This minireview briefly surveys the complexity of regulations governing the bone metabolism. The impact of clinical studies devoted to osteoporosis is briefly summarized and the emphasis is put on the significance of experimental mouse models based on an extensive use of genetically modified animals. Despite possible arising drawbacks, the studies in mice are of prime importance for expanding our knowledge on bone metabolism. With respect to human physiology and medicine, one should be always aware of possib le limitations as the experimental results may not be, or may be only to some extent, transposed to humans. If applicable to humans, results obtained in mice provide new clues for assessing un foreseen treatment strategies for patients. A recent publication representing in our opinion the important breakthrough in the field of bone metabolism in mice is commented in detail. It provides an evidence that skeleton is endocrine organ that affects energy metabolism and osteocalcin, a protein specifically synthesized and secreted by osteoblasts, is a hormone involved. If confirmed by other groups and applicable to humans, this study provides the awaited connection of long duration between bone disorders on one hand and obesity and diabetes on the other., O. Raška, K. Bernášková, I. Raška Jr., and Obsahuje seznam literatury
The peak bone mass and the rate of bone loss are in part genetically determined. It has been suggested that bone mineral density (BMD) may be related to allelic variation in the apolipoprotein E (ApoE) gene locus. ApoE is important in the receptor-mediated clearance of chylomicron particles from the plasma, Apo E4 having the highest and Apo E2 the lowest receptor affinity. Chylomicrons are the main carrier of vitamin K in the plasma; vitamin K plays an important role in the carboxylation of osteocalcin. We have tested the hypothesis that persons with E4 variant would have lower BMD and increased bone turnover than those with E2 variant. A total of 18 ApoE 2/2 and ApoE 4/4 homozygotes were selected from 873 patients who were examined for the ApoE genotype. BMD in lumbar vertebral, femoral neck and distal forearm was measured and plasma concentrations of osteocalcin and C-terminal fragments of collagen (CTx) were determined. BMD values (expressed as T-score) at the three specified sites were -0.12± 1.72, -0.52± 1.32 and -0.52± 0.81 in ApoE 2/2 group and -0.24± 1.22, 0.00± 0.84 and -0.17± 1.07 in the ApoE 4/4 group. Plasma osteocalcin and CTx were within normal limits in both groups. In conclusion, we did not observe any association of ApoE genotype with BMD and biochemical markers of bone metabolism in ApoE 2/2 and ApoE 4/4 homozygotes., T. Štulc, R. Češka, A. Hořínek, J. Štěpán., and Obsahuje bibliografii
After menopause, when estrogen levels decrease, there is room for the activity of anthropogenic substances with estrogenic properties - endocrine disruptors (EDs) - that can interfere with bone remodeling and changes in calcium-phosphate metabolism. Selected unconjugated EDs of the bisphenol group - BPA, BPS, BPF, BPAF, and the paraben family - methyl-, ethyl-, propyl-, butyl-, and benzyl-parabens - were measured by high performance liquid chromatography-tandem mass spectrometry in the plasma of 24 postmenopausal women. Parameters of calcium-phosphate metabolism and bone mineral density were assessed. Osteoporosis was classified in 14 women, and 10 women were put into the control group. The impact of EDs on calcium-phosphate metabolism was evaluated by multiple linear regressions. In women with osteoporosis, concentrations of BPA ranged from the lower limit of quantification (LLOQ) - 104 pg/ml and methyl paraben (MP) from LLOQ - 1120 pg/ml. The alternative bisphenols BPS, BPF and BPAF were all under the LLOQ. Except for MP, no further parabens were detected in the majority of samples. The multiple linear regression model found a positive association of BPA (β=0.07, p<0.05) on calcium (Ca) concentrations. Furthermore, MP (β=-0.232, p<0.05) was negatively associated with C-terminal telopeptide. These preliminary results suggest that these EDs may have effects on calcium-phosphate metabolism., J. Vitku, L. Kolatorova, L. Franekova, J. Blahos, M. Simkova, M. Duskova, T. Skodova, L. Starka., and Obsahuje bibliografii
Článek poskytuje přehlednou informaci o změnách na jednodivých etážích trávicího traktu, které je možno očekávat u seniorské populace. Jsou diskutovány další vlivy, které vývoj daný prostým stárnutím dále urychlují a zhoršují. V každém aspektu je zdůrazněn rozdíl v symptomatologií, diagnostice i terapii oproti mladší geníraci. V závěru článku jsou souhrnně uvedeny klinické syndromy způsobené snížením příjmu potravy, tekutin a zvláště vitaminů, minerálů a stopových prvků., The article gives a comprehensive information of the changes in individual segments of digestive system, which nay be expected at senior population. There are discussed other influences accelerating and deteriorating the development given by sole ageing. For each aspect there is emphasized the difference in symptomatology, diagnostics and therapy in comparison with younger generation. In the conclusion of the article there are summarily named the clinical syndromes caused by the decrease of food, fluid and especially vitamins, minerals and trace elements intake., Hana Kubešová, Pavel Weber, Hana Meluzínová, Lit: 16, and Souhrn: eng
