cases vitamin D plays an important role since the low levels of this vitamin seen in senior people may be associated to a deficit in bone formation and muscle function. In this review, the interaction between vitamin D and the musculoskeletal components of frailty are considered from the basic mechanisms to the potential therapeutic approach. We expect that these new considerations about the importance of vitamin D in the elderly will stimulate an innovative approach to the problem of falls and fractures which constitutes a significant burden to public health budgets worldwide.
Matti Narkia - 29 Jul 2006 13:34 GMT >Mol Aspects Med. 2005 Jun;26(3):203-19. >Vitamin D in the aging musculoskeletal system: an authentic strength [quoted text clipped - 19 lines] >problem of falls and fractures which constitutes a significant burden to >public health budgets worldwide. The full reference for the above article is
Montero-Odasso M, Duque G. Vitamin D in the aging musculoskeletal system: an authentic strength preserving hormone. Mol Aspects Med. 2005 Jun;26(3):203-19. Review. PMID: 15811435 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra ctPlus&list_uids=15811435>
Other articles about this topic:
Shionoiri A. [Fall preventing effect of vitamin D] Clin Calcium. 2006 Jul;16(7):111-6. Japanese. PMID: 16816481 [PubMed - in process] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra ctPlus&list_uids=16816481>
Nakagawa K. [Effect of vitamin D on the nervous system and the skeletal muscle] Clin Calcium. 2006 Jul;16(7):98-103. Japanese. PMID: 16816479 [PubMed - in process] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra ctPlus&list_uids=1681647>
Boonen S, Bischoff-Ferrari HA, Cooper C, Lips P, Ljunggren O, Meunier PJ, Reginster JY. Addressing the musculoskeletal components of fracture risk with calcium and vitamin D: a review of the evidence. Calcif Tissue Int. 2006 May;78(5):257-70. Epub 2006 Apr 21. Review. PMID: 16622587 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=R etrieve&dopt=abstractplus&list_uids=16622587>
Venning G. Recent developments in vitamin D deficiency and muscle weakness among elderly people. BMJ. 2005 Mar 5;330(7490):524-6. Review. PMID: 15746134 [PubMed - indexed for MEDLINE] <http://bmj.bmjjournals.com/cgi/content/full/330/7490/524>
Bischoff-Ferrari HA, Conzelmann M, Dick W, Theiler R, Stahelin HB. [Effect of vitamin D on muscle strength and relevance in regard to osteoporosis prevention] Z Rheumatol. 2003 Dec;62(6):518-21. German. PMID: 14685712 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=R etrieve&dopt=abstractplus&list_uids=14685712>
Visser M, Deeg DJ, Lips P; Longitudinal Aging Study Amsterdam. Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): the Longitudinal Aging Study Amsterdam. J Clin Endocrinol Metab. 2003 Dec;88(12):5766-72. PMID: 14671166 [PubMed - indexed for MEDLINE] <http://jcem.endojournals.org/cgi/content/full/88/12/5766>
Janssen HC, Samson MM, Verhaar HJ. Vitamin D deficiency, muscle function, and falls in elderly people. Am J Clin Nutr. 2002 Apr;75(4):611-5. Review. PMID: 11916748 [PubMed - indexed for MEDLINE] <http://www.ajcn.org/cgi/content/full/75/4/611>
McCarty MF. Vitamin D status and muscle strength. Am J Clin Nutr. 2002 Dec;76(6):1454-5; author reply 1455-6. PMID: 12450916 [PubMed - indexed for MEDLINE] <http://www.ajcn.org/cgi/content/full/76/6/1454>
Other potential contributing factor to sarcopenia may be diet related mild chronic metabolic acidosis, which is common in western countries and worsens with age due to age-related renal functional decline. Chronic metabolic acidosis is known to cause muscle protein breakdown. Supplements like potassium bicarbonate (KHCO3) neutralize metabolic acidosis and may prevent continuing age-related loss of muscle mass and restore previously accrued deficits. Similar effect may be achieved by including a large amount of alkaline producing vegetables, fruit and berries into the diet or/and supplementing with alkaline minerals calcium, potassium and magnesium.
