Could Lithium Lower Risk Of Alzheimer’s Disease?

MedicalResearch.com Interview with:

Val Andrew Fajardo, PhD. NSERC Postdoctoral Fellow | Centre for Bone and Muscle Health Brock University | Department of Health Sciences St. Catharines, ON, Canada 

Dr. Fajardo

Val Andrew Fajardo, PhD.
NSERC Postdoctoral Fellow | Centre for Bone and Muscle Health
Brock University | Department of Health Sciences
St. Catharines, ON, Canada 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Lithium is best known for its role as a mood stabilizer, and several ecological studies across a number of different regions have shown that trace levels of lithium in tap water can exert its mood stabilizing effect and reduce rates of suicide, crime, and homicide.

The results from our study show that these trace levels of lithium could also potentially protect against Alzheimer’s disease.  These findings are actually supported by several years of research using pre-clinical and clinical models to demonstrate low-dose lithium’s neuroprotective effect against Alzheimer’s disease. In addition, we also found that trace lithium in tap water may potentially protect against obesity and diabetes – an effect that is also supported with previous literature.  In fact, some of the earlier reports of lithium’s effect of increasing insulin sensitivity and improving glucose metabolism were first published in the 1920s.  Finally, we found that trace lithium’s effect on Alzheimer’s disease may be partly mediated by its effect on obesity and diabetes.

My collaborator Dr. Rebecca MacPherson who is an expert on Alzheimer’s disease as a metabolic disorder explains that this effect is in support of recent research demonstrating that obesity and diabetes are important risk factors in the development of Alzheimer’s disease.  So interventions aiming to reduce obesity and diabetes such as physical activity can go a long way in lowering risk for Alzheimer’s disease, which is also something we present in our study.

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Later Puberty Linked To Lower Adult Bone Density

MedicalResearch.com Interview with:

Dr. Cousminer

Dr. Cousminer

Diana L. Cousminer, PhD
Division of Human Genetics
Children’s Hospital of Philadelphia
Philadelphia, PA 19104

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Osteoporosis is a significant public health burden, with origins early in life. Later puberty and lower adolescent bone mineral density are both risk factors for osteoporosis.

Geneticists have identified hundreds of genetic variants across the genome that impact pubertal timing, and we found that collectively this variation also plays a role in bone mineralization during adolescence. Additionally, we found that later puberty caused lower adult bone density.

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Eczema Patients More Sensitive To Irritating Effects Of Hard Water

MedicalResearch.com Interview with:

Dr. Danby

Dr. Danby

Dr. Simon G. Danby, PhD
Independent Research Fellow
Sheffield Dermatology Research,
Department of Infection & Immunity & Cardiovascular Disease,
Faculty of Medicine, Dentistry & Healthy,
University of Sheffield
UK 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Living in a hard water area has been widely associated with a higher risk of developing atopic eczema, a chronic skin condition characterized by an intensely itchy red rash, however the reasons for this association were unclear. We therefore conducted a study to determine how hard water contributes to the development of this condition.

We found that exposing the skin to hard water damages the skin barrier – which is our defense against outside threats such as bacteria or sun burn – and increases the sensitivity of the skin to potentially irritant surfactants found in everyday wash products. This is because hard water contains high levels of calcium and magnesium ions that bind to surfactants, such as sodium lauryl sulfate (SLS) and sodium lauryl ether sulfate (SLES), making them insoluble so that they precipitate onto the skin.

Hard water also has a high alkalinity, meaning that it can help raise skin surface pH, so that it becomes more alkaline. Skin pH is normally acidic, and a shift towards alkaline pH disturbs the skins natural function as a physical barrier and leaves it prone to colonization by potentially pathogenic bacteria. By damaging the skin barrier, washing with hard water may contribute to the development of atopic eczema.

Importantly, patients with eczema were much more sensitive to the effects of hard water than people with healthy skin. This increase in sensitivity was associated with a genetic predisposition to a skin barrier defect brought about by mutations in the gene encoding filaggrin (FLG loss-of-function mutations). Filaggrin is a structural protein important for the formation of our skin’s barrier to the outside environment. Up to half of people with eczema carry a filaggrin gene. This new study illustrates the mechanism by which calcium and magnesium ions in hard water, surfactants and filaggrin interact to damage the skin barrier.

We report that removing the calcium and magnesium ions using an ion-exchange water softener could mitigate the negative effects of hard water on the skin. The implication is that using a water softener could help reduce the incidence of eczema by reducing the harmful effects of covert irritants in everyday wash products.

MedicalResearch.com: What should clinicians and patients take away from your report?

Response: That the way we care for our skin, including the products and the water we use, has a significant impact on the health of our skin. Further research is needed to identify the best approach to caring for our skin from birth.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: We are now embarking on a pilot trial to investigate whether installation of a domestic water softener around the time of birth can prevent skin barrier breakdown and eczema in those living in hard water areas.

The Softened Water for Eczema Prevention (SOFTER) trial will be undertaken by Dr Flohr and his team from King’s College London and the National Institute for Health Research (NIHR) Biomedical Research Centre at Guy’s & St Thomas’ NHS Foundation Trust in collaboration with the University of Sheffield team and colleagues from the University of Dundee, the Centre of Evidence-Based Dermatology at Nottingham University, Imperial College London, the National Institute for Health (Bethesda, USA), and Amsterdam Medical Centre. 

MedicalResearch.com: Is there anything else you would like to add?

Response: The study was funded by Harvey Water Softeners

The paper, The Effect of Water Hardness on Surfactant Deposition Following Washing and Subsequent Skin Irritation in Atopic Dermatitis Patients and Healthy Controls, is published in the Journal of Investigative Dermatology. DOI: 10.10.16/j.jid2017.08.037

To keep up to date with news from the Sheffield Dermatology Research group follow us on twitter @Shef_Derm

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

The Effect of Water Hardness on Surfactant Deposition Following Washing and Subsequent Skin Irritation in Atopic Dermatitis Patients and Healthy Controls
Danby SG1, Brown K2, Wigley AM3, Chittock J4, Pyae PK5, Flohr C6, Cork MJ7.
J Invest Dermatol. 2017 Sep 12. pii: S0022-202X(17)32938-X. doi: 10.1016/j.jid.2017.08.037. [Epub ahead of print]

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions. 

