[show abstract][hide abstract] ABSTRACT: This study was performed in order to analyze the relationships between hair zinc, lead, and cadmium with the kind of diet consumed (by recall of the diet consumed the previous 14 days), living area (urban or rural), tobacco smoking, and body mass index (BMI) among 419 individuals of the Canary Archipelago. Median values and interquartile range were 43 μg/g (18.50-132.50) for zinc, 4.09 μg/g (2.19-8.38) for lead, and 0.128 μg/g (0.05-0.30) for cadmium. We observed that hair zinc was markedly elevated among those consuming fish more frequently and, to a lesser amount, among those who consumed meat frequently, among those living in urban areas, and among those with BMI over 25 kg/m(2), keeping a significant relationship with BMI. Hair lead was also higher among fish consumers, showed a trend to higher values among inhabitants of urban areas, and was lower among obese individuals. Hair cadmium was higher among those who consumed less vegetables and fruits. By multivariate analysis, introducing the variables meat, fish, and vegetable consumption, urban/rural; sex; age; and BMI values, we observed that fish consumption (beta = 0.15) was the only variable independently associated to higher zinc levels; fish consumption (beta = 0.15) and meat consumption (beta = 0.17) were related to high cadmium levels, whereas meat consumption was significantly associated to higher hair lead levels (beta = 0.15). Therefore, we conclude that hair zinc, cadmium, and lead seem to depend more heavily on dietary habits than on tobacco consumption or living in rural or urban areas.
Biological trace element research 01/2014; · 1.92 Impact Factor
[show abstract][hide abstract] ABSTRACT: Alcohol induces cytokine secretion by Kupffer cells, which may exert also deleterious effects on distant organs, mediated in part by cytokine-derived increased production of reactive oxygen species (ROS). It is therefore important to assess antioxidant levels. The objective of this study is to analyse the relation of antioxidant vitamins with brain atrophy and cognitive dysfunction.
In 77 alcoholic patients admitted for withdrawal syndrome, subjected to brain computed tomography (CT), and 19 controls, we determined antioxidant vitamin levels and analysed their relationships with data of brain atrophy and dysfunction. Searching for causes of altered vitamin levels, we also assessed liver function, nutritional status, eating habits, alcohol intake, proinflammatory cytokine (TNF-α, IL-6, IL-8) levels and malondialdehyde (MDA) levels.
Both retinol (vitamin A) and tocopherol (vitamin E) levels were decreased in alcoholics, the former in relation with liver failure, and the latter in relation with triglyceride levels and fat mass. Both were related to data of brain atrophy and cerebellar shrinkage (to which also IL-6 was significantly related).
Among alcoholics, liver function impairment leads to altered serum vitamin A levels, which are related to brain alterations. Vitamin E levels are also decreased, but although in relation with liver function impairment, its decrease seems to be more dependent on nutritional status and irregular eating habits. Both vitamins are lower in patients with cerebellar atrophy and other features related to brain atrophy.
Alcohol and Alcoholism 09/2013; · 1.96 Impact Factor
[show abstract][hide abstract] ABSTRACT: Steatohepatitis is a common finding in chronic hepatitis C virus (HCV) infection. As in other forms of steatohepatitis, oxidative damage may play an outstanding role. However, there are conflicting results relative to the role of iron on hepatic lipogenesis. Proinflammatory cytokines up-regulate ferritin expression, probably reflecting a defensive mechanism against increased oxidative stress, capable to open haem ring and release reactive iron. On the contrary, some adipokines, such as adiponectin, are associated with low ferritin levels. The aim of this study is to analyse the relationships of the amount of liver steatosis with serum iron, transferrin and ferritin as well as with proinflammatory cytokines, such as tumour necrosis factor (TNF)-α and interleukin (IL)-6, and adiponectin levels. We included 82 HCV infected patients and assessed the amount of liver fat by histomorphometry and its relationships with serum iron, ferritin and transferrin, adiponectin and TNF-α and IL-6. Liver steatosis was observed in 67 patients out of 82; in the remaining 15 patients, no steatosis at all was found. Patients with steatosis showed significantly higher serum ferritin levels than patients without steatosis (Z = 2.14; p = 0.032). When patients were classified in quartiles according to the intensity of steatosis, we observed that both TNF-α (KW = 10.6; p = 0.014) and IL-6 (KW = 15.2; p = 0.002) were significantly different among the four groups. Patients with more intense steatosis (highest quartile) showed the highest TNF-α and IL-6 values. Patients with severe hepatitis had higher levels of serum iron than patients with mild to moderate hepatitis. Serum iron also showed a correlation with the proportion of fibrosis (ρ = 0.30; p = 0.007). Serum iron levels are related with biochemical and histological parameters derived from liver inflammation in HCV-associated liver disease. Serum ferritin is higher among those with intense steatosis and also shows a (non-significant) trend to be associated with the more severe forms of hepatitis.