Osteoporosis is a systemic disease of the skeleton, characterized by reduction of bone mass and concurrent deterioration of bone structure. Consequently, bones are more fragile, and there is increased risk of fractures. The potential for acquisition of maximum bone mass is influenced by a number of factors. Among those are heredity, sex, nutrition, endocrine factors, mechanical influences and some risk factors. The best documented nutrient for metabolism of bone is calcium. Major role in the pathogenesis of osteoporosis have some micro and macro nutrients, prebiotics, alcohol, alternative diets, starvation and anorexia. Meta analysis of 29 randomized trials showed that supplementation with calcium and vitamin D3 reduces risk of bone fractures by 24 % and significantly reduces loss of bone mass. Osteoporosis has multi factor etiology. Osteoporosis is one of diseases which are influenced by nutrition and life style. It is preventable by means of adequate nutrition and sufficient physical activity., M. Stránský, L. Ryšavá., and Obsahuje seznam literatury
Osteoporosis in chronic diseases is very frequent and pathogenetically varied. It complicates the course of the underlying disease by the occurrence of fractures, which aggravate the quality of life and increase the mortality of patients from the underlying disease. The secondary deterioration of bone quality in chronic diseases, such as diabetes of type 1 and type 2 and/or other endocrine and metabolic disorders, as well as inflammatory diseases, including rheumatoid arthritis - are mostly associated with structural changes to collagen, altered bone turnover, increased cortical porosity and damage to the trabecular and cortical microarchitecture. Mechanisms of development of osteoporosis in some inborn or acquired disorders are discussed., I. Zofkova, P. Nemcikova., and Obsahuje bibliografii
a1_Osteoporosis is a serious disease characterized by high morbidity and mortality due to atraumatic fractures. In the pathogenesis of osteoporosis, except environment and internal factors, such as hormonal imbalance and genetic background, are also in play. In this study candidate genes for osteoporosis were classified according to metabolic or hormonal pathways, which regulate bone mineral density and bone quality (estrogen,RANKL/RANK/OPG axis, mevalonate, the canonical circuit and genes regulating the vitamin D system). COL1A1 and/or COL1A2 genes, which encode formation of the procollagen 1 molecule, were also studied. Mutations in these genes are well-known causes of the inborn disease‘ osteogenesis imperfecta’. In addition to this, polymorphisms in COL1A1 and/or COL1A2 have been found to be associated with parameters of bone quality in adult subjects. The authors discuss the perspectives for the practical utilization of pharmacogenetics (identification of single candidate genes using PCR) and pharmacogenomics (using genome wide association studies (GWAS) to choose optimal treatment for osteoporosis). Potential predictors of antiresorptive therapy efficacy include the following well established genes: ER, FDPS, Cyp19A1, VDR, Col1A1, and Col1A2, as well as the gene for the canonical (Wnt) pathway. Unfortunately, the positive outcomes seen in most association studies have not been confirmed b y other researchers. The controversial results could be explained by the use of different methodological approaches in individual studies (different sample size, homogeneity of investigated groups, ethnic differences, or linkage disequilibrium between genes). The key pitfall of association studies is the low variability (7-10 %) of bone phenotypes associated with the investigated genes., a2_Nevertheless, the identification of new genes and the verification of their association with bone density and/or quality (using both PCR and GWAS), remain a great challenge in the optimal prevention and treatment of osteoporosis., I. Zofkova, P. Nemcikova, M. Kuklik., and Obsahuje bibliografii
Příliš vysoký přívod sodíku je spojován s řadou zdravotních komplikací, především s hypertenzí. Data o spotřebě potvrzují vysoký přívod sodíku v mnoha zemích světa. Ve většině případů je daleko vyšší než uvádí doporučení (2 g sodíku/den). Hypertenze je významným rizikovým faktorem pro kardiovaskulární onemocnění a s nimi spojená úmrtí. Mnoho studií potvrdilo, že snížením přívodu sodíku dochází ke snížení tlaku krve (TK). U normotenzních jedinců není pokles TK tak významný jako u hypertenzních, přesto převládá názor, že i mírné snížení přívodu sodíku může mít dlouhodobý pozitivní vliv na zdraví populace. Odhady naznačují, že snížení denního přívodu sodíku o 3 g by mohlo snížit výskyt ischemické choroby srdeční (ICHS) o 10 % a výskyt cévní mozkové příhody (CMP) o 13 %. Reakce organismu na přívod sodíku může být