 

 

 

 

 

Treating Iron Deficiency In Infants Has Beneficial Brain and Behavioral Effects In Children

MedicalResearch.com Interview with:

Staffan Berglund MD PhD Umeå University Sweden

Dr. Berglund

Staffan Berglund MD PhD
Umeå University
Sweden 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Iron deficiency has been associated with impaired neurodevelopment and iron supplementation is recommended to those at risk. While it is well known that very low birth weight infants are at risk of iron deficiency, less has been known regarding the large subgroup of children born with only marginally low birth weight (2000-2500g). In the present study, we previously showed that this relatively common group of otherwise healthy children is at risk of iron deficiency during infancy (Berglund Pediatrics 2010;126).

In the study published this week, we now also found that supplementation during the first six months of life had long term positive effects on their behavioral profile, with significant reduction of externalizing behavioral problems.

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Baby Teeth Can Expose Toxic Levels of Minerals Associated With Autism

MedicalResearch.com Interview with:

Manish Arora, PhD Associate Professor Environmental Medicine & Public Health Icahn School of Medicine at Mount Sinai

Dr. Arora

Manish Arora, PhD
Associate Professor
Environmental Medicine & Public Health
Icahn School of Medicine at Mount Sinai

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Autism has both genetic and environmental risk factors. Our aim was to study if exposure to toxic metals, such as lead, or disruptions in the uptake of essential nutrient elements such as manganese or zinc would be related to autism risk. Furthermore, we were interested in not only understanding how much exposure had taken place but also which developmental periods were associated with increased susceptibility to autism risk.

Researchers suspect that the risk factors for autism start early in life, even prenatally, but measuring in utero exposures is technically very challenging. We used a newly developed technique that uses lasers to map growth rings in baby teeth (like growth rings in trees) to reconstruct the history of toxic metal and essential nutrient uptake. We applied this technology in samples collected from twins, including twins who were discordant for autism. This allowed us to have some control over genetic factors.

We found that twins with autism had higher levels of lead in their teeth compared to their unaffected twin siblings. They also had lower levels of zinc and manganese. The lower uptake of zinc was restricted to approximately 10 weeks before birth to a few weeks after birth, indicating that as a critical developmental period.

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Food Costs Can Lead To Less Protein and Phosphorous in Indigent Kidney Transplant Patients

MedicalResearch.com Interview with:

Ms. Shifra Mincer Medical Student in the class of 2019 SUNY Downstate Medical School

Shifra Mincer

Ms. Shifra Mincer
Medical Student in the class of 2019
SUNY Downstate Medical School

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Hypophosphatemia is commonly encountered in the post-transplant setting. Early post-transplant hypophosphatemia has been ascribed to excess FGF23 and hyperphosphaturia.

Many patients remain hypohosphatemic months or even years after their transplant and the mechanism was assumed to be the same, however, our group recently reported that patients with late post-transplant hypophosphatemia had very little phosphorous in their urine (Wu S, Brar A, Markell, MS. Am J Kidney Dis. 2016,67(5): A18). We hypothesized that they were not eating enough phosphorous to compensate for the acute phosphorous losses they experienced immediately post-transplant.

In this study, using both 3-day diet journals and 24-hour diet recall questionnaires, we found that mean intake of phosphorous and protein was barely at the Recommended Daily Allowance, and that despite 70% of the patients using EBT, 30% of those patients still reported concerns regarding food security. Patients who reported that the cost of food influenced their dietary choices ate 43% less protein (average 48,5 gms vs. 85.8 gms) and 29% less phosphorous (average 887 mg vs 1257 mg). When ability to rise from a chair over a 30 second period was evaluated, only patients who expressed food cost concerns were unable to complete the test.

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Low Magnesium May Be Linked To Increased Risk of Hip Fractures

MedicalResearch.com Interview with:

Dr Setor Kunutsor Ba(Legon), MBChB(Legon), MA(Cantab), PhD(Cantab) Research Fellow Musculoskeletal Research Unit University of Bristol

Dr. Kunutsor

Dr Setor Kunutsor Ba(Legon), MBChB(Legon), MA(Cantab), PhD(Cantab)
Research Fellow
Musculoskeletal Research Unit
University of Bristol

MedicalResearch.com: What is the background for this study?

Response: Bone fractures are one of the leading causes of disability and ill health especially among the ageing population and are a burden to health care systems. There is established evidence that calcium and vitamin D play an important role in bone health.

Magnesium is an essential trace element, being the second most abundant intracellular cation after potassium and the fourth most abundant cation in the body. It serves several important functions in the body, which include protein synthesis, nucleic acid synthesis, enzymatic reactions, and has also been shown to be cardio-protective. It is also an important component of bone, with majority (67 percent) of total body magnesium known to be found in the bone tissue. There have been suggestions from both human and animal experiments that magnesium may have a beneficial effect on bone health; however, its relationship with fractures is not very certain.

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Compared To Other Blood Pressure Medications Diuretics Have Bone Protective Effect

MedicalResearch.com Interview with:

Joshua I. Barzilay, MD Kaiser Permanente of Georgia Duluth, GA 30096

Dr. Joshua I. Barzilay

Joshua I. Barzilay, MD
Kaiser Permanente of Georgia
Duluth, GA 30096

MedicalResearch.com: What is the background for this study?

Response: Hypertension (HTN) and osteoporosis (OP) are age-related disorders. Both increase rapidly in prevalence after age 65 years. Prior retrospective, post hoc studies have suggested that thiazide diuretics may decrease the risk of osteoporosis. These studies, by their nature, are open to bias. Moreover, these studies have not examined the effects of other anti HTN medications on osteoporosis.