Biological trace element research 07/2013; · 1.92 Impact Factor
[show abstract][hide abstract] ABSTRACT: Oxidative damage plays a key role in alcohol-mediated liver alterations. Selenium, a potent antioxidant, is decreased in alcoholics. This study was conducted to analyse if the supplementation with selenium may alter liver changes in a murine model fed ethanol and/or a 2 % protein-containing diet, following the Lieber-DeCarli design. Adult male Sprague Dawley rats were divided into eight groups which received the Lieber-DeCarli control diet; an isocaloric, 36 % ethanol-containing diet; an isocaloric, 2 % protein-containing diet; and an isocaloric diet containing 2 % protein and 36 % ethanol diet; and other similar four groups to which selenomethionine (1 mg/kg body weight) was added. After sacrifice (5 weeks later), liver fat amount and hepatocyte areas of pericentral and periportal cells were measured, and liver and serum selenium, activity of liver glutathione peroxidase (GPX), and liver malondialdehyde were determined. Ethanol-fed rats showed increased hepatocyte areas and fat accumulation especially when ethanol was added to a 2 % protein diet. Selenium caused a decrease in hepatocyte ballooning and liver fat amount, but an increase in GPX activity, and a marked increase in serum and liver selenium. The present study demonstrates that selenium, added to the diet of rats in the form of seleniomethionine, prevents the appearance of early signs of ethanol-mediated liver injury under the conditions of the Lieber-DeCarli experimental design.
Biological trace element research 07/2013; · 1.92 Impact Factor
[show abstract][hide abstract] ABSTRACT: AIMS: Sclerostin is an endogenous inhibitor of the Wnt/β-catenin pathway secreted by osteocytes, which inhibits osteoblast function, differentiation and survival. As a consequence, sclerostin tends to decrease bone mass. Alcoholics frequently present osteoporosis, mainly due to decreased bone synthesis. The behaviour of sclerostin in these patients is unknown. The aim of this work was to analyse the relationship between serum sclerostin levels and bone mineral density (BMD), ethanol consumption, nutritional status, liver function derangement and biomarkers of bone homeostasis in alcoholic patients. METHODS: We included 31 alcoholic patients, of whom 11 were infected with Hepatitis C virus (HCV) and 7 age and sex-matched controls. All underwent densitometry, and serum sclerostin, osteocalcin, collagen telopeptide, parathyroid hormone (PTH), vitamin D, cortisol and testosterone were determined. RESULTS: Sclerostin levels were significantly higher in patients (30.95 ± 18.91 pmol/l) than controls (t = 4.4; P < 0.001), especially in non-HCV patients; they showed an inverse correlation with osteocalcin, prothrombin activity and serum albumin, and a direct correlation with bilirubin and telopeptide, but not with BMD, nutritional status or ethanol intake. CONCLUSIONS: Serum sclerostin was raised in alcoholic patients, and it correlated with decreased markers of bone synthesis and increased markers of bone breakdown. The elevation in sclerostin levels was clearly related with liver function, but not with ethanol intake, nutritional status or concomitant HCV infection.