Related references:
Frassetto L, Morris RC Jr, Sebastian A. Potassium bicarbonate reduces urinary nitrogen excretion in postmenopausal women. J Clin Endocrinol Metab. 1997 Jan;82(1):254-9. PMID: 8989270 [PubMed - indexed for MEDLINE] <http://jcem.endojournals.org/cgi/content/full/82/1/254>
"Previously we demonstrated that low grade chronic metabolic acidosis exists normally in humans eating ordinary diets that yield normal net rates of endogenous acid production (EAP), and that the degree of acidosis increases with age. We hypothesize that such diet-dependent and age-amplifying low grade metabolic acidosis contributes to the decline in skeletal muscle mass that occurs normally with aging. This hypothesis is based on the reported finding that chronic metabolic acidosis induces muscle protein breakdown, and that correction of acidosis reverses the effect. Accordingly, in 14 healthy postmenopausal women residing in a General Clinical Research Center and eating a constant diet yielding a normal EAP rate, we tested whether correcting their "physiological" acidosis with orally administered potassium bicarbonate (KHCO3; 60120 mmol/day for 18 days) reduces their urinary nitrogen loss. KHCO3 reduced EAP to nearly zero, significantly reduced the blood hydrogen ion concentration (P < 0.001), and increased the plasma bicarbonate concentration (P < 0.001), indicating that pre-KHCO3, diet-dependent EAP was significantly perturbing systemic acid-base equilibrium, causing a low grade metabolic acidosis. Urinary ammonia nitrogen, urea nitrogen, and total nitrogen levels significantly decreased. The cumulative reduction in nitrogen excretion was 14.1 ± 12.3 g (P < 0.001). Renal creatinine clearance and urine volume remained unchanged. We conclude that in postmenopausal women, neutralization of diet-induced EAP with KHCO3 corrects their preexisting diet-dependent low grade metabolic acidosis and significantly reduces their urinary nitrogen wasting. The magnitude of the KHCO3-induced nitrogen-sparing effect is potentially sufficient to both prevent continuing age-related loss of muscle mass and restore previously accrued deficits."
Frassetto LA, Morris RC, Sebastian A. Effect of age on blood acid-base composition in adult humans: role of age-related renal functional decline. Am J Physiol. 1996 Dec;271(6 Pt 2):F1114-22. <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8 997384&dopt=Abstract>
"... Otherwise healthy adults manifest a low-grade diet- dependent metabolic acidosis, the severity of which increases with age at constant EAP, apparently due in part to the normal age-related decline of renal function."
Frassetto L, Sebastian A. Age and systemic acid-base equilibrium: analysis of published data. J Gerontol A Biol Sci Med Sci. 1996 Jan;51(1):B91-9. <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8 548506&dopt=Abstract>
"To investigate whether systemic acid-base equilibrium changes with aging in normal adult humans, we reviewed published articles reporting the acid-base composition of arterial, arterialized venous, or capillary blood in age- identified healthy subjects. We extracted or calculated blood hydrogen ion concentration ([H+]), plasma bicarbonate concentration ([HCO3(-)]), blood PCO2, and age, and computed a total of 61 age-group means, distributed among eight 10- year intervals from age 20 to 100 years. Using linear regression analysis, we found that with increasing age, there is a significant increase in the steady-state blood [H+] (p < .001), and reduction in steady-state plasma [HCO3(-)] (p < .001), indicative of a progressively worsening low-level metabolic acidosis. Blood PCO2 decreased with age (p < .05), in keeping with the expected respiratory adaptation to metabolic acidosis. Such age-related increasing metabolic acidosis may reflect in part the normal decline of renal function with increasing age. The role of age-related metabolic acidosis in the pathogenesis of the degenerative diseases of aging warrants consideration."