Here we used a prospective blood pressure study of ~5 years duration to examine the effects of a thiazide diuretic, a calcium channel blocker and an ACE inhibitor on hip and pelvic fractures. We chose these fractures since they are almost always associated with hospitalization and thus their occurrence can be verified.

After the conclusion of the study we added another several years of follow up by querying medicare data sets for hip and pelvic fractures in those participants with medicare coverage after the study conclusion.

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Children using stimulant medications may be at risk for lower bone density

MedicalResearch.com Interview with:
Alexis Jamie Feuer MD
Assistant Professor of Clinical Pediatrics
Weill Cornell Medical College

MedicalResearch.com: What is the background for this study?

Response: Osteoporosis is a debilitating disorder characterized by low bone density and increased risk of fractures. Adolescence and young adulthood are critically important times for accruing peak bone density and failure to obtain adequate bone mass by early adulthood may result in future osteoporosis. In children, the use of certain medications can lead to a decrement in the acquisition of bone mass. Past studies have shown that stimulant medications, such as those used to treat Attention Deficit Hyperactivity Disorder (ADHD), may slow the rate of linear growth in children. To date, little research has been done to see what effects stimulant use may have on bone density and bone accrual in children. Stimulants exert their effects via activation of the sympathetic nervous system, and as there is mounting evidence that indicates the sympathetic nervous system plays a critical role in the acquisition of bone density, we sought to determine if there is any association between stimulant medication use and bone mass in the pediatric population.

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Urinary Citrate Excretion May Be Indirect Biomarker of Bone Health

MedicalResearch.com Interview with:
Jonas Esche

Dipl.-Mol. Biomed
University of Bonn
Institute of Nutritional and Food Sciences
DONALD Study

MedicalResearch.com: What is the background for this study?

Response: Modern western diets increase diet-dependent acid load and net acid excretion which are suggested to have adverse long-term effects on bone. Urinary potential renal acid load (uPRAL) is an established parameter to assess nutritional acid load. Urinary citrate, on the other hand, integrates nutritional and also systemic influences on acid-base homeostasis with high citrate indicating prevailing alkalization.
Against this background urinary citrate excretion was used as a new index of acid-base status and its relationship with bone strength and long-term fracture risk was examined.

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Calcium Supplements May Raise Risk of Dementia in Elderly Women with Cerebrovascular Disease

MedicalResearch.com Interview with:

Silke Kern, MD, PhD Neuropsychiatric Epidemiology Unit and Clinical Neurochemistry Laboratory Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg, Sweden

Dr. Silke Kern

Silke Kern, MD, PhD
Neuropsychiatric Epidemiology Unit and Clinical Neurochemistry Laboratory
Department of Psychiatry and Neurochemistry
Institute of Neuroscience and Physiology
Sahlgrenska Academy
University of Gothenburg
Gothenburg, Sweden

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Calcium has an important role in ischemic neuronal cell death and atherosclerosis. Several studies suggest that increased serum calcium increases the risk for vascular events and worsens the outcome after stroke. Widespread ischemic neuronal cell death and atherosclerosis might lead to dementia. We therefore examined if Calcium supplementation is associated with development of dementia. Our study is the first to show a relationship between Calcium supplementation and increased risk for dementia in older women. This risk is mainly confined to women with cerebrovascular disease (history of stroke or presence of white matter lesions).

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Some Populations Are Genetically Immune to Osteoporosis

MedicalResearch.com Interview with:
Dr. Constance Hilliard
Department of History
University of North Texas
Denton, TX

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: As an evolutionary historian, I have devoted the last several years to researching the health implications of genetic diversity. I was particularly concerned with the tendency of medical researchers to unwittingly use the biology of people with Northern European ancestry as a universal standard for everyone. For instance, lactose intolerance may be a disorder in that community, which suffers high rates of osteoporosis. But since 65% of the world’s population are lactose intolerant and have low rates of osteoporosis, a one-size-fits-all approach to bone health can prove dangerous for those whose ethnic-specific biological needs are overlooked.

This study shows that osteoporosis is not a global problem. It has a strong and devastating impact in dairy-farming societies and is virtually non-existent in the tsetse zone of West Africa, where cattle rearing and dairying are not possible. Previous studies have tried to correlate the degenerative bone disease with socio-economic income. However, this study compares two regions of Africa with similar socio-economic conditions. In dairy-farming East Africa, the incidence of osteoporosis is 245 per 100,000. However in the tsetse belt of West Africa, where people do not consume dairy products, it is 3 per 100,000. When regression analyses are performed on 40 countries around the world, the association between dairy consumption and osteoporosis is high (0.851). It only correlates with national Gross National Product at a regression rate of 0.447.

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High Phosphates in Processed Foods May Contribute To Increased Blood Pressure

MedicalResearch.com Interview with:

Dr-Wanpen-Vongpatanasin.jpg

Dr. Vongpatanasin

Wanpen Vongpatanasin, MD
Professor of Medicine
Norman & Audrey Kaplan Chair in Hypertension Research
Director, Hypertension Section
Cardiology Division
UT Southwestern Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Inorganic phosphate has been added to our processed food at an enormous amount as food preservatives and flavor enhancer such that typical American diet contains twice as much as the recommended daily allowance. A high phosphate (Pi) diet was recently shown to trigger blood pressure (BP) elevation in otherwise normal rats but the mechanisms are still unknown.We found that rats treated with high phosphate diet that mimics the excess Pi consumed by the general American population developed high BP related to increased sympathetic nerve activity (SNA), resulting in excessive peripheral vasoconstriction. This exaggerated increase in SNA and BP is evident particularly during exercise. This study is conducted in collaboration with Drs. Masaki Mizuno and Scott Smith, the two leading experts in neural control of circulation at UT Southwestern in the Department of Health Care Sciences.