různá. U některých osob dojde po snížení přívodu sodíku k výraznému poklesu tlaku krve. V souvislosti s tím se používá termín citlivost na sůl. Častěji se vyskytuje u starších osob a u Afroameričanů. Je podmíněná geneticky. Dalším onemocněním dávaným do souvislosti se sodíkem je onemocnění ledvin. Studie potvrdily vliv redukce přívodu sodíku na proteinurii a albuminurii. Přívod sodíku může mít vliv také na hypertrofii levé komory, nelze však s jistotou prokázat, zda jde opravdu o jev nezávislý na tlaku krve. Sůl a solené potraviny jsou označovány za pravděpodobnou příčinu nádorového onemocnění žaludku. Vysoký přívod soli může vyvolat atrofickou gastritidu a ovlivnit i další stadia patogeneze. Zvýšená spotřeba sodíku vede ke zvýšené exkreci vápníku močí. Výsledky studií zaměřených na potvrzení souvislosti mezi přívodem sodíku a dalšími ukazateli osteoporózy, jako jsou markery kostní resorpce nebo výskyt zlomenin, jsou však nekonzistentní. Ve starší literatuře se objevovaly zmínky o možné souvislosti sodíku a astmatu. Autoři nejnovější přehledové studie došli k závěru, že snížení přívodu sodíku nemá větší vliv na zlepšení astmatu. Téma sodíku je i přes množství realizovaných studií stále kontroverzní. K objasnění zůstává mnoho nejasných vztahů a příčinných souvislostí. I přes tyto nejasnosti se zdá, že snižování přívodu sodíku v populaci má význam., Excessive sodium intake is associated with many health complications, especially hypertension. Data on sodium intake show too high consumption in many countries around the world. In many cases sodium intake exceeds recommendation for adults, which is 2 g sodium/day. Hypertension is a major risk factor for cardiovascular disease and mortality. Many studies have confirmed that dietary sodium reduction reduces blood pressure (BP). BP reduction was less significant in normotensive individuals than in individuals with hypertension. Nevertheless, there is a consensus that even a moderate decreasing in sodium intake is likely to have a beneficial impact on public health. Estimates suggest that a reduction of 3 g of daily sodium intake would reduce ischemic heart disease by 10% and strokes by 13%. BP response to change in dietary sodium varies widely among individuals. Significant BP reduction is evident in some patients following decreased sodium intake. This heterogeneity led to a concept of salt sensitivity. It is more common among the elderly and African-Americans. Salt sensitivity is determined genetically. Another disease associated with sodium intake is kidney disease. Studies have confirmed the effect of reducing sodium intake on proteinuria and albuminuria. Sodium intake can affect left ventricular hypertrophy but it is impossible to prove whether it is independent of blood pressure. Salt and salted foods have been identified as a probable risk factor of stomach cancer. High salt intake can induce gastric atrophy and affect the other stages of pathogenesis. Increased consumption of sodium leads also to increased urinary calcium excretion. Relationship between sodium intake and other indicators like bone biomarkers or fractures is unclear. Some older studies suggest that dietary sodium can be related to asthma. Authors of the latest systematic review have concluded, that there is no evidence that reduction of sodium intake improves asthma control. Despite the number of completed studies, the question of sodium intake is still controversial. There is a plethora of unclear causal relationships. Regardless of these uncertainties, it seems that sodium intake reduction is beneficial for the population., Marie Šubrtová, Halina Matějová, and Literatura
Introduction: We studied influence of mud-bath on bone status in male Wistar rats with subchronic arthritis. Methods: Arthritis was induced by 2 subplantar injections of Freund’s adjuvans with heat-killed Streptoccocus pyogenes into paw. Groups: intact (int) on chippings; (con) arthritis on chippings; (san38) arthritis on hot sand; (mu38) arthritis on hot mud; (mu21) arthritis on mild mud. Bone mineral density (BMD, g/cm2) was measured by dual energy X-ray absorptiometry and femurs were tested biomechanically. Bone markers osteocalcin (OC), PINP and CTX were analysed in bone. Results: BMD of right femur decreased vs. left in san38 (p = 0.030) and mu38 (p = 0.047). Fracture load of right/left femur (N) decreased in experimental groups, significantly in san38 (p = 0.05). Fracture threshold of neck decreased in right vs. left in experimental groups, but significantly in san38 (p = 0.05). OC decreased in mu38 vs. con (1.84 ± 0.14/2.62 ± 0.23). PINP decreased in int vs. san38 (p = 0.005) and mu21 (p < 0.001). CTX decreased in int vs. mu38 (p = 0.006) and mu21 (p = 0.005). Conclusion: The hot bath appears indifferent in relation to osteoporosis, while cold mud-bath shows good effect on bone metabolism. The cold mud-baths help to reduce arthritic inflammation and pain and thereby lead to higher mobility with positive consequence on bone., Helena Živná, Ljiljana Maric, Iveta Gradošová, Klára Švejkovská, Soňa Hubená, Pavel Živný, and Literatura 19