Search

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1532-5415.2009.02481.x Keywords: dietary acid load; nuts; Mediterranean diet; bone metabolism; clinical trials Abstract: OBJECTIVES: To analyze the effect of differing diet on the acid load content on bone metabolism. DESIGN: Multicentric, randomized, single-blind, parallel-group clinical trial. SETTING: Outpatient clinics. PARTICIPANTS: Two hundred thirty-eight elderly men and women aged 60 to 80 at high risk for cardiovascular disease were randomly assigned to three interventional groups: a recommended low-fat diet (control diet group), a Mediterranean diet supplemented with virgin olive oil, or a Mediterranean diet supplemented with mixed nuts. MEASUREMENTS: Main outcomes were 12-month changes from baseline in bone formation and resorption markers and bone mass measured according to quantitative ultrasound scanning. RESULTS: The baseline data on the anthropometric, bone densitometry, and biochemical variables did not differ between the three groups. Dietary potential renal acid load (PRAL) and daily net endogenous acid production (NEAP) at baseline did not differ between groups. After intervention, subjects allocated to the Mediterranean diet with mixed nuts had a significant increase of PRAL and NEAP. In comparison, subjects in the Mediterranean diet with nuts group had higher parathyroid hormone (PTH) levels (2.63, 95% confidence interval (CI)=-1.01-6.35, P=.02) and a nonsignificantly higher (0.31, 95% CI=-0.13-0.74, P=.14) urine free deoxypyridoxine:creatinine ratio, a marker of bone resorption, than the control group and the Mediterranean diet with virgin olive oil group. CONCLUSION: A Mediterranean dietary pattern associated with a high dietary acid load derived from consumption of mixed nuts does not seem to have a much greater effect on bone metabolism biomarkers, with the exception of PTH levels, than a Mediterranean diet without mixed nuts or a control diet in elderly subjects. Author Affiliation: (*)From the Human Nutrition Unit, School of Medicine, Institut d'Investigacions Sanitaries Pere i Virgili ([parallel])Lipids and Atherosclerosis Research Unit, School of Medicine, University Rovira i Virgili, Reus, Spain ([dagger])Centros de Investigacion Biomedica en Red, CB06/03 Physiopathology Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain ([double dagger])Preventive Medicine and Public Health Department, School of Medicine, University of Navarra, Pamplona, Spain; and (s.)Internal Medicine Department, Institut d'Investigacions Biomediques August Pi i Sunyer, Hospital Clinic, Barcelona, Spain. Article note: Address correspondence to Monica Bullo, Human Nutrition Unit, Faculty of Medicine of Reus, University Rovira i Virgili, C/Sant Llorenc 21, 43201 Reus, Spain. E-mail: monica.bullo@urv.cat

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1532-5415.2009.02318.x Keywords: aging; IGF-1; IGFBP; mortality Abstract: OBJECTIVE: To evaluate the relationship between serum insulin-like growth factor 1 (IGF-1), IGF-1 binding protein 1 (IGFBP-1), and IGF-1 binding protein 2 (IGFBP-2) and fasting insulin, fasting glucose, adiposity, and mortality in older adults. DESIGN: A prospective cohort study with mean follow-up of 6.2 years. SETTING: Participants were recruited and followed at two centers affiliated with academic medical institutions. PARTICIPANTS: Six hundred twenty-five men and women aged 70 and older and in good health at the time of enrollment. MEASUREMENTS: Serum IGF-1, IGFBP-1, and IGFBP-2; fasting serum insulin; fasting serum glucose; visceral fat; and total percent fat. RESULTS: Higher IGFBP-1 and higher IGFBP-2 were significantly associated with lower fasting insulin, lower fasting glucose, and lower adiposity, but higher IGFBP-1 and IGFBP-2 were associated with greater mortality. In multivariate adjusted models, the hazard ratio for all-cause mortality was 1.48 (95% confidence interval (CI)=1.14-1.92) per standard deviation (SD) increase in IGFBP-2 and 1.34 (95% CI=1.01-1.76) per SD increase in IGFBP-1. No association was found between IGF-1 and all-cause mortality. CONCLUSIONS: Higher IGFBP-1 and IGFBP-2 are associated with lower adiposity and decreased glucose tolearance but also with greater all-cause mortality. Higher levels of serum IGF-1 binding protein (IGFBP) may indicate greater IGF-1 activity and thus represent an association between higher IGF-1 activity and mortality in humans. Author Affiliation: (a)Department of Medicine (b)Institute for Human Genetics (c)Department of Anesthesia (d)Department of Epidemiology and Biostatistics (e)Helen Diller Family Comprehensive Cancer Center, University of California at San Francisco, San Francisco, California (f)Department of Kinesiology, University of Wisconsin, Madison, Wisconsin (g)Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania (h)Department of Preventive Medicine, University of Tennessee, Memphis, Tennessee (i)Jackson Laboratory and St. Joseph Hospital, Bangor, Maine (j)California Pacific Medical Center Research Institute, San Francisco, California; and (k)Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, Maryland. Article note: Address correspondence to Elad Ziv, 1701 Divisadero Street, Suite 554, UCSF Box 1732, San Francisco, CA 94115. E-mail elad.ziv@ucsf.edu