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Potassium Compound In Fruits/Vegetables May Reduce Oxidative Stress

MedicalResearch.com Interview with:

Dr-Wanpen-Vongpatanasin.jpg

Dr. Vongpatanasin

Dr. Wanpen Vongpatanasin MD
The Norman and Audrey Kaplan Chair in Hypertension
UT Southwestern Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Diet rich in fruits, vegetables, and dairy products, known as the DASH diet, is known to reduce blood pressure in hypertensive patients. More recently, the DASH diet was shown to reduce oxidative stress in people with and without high blood pressure . However, the main nutritional ingredient responsible for these beneficial effects of the DASH diet remain unknown. Because the DASH diet is rich in potassium (K), magnesium (Mg), and alkali, we performed a randomized, double-blinded, placebo-controlled study to compare effects of KMg Citrate (KMgCit), K Chloride (KCl), and K Citrate (KCit) to allow dissociation of the three in hypertensive and prehypertensive individuals. This study was conducted in collaboration with Drs. Charles Pak and Orson Moe at UT Southwestern, the two leading experts in the field of Mineral Metabolism. We found that oxidative stress was markedly reduced by KMgCit powder compared to placebo, K Chloride, and K Citrate. On the hand, KMgCit has no significant effects on blood pressure .

MedicalResearch.com Editor’s note:  DO NOT Take Potassium supplements unless under the direction of your health care provider.

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New Bone Balance Index Predicts Bone Loss Across Menopause Transition

MedicalResearch.com Interview with:
Albert Shieh, MD
Division of Endocrinology, Diabetes and Hypertension
David Geffen School of Medicine
University of California, Los Angeles

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Whether an individual loses or gains bone mass is dependent on how much bone is being broken down (by osteoclasts) and being formed (by osteoblasts). Both processes occur simultaneously in the human body. At present, we can measure markers of bone breakdown (resorption) and formation. However, we hypothesized that to better predict the amount of bone mass that will be lost in the future, these markers should be combined in an “index” to reflect both processes, rather than being interpreted in isolation. Indeed, we found that the ability of our new bone balance index predicted future bone loss across the menopause transition better than the bone resorption marker alone.

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Humanized Antibody Romosozumab May Increase Bone Mass In Resistant Osteoporosis Patients

MedicalResearch.com Interview with:

Bente Langdahl Professor, Consultant, PhD, DMSc Department of Endocrinology and Internal Medicine THG Aarhus University Hospital Aarhus Denmark

Dr. Bente Langdahl

Bente Langdahl
Professor, Consultant, PhD, DMSc
Department of Endocrinology and Internal Medicine THG
Aarhus University Hospital
Aarhus Denmark

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Romosozumab is a humanised antibody against sclerostin currently in development for the treatment of osteoporosis. Romosozumab has a dual effect on bone; it stimulates bone formation and inhibits bone resorption. If this new treatment obtains regulatory approval and becomes available for the treatment of osteoporosis, some of the patients who will be candidates for this new treatment will already have been treated with other available treatments, for example, bisphosphonates. This study compared the effects of romosozumab and teriparatide, a currently available bone forming treatment, on bone mass, bone structure and bone strength. The results showed that the percent change from baseline in BMD at the total hip through month 12 (the primary endpoint) was significantly greater with romosozumab compared with teriparatide: 2.6 percent versus –0.6 percent, respectively (p<0.0001). For the secondary endpoints; lumbar spine BMD by DXA, total hip and femoral neck BMD by DXA and QCT and bone strength estimated by finite element analysis patients treated with romosozumab had significantly larger increases from baseline compared with those taking teriparatide, with mean differences ranging from 3.1 percent to 4.6 percent (all p-values <0.0001).

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Dietary Calcium Intake May Reduce Risk of Cardiovascular Disease In Low Calcium Intake Populations

MedicalResearch.com Interview with:
Dr. Chan Soo Shin MD PhD

Professor of Medicine
Seoul National University College of Medicine
Seoul, 03080, Korea

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Recently, a series of secondary analyses on large clinical trials and meta-analysis have reveled increased rate of cardiovascular events in women allocated to calcium supplements. As most of these studies were conducted in Western countries where the dietary calcium intake is sufficient, we aimed to investigate the association between dietary calcium intake level and cardiovascular events or mortality in Korea where the average dietary calcium intake is as low as 470 mg per day.

We have analyzed data from 4,866 adults aged at least 50 years without previous CDV or stroke history participating in the Ansung and Ansan cohort study, an ongoing, prospective, community-based study in Korea (2,690 women). Participants completed periodic food frequency questionnaires; CVD, stroke and fractures were recorded during interviews and examinations every 2 years. Researchers used proportional Cox regression analysis was used to determine HRs for all-cause mortality, CVD, cerebrovascular disease and fractures, adjusting for age, BMI, vegetable and fruit intake, protein and sodium intake, physical activity, smoking and drinking status, diabetes and hypertension history and total energy from diet. Researchers also adjusted for menopausal status and hormone replacement therapy in women. Women were followed for a mean of 9.2 years; men followed for a mean of 8.9 years.

Within the cohort, 359 participants died (243 men); 340 developed CVD (153 men); 157 experienced stroke (59 men); 568 experienced incident fractures (212 men).

In comparing the four quartiles for energy-adjusted calcium intake, women experienced an increased reduction in CVD risk with increasing dietary calcium intake. Women in the highest quartile saw the greatest reduced risk for CVD vs. the lowest quartile (HR = 0.53; 95% CI, 0.33-0.86), followed by women in the third (HR = 0.56; 95% CI, 0.36-0.85) and second quartiles (HR = 0.80; 95% CI, 0.55-1.17) when compared with women in the lowest quartile. We found no association between dietary calcium intake and stroke or fracture risk in women.

Dietary calcium intake did not affect all-cause mortality, CVD risk, stroke risk or fracture risk in men.