Alcohol and Alcoholism 01/2013; · 1.96 Impact Factor
[show abstract][hide abstract] ABSTRACT: In bare bones, transverse lines may have several origins. Defleshing of a prey generates cutmarks, which can also appear in relation with traumatic events, post-mortem changes such as marks of animal teeth, rodent gnawing, or impact of stones, or even bone decoration. We hypothesize that in some instances they may be due to hyperplastic vessels beating on the bone surface, as expression of increased blood flow demand imposed by hypertrophied muscles. We analyzed 140 well-preserved tibiae which belonged to pre-Hispanic individuals from El Hierro, in the Canary Archipelago, currently kept at the Department of Archaeology and Prehistory of the University of La Laguna, and determined robusticity indices. Tibial marks were found in 53 out of 140 cases. Epiphyseal and diaphyseal robusticity indices were significantly higher in the first case among those with marks than among those without marks (T=3.13; p=0.002), and nearly significantly in the latter case (T=1.88; p=0.063). Considering only men, similar differences were observed regarding epiphyseal robusticity index (T=2.90; p=0.005) and diaphyseal robusticity index (T=2.11; p=0.039). There were also differences regarding the depth of the tibial marks: a higher epiphyseal robusticity index was associated with a more marked depth of the lines (T=2.11; p=0.042). An association was also observed between depth of the marks and sex (χ2=4.12; p=0.042), more profound marks being observed among men. In conclusion, we here describe subtle bone marks in tibiae, which seem to correspond to vascular imprinting and are related to bone robustness. Whether or not they really represent an adaptation to an increased blood flow demand by hypertrophied muscles in relation with increased weight-bearing activity remains speculative, but this hypothesis may explain their presence
[show abstract][hide abstract] ABSTRACT: BACKGROUND AND AIMS: Most studies have shown that patients with chronic hepatitis C virus (HCV) infection are affected by osteoporosis. However, liver function impairment and deranged nutrition may both play a role in the bone alterations observed. In some works no osteoporosis was found, and some cases of osteosclerosis have been reported. The aim of the study is to assess bone alterations in treatment-naïve, well-nourished HCV patients, in order to discern whether or not HCV infection causes osteoporosis. METHODS: Whole-body bone densitometry and assessment of T-score at lumbar spine and hip were performed to 40 patients and 40 age- and sex-matched controls, with a Lunar Prodigy Advance (General Electric, Piscataway, NJ, USA). All the patients underwent liver biopsy. Nutritional evaluation was performed by subjective nutritional assessment, body mass index (BMI), and densitometric assessment of total lean mass and total fat mass. Serum osteocalcin, osteoprotegerin, RANKL, PTH, crosslaps, vitamin D3, testosterone, IGF-1, and estradiol were determined. RESULTS: Patients did not show differences in total bone mineral density (BMD) or T-score with controls. On the contrary, about a third of them showed positive T scores. Patients showed lower IGF-1, vitamin D3 and testosterone, but higher telopeptide levels, and a trend to higher osteoprotegerin levels. Multivariate analyses disclosed that age, sex, and total lean mass were the only parameters independently related with BMD. CONCLUSIONS: Therefore, chronic HCV infection in well nourished patients with preserved liver function does not cause osteoporosis.
European Journal of Internal Medicine 09/2012; · 2.05 Impact Factor
[show abstract][hide abstract] ABSTRACT: In alcoholics, the activation of Kupffer cells by gram negative bacteriae leads to an inflammatory response and cytokine secretion, which in turn activate T-lymphocytes. Possibly, Th-1 lymphocytes are activated first, followed by a Th-2 response. Th-2 cytokines, especially interleukin (IL)-13 (scarcely studied in alcoholics), may be involved in the progression to chronic stages.
The aim of the study was to analyze the relationship of Th-1 and Th-2 cytokines with liver function, alcohol consumption, nutritional status and survival.
Serum Th-1 [interferon-γ (IFN-γ)] and Th-2 cytokines (IL-4, IL-13), IL-10, IL-6 and tumor necrosis factor (TNF-α), were determined for 18 controls and 47 stable alcoholics with variable liver function impairment, who were followed-up during a median time of 90 months, a period during which 14 patients died.
IL-4 was lower among patients; no differences were observed regarding IL-6, but the remaining ILs were higher among alcoholics. IL-10 and IL-13 were even higher in cirrhotics (Z = 2.88, P = 0.004, and Z = 2.09, P = 0.037, respectively). A significant, direct, correlation was observed between IL-13 and IL-10 (ρ = 0.49, P = 0.001), and non-significant, inverse ones were observed between IFN-γ and IL-13 (ρ = -0.23), IL-4 (ρ = -0.14) and IL-10 (ρ = -0.09). IL-13 and IL-10 were inversely related with liver function and, directly with immunoglobulin A levels, but not with survival.