Mitch WE, Medina R, Grieber S, May RC, England BK, Price SR, Bailey JL, Goldberg AL. Metabolic acidosis stimulates muscle protein degradation by activating the adenosine triphosphate-dependent pathway involving ubiquitin and proteasomes. J Clin Invest. 1994 May;93(5):2127-33. PMID: 8182144 [PubMed - indexed for MEDLINE] <http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=8182144>
"Metabolic acidosis often leads to loss of body protein due mainly to accelerated protein breakdown in muscle. [...] These results are consistent with, but do not prove that acidosis stimulates muscle proteolysis by activating the ATP-ubiquitin-proteasome-dependent, proteolytic pathway."
May RC, Masud T, Logue B, Bailey J, England BK. Metabolic acidosis accelerates whole body protein degradation and leucine oxidation by a glucocorticoid-dependent mechanism. Miner Electrolyte Metab. 1992;18(2-5):245-9. PMID: 1465068 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=1 465068&dopt=Abstract>
"... We conclude that chronic metabolic acidosis accelerates whole body protein turnover and reduces the efficiency of protein utilization by accelerating amino acid oxidation. These changes may require an intact glucocorticoid axis."
May RC, Masud T, Logue B, Bailey J, England B. Chronic metabolic acidosis accelerates whole body proteolysis and oxidation in awake rats. Kidney Int. 1992 Jun;41(6):1535-42. PMID: 1501410 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=1 501410&dopt=Abstract>
"... We conclude that chronic metabolic acidosis accelerates whole body protein turnover and affects the reincorporation of amino acid into body proteins by accelerating amino acid oxidation."
May RC, Kelly RA, Mitch WE. Metabolic acidosis stimulates protein degradation in rat muscle by a glucocorticoid-dependent mechanism. J Clin Invest. 1986 Feb;77(2):614-21. PMID: 3511100 [PubMed - indexed for MEDLINE] <http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=3511100>
"... We conclude that chronic metabolic acidosis depresses nitrogen utilization and increases glucocorticoid production. The combination of increased glucocorticoids and acidosis stimulates muscle proteolysis but does not affect protein synthesis. These changes in muscle protein metabolism may play a role in the defense against acidosis by providing amino acid nitrogen to support the glutamine production necessary for renal ammoniagenesis."
Williams B, Layward E, Walls J. Skeletal muscle degradation and nitrogen wasting in rats with chronic metabolic acidosis. Clin Sci (Lond). 1991 May;80(5):457-62. PMID: 1851685 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=1 851685&dopt=Abstract>
"1. Chronic metabolic acidosis is associated with impaired growth and negative nitrogen balance, suggesting that it promotes endogenous protein catabolism. 2. Skeletal muscle is the major repository of body protein and is a potential target for stimuli of protein catabolism. 3. This study in vivo examines the effects of chronic metabolic acidosis on the relationship between growth, nitrogen disposal and skeletal muscle catabolism in the rat. 4. Growth, nitrogen utilization and acquisition of body mass were significantly impaired in acidotic animals compared with pair-fed controls. 5. Total nitrogen excretion was significantly increased in acidotic rats despite decreased urea production. The time course of this response to acidosis was synchronous with that of accelerated protein catabolism in skeletal muscle. 6. It is proposed that metabolic acidosis impairs growth by stimulating skeletal muscle protein catabolism. It is suggested that this forms part of a co- ordinated multi-organ homoeostatic response to acidosis, skeletal muscle and down-regulated urea production supplying the nitrogen required for renal ammoniagenesis."