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Mediterranean Diet in Post Menopausal Women Linked to Better Bone Health

MedicalResearch.com Interview with:
Bernhard Haring, MD MPH
Department of Medicine I
Comprehensive Heart Failure Center
University of Würzburg
Germany

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Haring: The primary aim of this study was to examine the association between adherence to a diet quality index constructed on the basis of dietary recommendations or existing healthy dietary patterns and bone outcomes in a large population of postmenopausal women.

We found that higher diet quality based on a Mediterranean diet may play a role in maintaining bone health in postmenopausal women.
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Zinc Levels Can Be Improved In Nursing Home Patients with Supplementation

MedicalResearch.com Interview with:

Simin Nikbin Meydani, D.V.M., Ph.D. Director, JM USDA-HNRCA at Tufts University Professor of Nutrition and Immunology Friedman School of Nutrition Science and Policy and Sackler Graduate School at Tufts University Boston, MA 02111

Dr. Simin Meydani

Simin Nikbin Meydani, D.V.M., Ph.D.
Director, JM USDA-HNRCA at Tufts University
Professor of Nutrition and Immunology
Friedman School of Nutrition Science and Policy
and Sackler Graduate School at Tufts University
Boston, MA 02111

Medical Research: What is the background for this study?

Dr. Meydani: A significant number of older people are zinc deficient which can result in a compromised immune system which weakens as the body ages, making older adults more susceptible to infections and higher incidence and morbidity from pneumonia. Older adults with impaired immune response, particularly T cell-mediated function, have a higher susceptibility to infections and cancer. Our research team from the Jean Mayer USDA Human Nutrition Research Center on Aging created a small double-blind, placebo-controlled trial involved adults age 65 or older from three Boston-area nursing homes to determine the feasibility of increasing serum zinc concentrations in older adults. The full findings are published in The American Journal of Clinical Nutrition.

These results have a significant public health implication for the older adults because it shows directly that correction of a nutrient deficiency can improve immune response in older adult (a biological function which consistently has been shown to be impaired with aging).

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Study Finds No Evidence of Benefit from Chromium Supplements

Prof. Peter Lay PhD Professor of Inorganic Chemistry School of Chemistry | Faculty of Science Director, Vibrational Spectroscopy Core Facility Research Portfolio The University of Sydney

Prof. Peter Lay

MedicalResearch.com Interview with:
Prof. Peter Lay PhD

Professor of Inorganic Chemistry
School of Chemistry | Faculty of Science
Director, Vibrational Spectroscopy Core Facility
Research Portfolio
The University of Sydney

Medical Research: What is the background for this study? What are the main findings?
Response: My group has been studying the molecular mechanisms of chromium(VI)-induced cancers and the biochemistry of vanadium over the last three decades. Vanadium drugs have been in clinical trials for their anti-diabetic effects that occur via species with very similar chemistry to chromium(VI).  The more we understood the biochemistry of each, the more we questioned whether the efficacies of anti-diabetic chromium(III) supplements were associated with the generation of carcinogenic chromium(VI) and chromium(V). To test this, we conducted experiments to either provide evidence for our hypothesis or disprove it.  This work commenced some 15 years ago with studies on the changes in the nature of chromium(III) supplements exposed to simulated gastrointestinal juices, as well as in human and animal blood serum over times that mimicked the residence time of the supplements in the human body.

We discovered that all supplements were changed to a range of different Cr(III) species in both the GI tract and the blood.1,2  Common species were observed, but the rates at which they formed were dependent on the nature of the chromium(III) supplement.  Both the supplements themselves and the chromium(III) species that formed in blood serum were partially oxidised to Cr(VI) at concentrations of the oxidant, hydrogen peroxide (a type of bleach), found in the blood of people with type II diabetes.1,2 One of the clinical features of patients with type II diabetes is increased levels of oxidants, such as hydrogen peroxide, in their blood and cells. These oxidants are associated with many of the side-effects of type II diabetes that are associated with reduced life expectancy.

These transformed chromium(III) species bound to blood proteins were more easily oxidised to chromium(VI) than the administered Cr(III) supplements.  The faster a particular chromium(III) supplement reacted with blood proteins to form these easily oxidised chromium(III)-protein species, the more active was the Cr(III) supplement in its anti-diabetic activity in animal and human studies reported by other groups.1-5  According to many health and regulatory bodies, chromium(III) has minimal or no efficacy in glucose metabolism and no other beneficial effects, such as weight loss or muscle building, in well conducted human and animal trials with non-diabetic subjects. This is consistent with our proposed mechanism of action. It is only under oxidising physiological conditions associated with type II diabetes that chromium(III) can be partially transformed to sufficient concentrations of carcinogenic chromium(VI) to enable significant biological activity.  In a large clinical trial where diabetic patients were treated with high doses of chromium(III) picolinate (one of the least efficacious supplements in animal studies), there was no efficacy in patients with controlled type II diabetes. Only those patients with uncontrolled type II diabetes exhibited improved glucose metabolism.  These patients, who have the highest concentrations of oxidants with the ability to transform chromium(III) to chromium(VI) in blood, are therefore at the greatest risk of developing Cr-induced cancers. Even where efficacy was observed, glucose metabolism was only reduced to the levels in patients with controlled type II diabetes; i.e., no patients exhibited a return to normal glucose metabolism.4,5

Coupled with all of this information our separate studies showed that chromium(VI) and chromium(V), but not chromium(III), are strong inhibitors of protein tyrosine phosphatase (PTP) enzymes.  The relevance of this is that drugs that inhibit PTPs activate circulating insulin in people with type II diabetes.  That is, it causes insulin to bind more strongly to cells involved in glucose metabolism (such as fat cells) to bring about the cascade of biochemical reactions that import glucose into cells and metabolise it.1-5

Thus we were able to link all of the animal, human and in vitro studies to show that physiological conditions under which chromium(III) had the highest probability of being transformed to chromium(VI) were also those in which chromium(III) supplements were most active.1-5 Moreover, we were able to provide a mechanism of activity that required chromium(VI) and chromium(V) to be generated for insulin enhancing activity.1-5  What remained was to establish whether we could observe Cr(VI) and Cr(V) in cells treated with chromium(III) supplements. This has now been established in our most recent study6 that have just been published. Contrary to the press releases of the dietary supplement industry, the published paper was carefully planned to mimic those conditions found in vivo.  The chromium(III) supplement chosen was that which had a chemical structure most closely resembling those generated in blood plasma. Thus we were able to complete the circle in linking our extensive studies on the biochemistry of chromium(III) species generated from chromium(III) supplements in the blood and show that such species were absorbed by the relevant cells and partially oxidised to chromium(VI) and chromium(V).