Serum IFN-γ values were increased in alcoholics, who also showed raised IL-13 and IL-10, but lower IL-4 levels. Given the immunomodulatory roles of IL-10 and IL-13, this increase may be interpreted as a compensatory rise of anti-inflammatory cytokines. We failed to find any relation with mortality.
Alcohol and Alcoholism 04/2012; 47(4):390-6. · 1.96 Impact Factor
[show abstract][hide abstract] ABSTRACT: Cytokine levels are raised in acute alcoholic hepatitis. However, there are disparate results regarding the duration of altered plasma levels, and there are also discrepancies about the relation of changes during the first 15 days after admission with short-term (in-hospital) or long-term mortality. In 56 patients with acute alcoholic hepatitis we found that IL-8, IL-4, Interferon-γ (IFN-γ), malondialdehyde and C-reactive protein remained higher in patients than in 18 age- and sex-matched controls at admission, at the 7th day and at the 15th day after admission. Moreover, IL-4 levels (and to a lesser extent, IL-10 and IFN-γ ones) increased along the three determinations. However, comparing patients who died during the admission with those who did not, there were no statistically significant differences, but there was a nearly significant trend for MDA (Z=1.89; p=0.059), with higher levels among those who died. When changes between the first and the second determinations were compared with long-term survival, only IL-8 and IFN-γ showed a relation with mortality. IFN-γ values increased among those who survived and decreased among those who died (p=0.048). IFN-γ values at the first determination also showed a relation with long-term mortality, especially when patients with IFN-γ values in the first quartile were compared with those of the 4th one (log rank=5.64; p=0.018; Breslow=4.64; p=0.031). Besides Interferon-γ, only C-reactive protein showed differences between the first and the 4th quartile regarding mortality (Log rank=4.50; p=0.034; Breslow 4.33; p=0.038). In contrast with other studies, no relation was found between TNF-α or IL-6 and mortality.
[show abstract][hide abstract] ABSTRACT: The obesity paradox refers to the improved survival of obese compared with non-obese elderly or diseased patients for reasons that are not clear. To assess the relative roles of fat and other factors in this improved survival, we analyzed the prognostic value of overweight and obesity elderly patients with heart failure (HF), controlling for other nutritional data such as midarm anthropometrics, serum proteins, and muscle strength.
Two hundred forty-four patients (83.2 ± 0.5 y old) hospitalized for HF were included. A nutritional survey was performed in all patients. After discharge, the patients were followed up by telephone.
Fourteen patients (5.7%) died during hospitalization. The median survival was 984 d. Patients with better nutritional status as assessed by the body mass index (BMI), subjective score, midarm muscle area, triceps skinfold thickness, handgrip, lymphocyte count, and serum albumin, prealbumin, and cholesterol levels showed better short- and long-term prognoses. Obese patients with a BMI above 30 kg/m(2) showed a better long-term prognosis than those with a BMI from 25 to 30 kg/m(2), those with a BMI from 20 to 25 kg/m(2), and those with a BMI lower than 20 kg/m(2). However, survival was not significantly related to a triceps skinfold thickness above the 95th percentile. Obese and overweight patients were younger and had better a nutritional status than those with a normal or decreased BMI as shown by the anthropometrics, subjective score, handgrip, lymphocyte count, hemoglobin, and serum albumin, prealbumin, and cholesterol levels. All the nutritional data correlated closely with each other. New York Heart Association class also correlated with nutrition-derived data: as the HF class increased, the nutritional status deteriorated. On multivariate analysis, to predict long-term survival, neither BMI nor triceps skinfold thickness showed an independent predictive value, whereas a larger midarm muscle area did.
The obesity paradox was confirmed in this series of elderly patients with HF. Those with a high BMI and improved survival had a better nutritional status and New York Heart Association functional class than those with a lower BMI, which may explain the differences in survival.