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1532-5415.2009.02257.x Byline: Mikko P. Bjorkman (*[dagger]), Antti J. Sorva ([double dagger]), Juha Risteli (s.), Reijo S. Tilvis (*[dagger]) Keywords: parathyroid hormone; hip fracture; aged patients; chronic immobilization Abstract: OBJECTIVES: To identify the clinical conditions associated with low parathyroid hormone (PTH) in patients with vitamin D deficiency and to evaluate the stability of the blunted PTH response to vitamin D deficiency over 6 months. DESIGN: Secondary analysis of a randomized double-blind controlled vitamin D supplementation trial. SETTING: Four long-term care hospitals in Helsinki, Finland. PARTICIPANTS: Two hundred eighteen chronically bedridden patients. MEASUREMENTS: Plasma 25-hydroxyvitamin D (25-OHD), intact PTH, amino-terminal propeptide of type I procollagen (PINP), carboxy-terminal telopeptide of type I collagen (ICTP), activities of daily living (ADLs), and body mass index (BMI) were measured at baseline and at 6 months. Patient records were reviewed for demographic data. RESULTS: PTH was within reference values (8-73 ng/L) despite low 25-OHD level ( CONCLUSION: The absence of secondary hyperparathyroidism seems to be common and persistent in frail chronically bedridden patients with vitamin D deficiency. Attenuated parathyroid function appears to be associated with immobilization that causes accelerated bone resorption. Further studies addressing the possible adverse effects of low PTH are warranted. Author Affiliation: (*)Internal Medicine and ([dagger])Geriatrics, Helsinki University Central Hospital, Helsinki, Finland ([double dagger])Department of Long-Term Care, Helsinki Health Center, Helsinki, Finland; and (s.)Department of Clinical Chemistry, University of Oulu, Oulu, Finland. Article note: Address correspondence to Mikko Bjorkman, Helsinki University Central Hospital, Clinics of Internal Medicine and Geriatrics, POB 340, FI-00029 HUS, Helsinki, Finland. E-mail: mikko.bjorkman@helsinki.fi

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1532-5415.2008.01966.x Keywords: PTH; falls; physical performance Abstract: OBJECTIVES: To examine the association between serum parathyroid hormone (PTH) levels and incident falls in older adults with diabetes mellitus. DESIGN: Longitudinal analysis of incident falls over 1 year in a substudy of participants with diabetes mellitus in the Health, Aging and Body Composition Study. SETTING: Pittsburgh, Pennsylvania, and Memphis, Tennessee. PARTICIPANTS: Well-functioning, community-dwelling black and white adults aged 70 to 79 with diabetes mellitus (N=472). MEASUREMENTS: Measured baseline serum PTH. Self-report of falls over the subsequent 12 months. Baseline physical performance and self-reported demographic, behavioral, and health status measures including kidney function, chronic conditions, and medication use. RESULTS: One-third (30.3%) of participants reported falling over 1 year of follow-up. Mean baseline serum PTH was 53.5[+ or -]30.0 pg/mL in nonfallers and 62.6[+ or -]46.2 pg/mL in fallers (P=.01). For every 1 standard deviation (36 pg/mL) increment in baseline serum PTH, there was approximately a 30% greater likelihood of reporting a fall in the subsequent year, after adjusting for age, sex, race, field center, alcohol consumption, body mass index, physical activity, and winter or spring season (adjusted odds ratio (aOR)=1.30, 95% confidence interval (CI)=1.06-1.59). Further adjustment for kidney function, chronic conditions, medication and supplement use, and physical performance attenuated the association slightly (aOR=1.26, 95% CI=1.01-1.58). A trend remained after additional adjustment for reported falls in the previous year. CONCLUSION: Higher serum PTH was associated with incident falls in older, well-functioning men and women with diabetes mellitus. Further investigation aimed at understanding the underlying mechanism for the association between serum PTH and falls is needed. Author Affiliation: (*)Sticht Center on Aging ([dagger][dagger])Department of Cancer Biology, Wake Forest University, Winston-Salem, North Carolina ([dagger])Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California ([double dagger])Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania (s.)Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee (#)Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland ([paragraph])Clinical Research Branch, National Institute on Aging, Baltimore, Maryland (**)Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, Georgia Article note: Address correspondence to Denise K. Houston, Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157. E-mail: dhouston@wfubmc.edu