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No evidence dietary acid load has detrimental effect on childhood bone health

Audry H. Garcia PhD Scientist Department of Epidemiology Erasmus MC, University Medical Center Rotterdam Rotterdam, The Netherlands

Dr. Garcia

MedicalResearch.com Interview with:
Audry H. Garcia PhD
Scientist Department of Epidemiology
Erasmus MC, University Medical Center Rotterdam
Rotterdam, The Netherlands

Medical Research: What is the background for this study? What are the main findings?

Dr. Garcia: Mild and chronic metabolic acidosis as a result of a diet rich in acid-forming nutrients, such as cheese, fish, meat and grain products, may interfere with optimal bone mineralization and indirectly increase the risk of osteoporosis later in life. Previous observational studies in adults have reported inverse associations between dietary acid load and bone mass. However, the evidence in younger populations is scarce; only a few studies have been performed in healthy children and adolescents with inconsistent results, and not much is known on the effects of dietary acid load on bone mass in younger children or in children with a non-European background.

In a prospective multiethnic population-based cohort study of 2,850 children from the city of Rotterdam, the Netherlands, we found that dietary acid load estimated as dietary potential renal acid load (dPRAL), and as protein intake to potassium intake ratio (Pro:K) at 1 year of age, was not consistently associated with childhood bone health. Furthermore, associations did not differ by sex, ethnicity, weight status, or vitamin D supplementation.

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Study Suggests Long-Term, High Dose PPIs Should Be Avoided if Possible

MedicalResearch.com Interview with:
Andrew M Hinson, MD
UAMS Postdoctoral Research Fellow
Thyroid/Parathyroid Diseases & Surgery and
Donald L. Bodenner, MD, PhD
Department of Otolaryngology-Head and Neck Surgery
Department of Geriatrics
University of Arkansas for Medical Sciences, Little Rock, Arkansas.

Medical Research: What is the background for this study?

Response: Proton pump inhibitors (PPIs)​ are widely prescribed, highly effective and generally safe for the treatment of acid-related gastrointestinal disorders. However, there are risks that may be elevated for some older people when PPIs are used in high doses over long periods of time. There is also evidence that fracture risk may even be higher in older patients who are being treated with concurrent oral bisphosphonate medications, which are used to prevent fractures in patients with osteoporosis. While the mechanism remains unknown, PPIs may increase fracture risk by decreasing gastrointestinal absorption (e.g., calcium, vitamin B12, and/or bisphosphonates) or by inhibiting a major mechanism by which bisphosphonates work.

To learn more about this process, we studied patients 60 years or older with normal renal function and vitamin D levels to see how PPIs (with and without concurrent bisphosphonate administration) impacted measurements in parathyroid hormone (PTH) and calcium.

Medical Research: What are the main findings?

Response: We found that chronic PPI exposure in elderly adults is associated with mild secondary hyperparathyroidism regardless of concurrent oral blood pressure administration. Secondary hyperparathyroidism refers to the excessive secretion of PTH by the parathyroid glands in response to low blood calcium levels. This is often associated with renal failure; however, all of our patients had normal renal function.

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Calcium Supplements Linked To Increased Risk of Kidney Stones

MedicalResearch.com Interview with:
Christopher Loftus M.D. candidate
Cleveland Clinic Lerner College of Medicine

Medical Research: What is the background for this study? What are the main findings?

Response: Most kidney stones are made, at least partially, of calcium composite. In a prospective study of nurses in the post-menopausal age, it was found that diets that contained high amounts of calcium were beneficial in preventing kidney stones in this population. In the gut, calcium can bind to oxalate which prevents it from being absorbed into the body and decreases the concentration of calcium in the urine. However there has been debate as to whether supplemental calcium (calcium pills) has the same beneficial effects as calcium in the diet. Supplemental calcium enters the gut in large quantities all at once so it may enter the blood stream in higher concentrations over smaller amounts of time. By the same token, vitamin D plays a role in the management and balance of calcium in the body and could potentially have an effect on stone formation as well.  It has also been debated whether vitamin D supplementation has major effect on patients who are known to be stone formers.  So we reviewed CT scans of patients and 24 hour urine collections (both male and female of adult age) who were known to have kidney stones and measured the growth of stones over a period of time.

Our main findings were that supplementary calcium increased the rate of stone formation in these patients. We also found that vitamin D had a protective effect and patients taking only vitamin D had a slower rate of stone progression.

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Calcium Supplements Do Not Prevent Bone Fractures

MedicalResearch.com Interview with:
Dr. Mark J Bolland
Associate professor of medicine
Department of Medicine
University of Auckland
Auckland New Zealand

Medical Research: What is the background for this study?
Dr. Bolland: Many guidelines advise older people to take at least 1000-1200 mg/day of calcium to improve bone density and prevent fractures. The average calcium intake in most countries is a lot less than these recommendations, and so many people take calcium supplements to increase their calcium intake. However, recent concerns about the safety of calcium supplements have led experts to recommend increasing calcium intake through food rather than by taking supplements, even though the effect of increasing dietary calcium intake on bone health had not been clearly established. Our study was designed to fill this evidence gap.