Morris RC, Schmidlin O, Tanaka M, Forman A, Frassetto L, Sebastian A. Differing effects of supplemental KCl and KHCO3: pathophysiological and clinical implications. Semin Nephrol. 1999 Sep;19(5):487-93. Review. <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1 0511388&dopt=Abstract>
Kurtz I, Maher T, Hulter HN, Schambelan M, Sebastian A. Effect of diet on plasma acid-base composition in normal humans. Kidney Int. 1983 Nov;24(5):670-80. PMID: 6663989 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=6 663989&dopt=Abstract>
Sebastian A, Frassetto LA, Sellmeyer DE, Merriam RL, Morris RC Jr. Estimation of the net acid load of the diet of ancestral preagricultural Homo sapiens and their hominid ancestors. Am J Clin Nutr. 2002 Dec;76(6):1308-16. PMID: 12450898 [PubMed - indexed for MEDLINE] <http://www.ajcn.org/cgi/content/full/76/6/1308>
"... Results: The mean (± SD) NEAP for 159 retrojected preagricultural diets was -88 ± 82 mEq/d; 87% were net base- producing. The computational model predicted NEAP for the average American diet (as recorded in the third National Health and Nutrition Examination Survey) as 48 mEq/d, within a few percentage points of published measured values for free-living Americans; the model, therefore, was not biased toward generating negative NEAP values. The historical shift from negative to positive NEAP was accounted for by the displacement of high-bicarbonate-yielding plant foods in the ancestral diet by cereal grains and energy-dense, nutrient- poor foods in the contemporary dietneither of which are net base-producing.
Conclusions: The findings suggest that diet-induced metabolic acidosis and its sequelae in humans eating contemporary diets reflect a mismatch between the nutrient composition of the diet and genetically determined nutritional requirements for optimal systemic acid-base status."
 Signature Matti Narkia
Matti Narkia - 29 Jul 2006 14:11 GMT >>Mol Aspects Med. 2005 Jun;26(3):203-19. >>Vitamin D in the aging musculoskeletal system: an authentic strength [quoted text clipped - 84 lines] >PMID: 12450916 [PubMed - indexed for MEDLINE] ><http://www.ajcn.org/cgi/content/full/76/6/1454> Additional references about the topic:
Bischoff-Ferrari HA, Orav EJ, Dawson-Hughes B. Effect of cholecalciferol plus calcium on falling in ambulatory older men and women: a 3-year randomized controlled trial. Arch Intern Med. 2006 Feb 27;166(4):424-30. PMID: 16505262 [PubMed - indexed for MEDLINE] <http://archinte.ama-assn.org/cgi/content/abstract/166/4/424>
Bischoff-Ferrari HA, Dietrich T, Orav EJ, Hu FB, Zhang Y, Karlson EW, Dawson-Hughes B. Higher 25-hydroxyvitamin D concentrations are associated with better lower-extremity function in both active and inactive persons aged > or =60 y. Am J Clin Nutr. 2004 Sep;80(3):752-8. PMID: 15321818 [PubMed - indexed for MEDLINE] <http://www.ajcn.org/cgi/content/full/80/3/752>
Bischoff-Ferrari HA, Dawson-Hughes B, Willett WC, Staehelin HB, Bazemore MG, Zee RY, Wong JB. Effect of Vitamin D on falls: a meta-analysis. JAMA. 2004 Apr 28;291(16):1999-2006. Review. PMID: 15113819 [PubMed - indexed for MEDLINE] <http://jama.ama-assn.org/cgi/content/full/291/16/1999>
Bischoff-Ferrari HA, Borchers M, Gudat F, Durmuller U, Stahelin HB, Dick W. Vitamin D receptor expression in human muscle tissue decreases with age. J Bone Miner Res. 2004 Feb;19(2):265-9. PMID: 14969396 [PubMed - indexed for MEDLINE] <http://www.jbmronline.org/pubmed/abs/14969396>
Bischoff-Ferrari HA, Conzelmann M, Dick W, Theiler R, Stahelin HB. [Effect of vitamin D on muscle strength and relevance in regard to osteoporosis prevention] Z Rheumatol. 2003 Dec;62(6):518-21. German. PMID: 14685712 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra ctPlus&list_uids=14685712>
Doherty TJ. Invited review: Aging and sarcopenia. J Appl Physiol. 2003 Oct;95(4):1717-27. Review. PMID: 12970377 [PubMed - indexed for MEDLINE] <http://jap.physiology.org/cgi/content/full/95/4/1717>
 Signature Matti Narkia