[show abstract][hide abstract] ABSTRACT: Both manganese and copper may affect bone synthesis. Bone content of both metals can be altered in alcoholics, although controversy exists regarding this matter. To analyse the relative and combined effects of ethanol and a low protein diet on bone copper and manganese, and their relationships with bone structure and metabolism, including trabecular bone mass (TBM), osteoid area (OA), osteocalcin (OCN), insulin-like growth factor-1 (IGF-1), parathyroid hormone (PTH), urinary hydroxyproline (uHP) and vitamin D. Adult male Sprague-Dawley rats were divided into four groups. The control rats received a 18% protein-containing diet; a second group, an isocaloric, 2% protein-containing diet; a third one, an isocaloric, 36% ethanol-containing diet and a fourth, an isocaloric diet containing 2% protein and 36% ethanol. After sacrifice, TBM and OA were histomorphometrically assessed; bone and serum manganese and copper were determined by atomic absorption spectrophotometry, and serum OCN, IGF-1, PTH, uHP and vitamin D by radioimmunoassay. Ethanol-fed rats showed decreased TBM and bone manganese. Significant relationships existed between bone manganese and TBM, serum IGF-1 and OCN. Ethanol leads to a decrease in bone manganese, related to decreased bone mass and bone synthesis. No alterations were found in bone copper.
Biological trace element research 12/2011; 147(1-3):226-32. · 1.92 Impact Factor
[show abstract][hide abstract] ABSTRACT: The prognostic value of nutritional status and/or lean and fat mass assessed by dual-energy X-ray absorptiometry (DEXA) has been widely analyzed, in both alcoholics and non-alcoholics. However, the prognostic value of changes in fat and lean mass over time in alcoholics has scarcely been studied, nor has the effect of alcohol abstinence on these changes.
From an initial cohort of 113 alcoholic patients, 70 prospectively underwent two DEXA assessments six months apart. One hundred and five patients (including 66 of those who underwent two DEXA assessments) were followed up for 34.9 ± 36.4 months (median = 18 months, interquartile range = 7.25-53.75 months). During this follow-up period, 33 died (including 20 of those who had undergone a second DEXA assessment).
Forty-two of the 70 patients undergoing a second DEXA assessment had abstained from alcohol. Of these, 69.04% (29) gained left arm lean mass, compared with only 35.71% (10 of 28) of those who had continued drinking (χ² = 7.46; p = 0.006). Similar results were observed regarding right arm lean mass (χ² = 4.68; p = 0.03) and right leg lean mass (χ² = 7.88; p = 0.005). However, no associations were found between alcohol abstinence and changes in fat parameters. Analysis by means of Kaplan-Meier curves showed that loss of total lean mass, right leg lean mass, left leg lean mass and total fat mass were all significantly associated with reduced survival. However, within 30 months of the second evaluation, significant associations were observed between changes of all parameters related to lean mass, and mortality, but no association between changes in fat parameters and mortality.
Loss of lean mass over a period of six months after a first assessment is associated with worse prognosis in alcoholics, irrespective of whether they stop drinking during this period or not. Continued drinking is associated with greater loss of lean mass, but not with changes in fat mass.
[show abstract][hide abstract] ABSTRACT: Interleukin (IL)-15 is highly expressed in skeletal muscle, where it exerts anabolic effects, increasing protein content in muscle fibres and promoting muscle growth. Alcoholics frequently suffer myopathy. Therefore, we analyse the behaviour of IL-15 (and other myokines, such as IL-6, IL-8 and tumour necrosis factor α (TNF-α)) in alcoholics.
These myokines and also malondialdehyde (MDA)--a lipid peroxidation product--were determined by radioimmunoanalytic techniques in blood samples of 35 chronic alcoholics and 13 age- and sex-matched controls, and compared with body composition, nutritional status, liver function, amount of ethanol and routine biochemical variables.
IL-15, IL-6, TNF-α, IL-8 and MDA were all higher in alcoholics than in controls; MDA and IL-6 were clearly related with liver function impairment and short-term prognosis, whereas IL-15 was higher among those who died and was related to serum bilirubin. No relation was found between IL-15 and lean mass.
IL-15 levels were higher in alcoholics than in controls, especially among those who died within 18 months after admission. They are not related with muscle mass, intensity of alcoholism or nutritional status, but only with serum bilirubin. IL-6 showed inverse correlations with liver function, intensity of alcoholism, nutritional status, left arm muscle mass and short-term mortality.