Medical Research: What are the main findings?

Dr. Bolland: Firstly, we found that increasing calcium intake either from the diet or by taking calcium supplements led to similar, small, one-off increases in bone density of 1-2%. These increases do not build up over time and are too small to produce significant reductions in the chance of having a fracture.

Secondly, the level of dietary calcium intake is not associated with the risk of having a fracture.

Thirdly, in clinical trials, calcium supplements have only small, inconsistent benefits on preventing fractures, with no effect on fractures seen in the highest quality trials
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Growth Hormone Reduced Fractures in Osteoporosis Patients

MedicalResearch.com Interview with:
Emily Krantz (né Amundson) MD
Södra Älvsborgs Hospital
Borås, Sweden

Medical Research: What is the background for this study? What are the main findings?

Response: This study is a 10-year follow up of a double-blind placebo controlled trial in which women with post menopausal osteoporosis received Growth Hormone (GH) for 3 years (Landin-Wilhelmsen JBMR 2003;18:393-404). Positive effects of the treatment on the patients bone mineral density and bone mineral content were seen after another 7 years. Furthermore and most interestingly, fracture incidence decreased dramatically from 56% to 28% (p=.0003) in the osteoporosis patients while fractures increased significantly in the control group, from 8% to 32% (p=.0008). Health Related Quality of Life was also measured throughout the study’s duration and it did not change nor did it differ from the control group.

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Serum Phosphorus Level May Be a Biomarker For Anemia

MedicalResearch.com Interview with:
Lac Tran, MD
Division of Nephrology and Hypertension
Kaiser Permanente Los Angeles Medical Center
Los Angeles, CA

Medical Research: What is the background for this study? What are the main findings?

Dr. Tran: Abnormal serum phosphorus levels have been associated with adverse cardiovascular outcomes and progression to renal failure.  Given phosphorus’s important biological roles in cellular replication and bone mineral metabolism, we sought to investigate the association between phosphorus levels and anemia in normal kidney function and early chronic kidney disease.

Our study is a population-based study among a large racially/ethnically diverse population within the Kaiser Permanente Southern California health system.
Among 155, 974 individuals, 4.1% had moderate anemia and 12.9% had mild anemia.  We found that phosphorus levels greater than 3.5 mg/dL and less than 2.0 mg/dL showed a greater likelihood for moderate anemia.  Every 0.5 mg/dL phosphorus level increase demonstrated a 16% greater likelihood for moderate anemia.  The highest phosphorus tertile of our population had a 26% greater likelihood for anemia compared to the middle tertile.  We also found that female sex, Asian race, diabetes, low albumin, and low iron saturation were risk factors for anemia.

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Osteoporosis May Increase Risk of Hearing Loss

Dr. Kai-Jen Tien MD Division of Endocrinology and Metabolism, Department of Internal Medicine Chi Mei Medical Center, Tainan, TaiwanMedicalResearch.com Interview with:
Dr. Kai-Jen Tien MD
Division of Endocrinology and Metabolism, Department of Internal Medicine
Chi Mei Medical Center, Tainan, Taiwan

Medical Research: What is the background for this study? What are the main findings?

Response: Previous studies investigating the relationship between osteoporosis and sudden sensorineural hearing loss were rare. Most of the studies were of small sample size, or cross-sectional designs and their results were inconclusive. Our population-based study found an approximately 1.76-fold increase in the incidence of sensorineural hearing loss for patients with osteoporosis compared with the comparison group.Patients with more severe osteoporosis may have a higher risk of SSNHL than patients with osteoporosis of milder severity.

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Space Flight Model Links Aging, Osteoporosis and Immunity

Dr. Jean-Pol Frippiat Stress, Immunity and Pathogens Laboratory at Lorraine University Vandoeuvre-lès-Nancy, FranceMedicalResearch.com Interview with:
Dr. Jean-Pol Frippiat
Stress, Immunity and Pathogens Laboratory
Lorraine University
Vandoeuvre-lès-Nancy, France 


What is the background for this study? What are the main findings?

Dr. Frippiat: Osteoporosis is associated to spaceflight. Consequently, we wondered whether changes in bone micro-structure induced by a ground-based model of spaceflight, hindlimb unloading (HU) that simulates some of the effects of spaceflight on mice, induces changes in B lymphocyte production in the bone marrow.

To this end, we analyzed both bone parameters and the frequency of cells of the B lineage in the bone marrow of young, old and HU mice. We found that HU leads to a decrease in both bone micro-structure and the frequency of B cell progenitors in the bone marrow. A major block at the pro-B to pre-B cell transition was observed indicating a decrease in the formation of B cells in the bone marrow. Interestingly, the modifications in B cell production were similar to those observed in aged mice.

These findings demonstrate that mechanical unloading, to which astronauts are subjected during spaceflight, results in a decrease in B cell differentiation that resemble age-related modifications in B lymphopoiesis.

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Calcium Supplements in Women: Is there an Increased Risk of Stroke or Heart Disease?

Dr. Julie Paik, MD MPH Instructor, Harvard Medical School Brigham and Women's Massachusetts GeneralMedicalResearch.com Interview with:
Dr. Julie Paik, MD MPH MSc
Instructor, Harvard Medical School
Brigham and Women’s Hospital

MedicalResearch: What are the main findings of the study?

Dr. Paik: Many women in the United States take calcium supplements. One study found that over 60% of women aged 60 and over in the United States were taking calcium supplements. However, the medical community is still not certain of the effects of calcium supplements in women, particularly on cardiovascular disease risk. For this reason, we studied 74,245 women participating in the Nurses’ Health Study over a 24-year follow-up period for their risk of developing cardiovascular disease (heart disease or stroke). We found that there was no increased risk of heart disease or stroke among women taking calcium supplements during the 24-year follow-up period. Our paper has several distinct strengths compared to prior studies including the large sample size, long follow-up period, cases of cardiovascular disease that were confirmed by medical record review, detailed and repeated assessment of calcium supplement use, and detailed information about other risk factors for cardiovascular disease.