Matti Narkia - 29 Jul 2006 14:49 GMT >Other potential contributing factor to sarcopenia may be diet related >mild chronic metabolic acidosis, which is common in western countries [quoted text clipped - 212 lines] > nutritional requirements for optimal systemic acid-base > status." Additional references:
Frassetto L, Morris RC Jr, Sebastian A. Long-term persistence of the urine calcium-lowering effect of potassium bicarbonate in postmenopausal women. J Clin Endocrinol Metab. 2005 Feb;90(2):831-4. Epub 2004 Nov 30. PMID: 15572425 [PubMed - indexed for MEDLINE] <http://jcem.endojournals.org/cgi/content/full/90/2/831>
Heaney RP, Rafferty K, Davies KM. Letter re: Long-term persistence of the urine calcium-lowering effect of potassium bicarbonate in postmenopausal women. J Clin Endocrinol Metab. 2005 Jul;90(7):4417; author reply 4417-8. PMID: 16002413 [PubMed - indexed for MEDLINE] <http://jcem.endojournals.org/cgi/content/full/90/7/4417>
A. Sebastian, L. Frassetto, and R. C. Morris Jr. Authors' Response: Long-Term Persistence of the Urine Calcium-Lowering Effect of Potassium Bicarbonate in Postmenopausal Women J. Clin. Endocrinol. Metab., July 1, 2005; 90(7): 4417 - 4418. <http://jcem.endojournals.org/cgi/content/full/90/7/4417-a>
Frassetto L, Morris RC Jr, Sellmeyer DE, Todd K, Sebastian A. Diet, evolution and aging--the pathophysiologic effects of the post-agricultural inversion of the potassium-to-sodium and base-to-chloride ratios in the human diet. Eur J Nutr. 2001 Oct;40(5):200-13. Review. PMID: 11842945 [PubMed - indexed for MEDLINE] <http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstra ctPlus&list_uids=11842945>
 Signature Matti Narkia
ironjustice@aol.com - 30 Jul 2006 02:35 GMT > Mol Aspects Med. 2005 Jun;26(3):203-19. > Vitamin D in the aging musculoskeletal system: an authentic strength [quoted text clipped - 19 lines] > problem of falls and fractures which constitutes a significant burden to > public health budgets worldwide. What significance is the fact iron destroys vitamin D or more precisely
in those with iron overload .. vitamin D is decreased .. in those with supplemental iron induced iron overload .. vitamin D is decreased.
Bleeding / venesection / bloodletting / phlebotomy .. RESTORES .. vitamin D .
<<snip>> The results reveal that the low serum 25-OHD concentration in patients with hemochromatosis is directly related to the extent of iron loading and it is improved by venesection therapy. <<snip>>
Iron induced decreased vitamin D.
<<snip>> when transferrin is saturated with iron, may impair bone formation and aggravate osteomalacia. <<snip>>
Saccharated ferric oxide (SFO)-induced osteomalacia: in vitro inhibition by SFO of bone formation and 1,25-dihydroxy-vitamin D production in renal tubules. Sato K, Nohtomi K, Demura H, Takeuchi A, Kobayashi T, Kazama J, Ozawa H
Bone. 1997 Jul ; 21(1): 57-64
A 60-year-old man with portal hypertensive gastropathy due to type C liver cirrhosis developed severe bone pains, marked hypophosphatemia with inappropriately increased urinary excretion of phosphate (%TRP; 9.6%), and hyperalkaline phosphatasia, after intravenous administration
of saccharated ferric oxide (SFO) at a dose of 80-240 mg/week over a period of more than 5 years. The total iron infused was estimated to be
more than 25 g. On a diagnosis of SFO-induced osteomalacia, the infusion of iron was immediately discontinued, and phosphate and vitamin D2 (1000 IU/day) were administered. Serum levels of 25-OHD2 increased after 1 week, whereas levels of 1,25-(OH)2D2 did not increase
until 3 months later, accompanied by improvement of renal tubular reabsorption of phosphate and gradual improvement of the bone pains. The patient has been doing well for the last 2 years, with normal serum
levels of phosphate, calcium, and alkaline phosphatase, without any supplementation of phosphate, vitamin D, or iron-containing agents. In primary culture of neonatal mouse renal tubules, in which 1,25-(OH)2D3 was produced from 25-OHD3 in response to PTH, SFO significantly inhibited PTH-induced production of 1,25-(OH)2D3 at 30 mumol/L, which is attainable in the urine of patients receiving a therapeutic intravenous dose of SFO. Furthermore, SFO decreased the calcium content