Alcohol and Alcoholism 06/2011; 46(5):529-33. · 1.96 Impact Factor
[show abstract][hide abstract] ABSTRACT: It is well known that alcoholics are prone to severe infections and that the immune system is impaired by chronic ethanol abuse. The aim of this study is to compare serum inflammatory mediators in response to sepsis in chronic alcoholic with sepsis, non-alcoholics with sepsis and non-infected alcoholics.
We included 25 alcoholics with sepsis, 34 non-alcoholics with sepsis, 34 non-infected alcoholics admitted for programmed withdrawal, and 27 healthy control subjects. After initial evaluation, blood samples were taken for determination of serum cytokine levels.
We found similar responses for the inflammatory mediators analyzed among our sepsis patients, regardless of alcohol abuse. The only difference was that alcoholics with sepsis showed lower CRP and G-CSF than non-alcoholic sepsis patients. There were no differences regarding leukocyte count. Alcoholics admitted for programmed withdrawal showed higher IL-6, IFN-γ, IL-10, Il-4 and ICAM-1 serum levels than healthy controls. Serum IL-5 levels were decreased in both alcoholic groups.
The inflammatory response of alcoholics with sepsis is similar to that of non-alcoholic sepsis patients. However, the low G-CSF levels in alcoholic sepsis patients might suggest a predisposition to infections in alcohol abusers.
[show abstract][hide abstract] ABSTRACT: Some observations suggest that oxidative damage may affect both osteoblastic function and osteoclastic activity in alcohol-mediated bone alterations. Selenium, a potent antioxidant, is decreased in alcoholics.
To analyse if the supplementation with selenium may alter bone changes observed in a murine model fed ethanol and/or a 2% protein-containing diet, following the Lieber-deCarli design.
Adult male Sprague-Dawley rats were divided into 8 groups, which received the Lieber-DeCarli control diet, an isocaloric, 36% ethanol-containing diet, an isocaloric, 2% protein-containing diet; and an isocaloric diet containing 2% protein and 36% ethanol diet, and another similar four groups to which selenomethionine (1mg/kg body weight). After sacrifice (5 weeks later), trabecular bone mass was histomorphometrically assessed, bone and serum selenium were determined by flame atomic absorption spectrophotometry, and serum osteocalcin, insulin growth factor 1 (IGF-1), PTH and telopeptide, by radioimmunoanalysis. Liver glutathione peroxidase (GPX) activity was also determined.
Ethanol-fed rats showed decreased TBM, IGF-1 and osteocalcin, especially when ethanol was added to a 2%-protein diet. Selenium did not modify at all bone parameters, despite a marked increase in serum selenium and a less pronounced one in bone selenium, and an increase in liver GPX.
Our results do not support the existence of a beneficial effect of selenium addition on bone changes observed in this murine model treated following the Lieber-deCarli experimental design.
Journal of Trace Elements in Medicine and Biology 03/2011; 25(2):113-7. · 1.96 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aim of the present study is to perform a paleodietary and paleonutritional survey on 17 individuals buried in accordance with the prehispanic ritual in the central plateau of the island Tenerife, called Las Cañadas del Teide. We recorded hydrogen, nitrogen and carbon isotope compositions of human bone collagen, bone barium and strontium, and histomorphometrically assessed trabecular bone mass (TBM). Bone trace elements and TBM were compared with reference data derived from a modern sample consisting of 13 individuals. In addition, δ15N and δ13C values were determined in several modern indigenous plants, bone collagen of prehistoric domestic animals (goat and pig), and prehistoric wild animals (a giant lizard, Gallotia goliath and a giant rat, Canaryomis bravoi), which represent food sources potentially consumed by the prehistoric population of the Island. The carbon stable isotope composition of bone collagen ranged between −20.5 and −18.6‰ (VPDB), indicating a diet based on C3 plants. Nitrogen isotope values ranged from 8.2 to 12.4‰ (AIR), suggesting a general meat-enriched diet, most likely domestic goats, of higher level consumers. Hydrogen isotope values ranged from −18 to +4‰, whereas log Ba/Sr was greater than −0.40 in the vast majority of cases. TBM showed a tendency to osteoporosis in 30% of the individuals analyzed. C-14 dating showed that two burial sites, including 5 individuals, belonged to the post-conquest era (after the 15th century), despite a fully “prehispanic” burial ritual, which lends credenceto the oral tradition that some of the prehispanic population fled to the highlands at the time of the Spanish conquest, and lived there during decades or even centuries. These individuals showed lower δD, δ13C and δ15N, and higher log Ba/Sr values than those buried before the Spanish conquest, suggesting dietary differences between the two groups. Also, women showed a trend to a higher consumption of vegetables than men.