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Cardiovascular Risk: Effects of High Dose Calcium Tablets

Joshua Lewis, Ph.D Raine Foundation / Alan Robson Fellow Bone and Vascular Research Group School of Medicine and Pharmacology University of Western Australia Department of Endocrinology and Diabetes Sir Charles Gairdner Hospital Hospital Avenue, Nedlands 6009MedicalResearch.com Interview with:
Joshua Lewis, Ph.D
Raine Foundation / Alan Robson Fellow
Bone and Vascular Research Group
School of Medicine and Pharmacology
University of Western Australia
Department of Endocrinology and Diabetes
Sir Charles Gairdner Hospital
Hospital Avenue, Nedlands 6009

www.boneandvascularresearch.org.au

MedicalResearch.com: What are the main findings of the study?

Dr. Lewis: The paper reports the findings from an ancillary study of the effects of 1200 mg per day of calcium supplementation on a major predictor of heart disease risk, carotid artery intima-medial thickness and atherosclerosis. The principle study was a large five-year double blind randomized controlled trial of calcium supplements or a placebo. After 3 years of calcium supplementation or placebo measures of carotid artery intima-medial thickness were identical in the placebo and calcium treated patients.  Atherosclerotic plaque was reduced in calcium treated patients when analysed as total calcium intake. These findings argue strongly against an adverse effect of high dose calcium tablets on cardiovascular risk.

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Bisphosphonates: Risks of AFib and Stroke

Abhishek Sharma, M.B.B.S. Maimonides Medical Center in Brooklyn, N.Y.MedicalResearch.com Interview with:
Abhishek Sharma, M.B.B.S.
Maimonides Medical Center in Brooklyn, N.Y.

 

MedicalResearch.com: What are the main findings of the study?

Answer:  Evidence from RCT’s and observational studies suggests a significantly increased risk of atrial fibrillation (AF) requiring hospitalization, but no increase in risk of stroke or cardiovascular mortality with the use of bisphosphonate. Continue reading

Hypertension: Lower Chloride Levels Associated with Increased Mortality

MedicalResearch.com Interview with: Dr Sandosh Padmanabhan Institute of Cardiovascular and Medical Sciences University of Glascow, ScotlandMedicalResearch.com Interview with:
Dr Sandosh Padmanabhan

Institute of Cardiovascular and Medical Sciences
University of Glascow, Scotland

 

MedicalResearch.com: What are the main findings of the study?

Dr. Padmanabhan: In the study “Serum Chloride Is an Independent Predictor of Mortality in Hypertensive Patients” we analysed data on 12,968 patients with hypertension followed up at the Glasgow Blood Pressure Clinic. We found that patients in the lowest quintile of serum Cl (<100 mmol/L), compared with all other patients, had a 23% higher mortality (all-cause, cardiovascular, and non-cardiovascular). Each 1-mmol/L increase in serum Cl was associated with a 1.1% to 1.5% lower all-cause mortality, cardiovascular mortality and non-cardiovascular mortality. This was independent of serum concentrations of sodium, bicarbonate or potassium. We did not find any association with longitudinal blood pressure control.

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Breast Cancer: Surgical Oophoretomy + Tamoxifen – Impact on Bone Loss

Richard R. Love, MD MS International Breast Cancer Research Foundation Professor of Medicine and Public Health The Ohio State University Columbus, OHMedicalResearch.com: Interview with:

Richard R. Love, MD MS
International Breast Cancer Research Foundation
Professor of Medicine and Public Health The Ohio State University
Columbus, OH
MedicalResearch.com: What are the main findings of the study?

Answer: Surgical oophorectomy and tamoxifen treatment was associated with no loss of bone mineral density (BMD) in the femoral neck, and loss of BMD in the first year, followed by stabilization in the lumbar spine.
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Iron Stores and Bone Loss During Long-Duration Space Flight on the International Space Station

Scott M. Smith, Ph.D.  Nutritionist, Manager for Nutritional Biochemistry Biomedical Research and Environmental Sciences Division NASA Johnson Space Center Houston, TX 77058MedicalResearch.com Interview with:
Scott M. Smith, Ph.D.

Nutritionist, Manager for Nutritional Biochemistry
Biomedical Research and Environmental Sciences Division
NASA Johnson Space Center
Houston, TX 77058

Iron status and its relations with oxidative damage and bone loss during long-duration space flight on the International Space Station

MedicalResearch.com: What are the main findings of the study?

Dr. Smith:  The key finding from this study is that the increase in iron stores during spaceflight is related to both oxidative damage and bone loss.  Iron stores increase in microgravity because blood volume decreases during the initial weeks of spaceflight. The iron in excess red blood cells is not reused by new RBCs during spaceflight and is stored.  This increase in iron stores was associated with increased indices of oxidative damage, and furthermore, the magnitude of the increase in iron stores during flight (i.e., the area under the curve) was correlated with bone mineral density loss.  That is, the greater the iron stores, the more bone loss.
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Calcium-deficiency assessment and biomarker identification by an integrated urinary metabonomics analysis

 MedicalResearch.com eInterview with Maoquing Wang

Department of Nutrition and Food Hygiene, School of Public Health, Harbin MedicalUniversity, 157 Baojian Road, Nangang District, Harbin, 150081, P. R. China MedicalResearch.com: What are the main findings of the study?

Dr. Wang: Our group first reported that the 2-week low-calcium diet could result in metabolic changes and 27 reliable biomarkers of calcium deficiency were identified. The correlations between calcium intake and two of the biomarkers indicated that these biomarkers could be used alone or in combination as a non-invasive screening method with greater sensitivity and specificity for the diagnosis of calcium deficiency in humans in future. The identified biomarkers give new insights into the pathophysiological changes and molecular mechanisms of calcium deficiency.
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