and inhibited 45Ca incorporation in cultured fetal mouse parietal bones
at 3 mumol/L. Such SFO concentration may be transiently observed in the
plasma of patients receiving excessive intravenous doses of SFO for a prolonged period. These in vitro findings together with the clinical observations suggest that SFO, after filtration through the glomerulus and reabsorption in the proximal renal tubules, impaired proximal renal
tubular function, such as tubular reabsorption of phosphate and 1 alpha-hydroxylase activity, leading to hypophosphatemic osteomalacia. Furthermore, it is highly likely that SFO in the peripheral blood, when
transferrin is saturated with iron, may impair bone formation and aggravate osteomalacia. Although SFO-induced osteomalacia is reversible
simply by discontinuation of the agent, excessive and prolonged administration of SFO should be avoided.
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1: Gastroenterology. 1985 Apr;88(4):865-9. Related Articles, Links
Low serum 25-hydroxyvitamin D in hereditary hemochromatosis: relation to iron status.
Chow LH, Frei JV, Hodsman AB, Valberg LS.
Under normal conditions, vitamin D absorbed from the diet or synthesized in the skin is transported to the liver where it undergoes hydroxylation. The purpose of this study was to determine whether excess hepatic iron affects this process and the subsequent production of 1,25-dihydroxyvitamin D (1,25-[OH]2D) in the kidney. Mean serum 25-hydroxyvitamin D (25-OHD) concentrations in untreated hereditary hemochromatosis were 13 +/- 6 (SD) in 9 patients with cirrhosis, 13 +/-
6 in 5 patients with hepatic fibrosis, and 22 +/- 6 in 10 patients with
normal hepatic architecture aside from siderosis and were significantly
lower than the levels found in 24 controls matched for age, sex, and season, p less than 0.05. The mean serum 25-OHD levels in the two groups with hemochromatosis and hepatic damage were significantly lower
than the value in the group with normal hepatic architecture, p less than 0.05. Serum 25-OHD levels in individual patients were inversely related to the size of body iron stores as measured by exchangeable body iron, r = -0.64, or serum ferritin, r = -0.47, p less than 0.05. In 15 patients removal of excess body iron by venesection therapy produced a significant increase in the mean serum 25-OHD from 20 ng/ml to 30 ng/ml, p less than 0.05. In contrast, mean serum 1,25-[OH]2D levels were similar in iron-loaded and control subjects, indicating that the regulation of this metabolite was intact in patients with hemochromatosis. The results reveal that the low serum 25-OHD concentration in patients with hemochromatosis is directly related to the extent of iron loading and it is improved by venesection therapy.
PMID: 3838288 [PubMed - indexed for MEDLINE]
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Will Brink - 30 Jul 2006 16:07 GMT > Mol Aspects Med. 2005 Jun;26(3):203-19. > Vitamin D in the aging musculoskeletal system: an authentic strength [quoted text clipped - 19 lines] > problem of falls and fractures which constitutes a significant burden to > public health budgets worldwide. Interesting, but other variables are far more important to sarcopenia, such as lack of exercise (in particular resistance exercise), adequate protein intakes (elderly people are a population who often lack protein in their diet), adequate buffering agents (eg,mag, cal, etc) to avoid low level acidosis, low levels of anabolic hormones: testosterone, GH, etc, and other issues. Adequate vitamin intakes (including D) are also essential, but alone, without addressing the above issues, will have little effect.
 Signature Will Brink @ www.BrinkZone.com
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