Journal of Archaeological Science - J ARCHAEOL SCI. 01/2011; 38(4):884-895.
[show abstract][hide abstract] ABSTRACT: Some observations suggest that iron overload may directly affect bone metabolism, leading to osteopenia. Obiective: To analyze the relationship between bone iron overload and bone metabolism, including trabecular bone mass, osteocalcin, insulin-like growth factor-I (IGF-l) and parathormone, in ethanoland/or 2% protein-fed rats. Method: Adult male Sprague-Dawley rats were divided into 4 groups. The control rats received the LieberDeCarli control diet (Dyets mc, Bethlehem, PA, USA), containing 18% protein and I kcallml; a second group was fed an isocaloric, 36% ethanol-containing diet; the third one was fed an isocaloric, 2% protein-containing diet; and the fourth group was fed an isocaloric diet containing 2% protein and 36% ethanol. After sacrifice (5 weeks later), trabecular bone mass (TBM) and osteoid area were histomorphometrically assessed, bone and liver iron were determined by flame atomic absorption spectrophotometry, and serum osteocalcin, insulinlike growth factor-I (IGF-1), and PTH, by radioimmunoanalysis. Results: Ethanol-fed rats showed decreased TBM and increased liver iron (especially when protein deficiency was also present), and significant relationships were found both between bone iron and liver iron and TBM. Bone iron was also inversely related to osteocalcin. Multivariate analysis showed that trabecular bone mass was independently related to liver iron and albumin, in this order, whereas osteoid was related to liver iron and bone iron, in this order. Conclusion: Our results suggest that bone iron and liver iron overload are related to decreased bone mass and decreased bone synthesis in rats fed the Lieber-de Carli ethanol and/or protein-deficient diets.
Trace Elements and Electrolytes 01/2011; 28(1):18-25. · 0.50 Impact Factor
[show abstract][hide abstract] ABSTRACT: Osteoporosis is frequent among alcoholics all by a direct effect of ethanol, malnutrition, and liver failure. Therefore, it may be related to survival. The aim of this study was to assess bone mineral density (BMD), bone mineral content, hormonal status, and to determine prognostic value of these parameters in a total of 124 alcoholics followed up for a median period of 57 months. Several bone homeostasis-related hormones were measured in patients and age- and sex-matched controls. Whole-body densitometry was performed by a Hologic QDR-2000 (Waltham, MA) densitometer; nutritional status and liver function were assessed. Sixty patients underwent a second evaluation 6 months later. Patients showed lower serum insulin-like growth factor-1 (median=58, interquartile range [IQR]=33-135 vs. 135ng/mL, IQR=116-243ng/mL, P<.001), vitamin D (25.5, IQR=18.3-36.8 vs. 79.9pg/mL, IQR=59.2-107.8pg/mL, P<.001), and osteocalcin (2.1, IQR=1.1-4.5 vs. 6.5ng/mL, IQR=4.7-8.7ng/mL, P<.001) than controls, and lower BMD values, and lower Z- and T-scores at right and left legs and arms, thoracic and lumbar spine, pelvis, and right and left ribs. By multiple regression analysis, BMD mainly depends on nutritional parameters and liver function. Kaplan-Meier curves show that subtotal BMD and BMD at both arms and pelvis were significantly related with survival. Patients who had lost total hip BMD after 6 months showed a shorter survival than those who had not, but using Cox's regression, encephalopathy, ascites, and nutritional parameters displaced BMD as prognostic factor. Therefore, osteopenia ensues in chronic alcoholic patients. It mainly depends on poor nutrition and is related to survival, although surpassed in this sense by encephalopathy, ascites, and nutritional parameters.