E González-Reimers

Hospital Universitario de Canarias, San Cristóbal de La Laguna, Canary Islands, Spain

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Publications (138)343.7 Total impact

  • Medicina clinica. 05/2014;
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    ABSTRACT: Selenium is a main component of glutathione peroxidase (GPX), a key antioxidant enzyme. Other elements, such as zinc, copper, manganese and iron, are also involved in the pathogenesis of oxidative damage as well as in other important metabolic pathways. The effects of selenium supplementation on the metabolism of these elements have yield controversial results .The aim of this study is to analyse the effects of selenium supplementation on liver, muscle and urinary excretion of zinc, copper, iron and manganese in a situation of oxidative stress, such as protein deficiency. The experimental design included four groups of adult male Sprague-Dawley rats, which received the Lieber-DeCarli control diet, an isocaloric 2 % protein-containing diet and another similar two groups to which selenomethionine (6 mg/l liquid diet) was added. After sacrifice (5 weeks later), muscle, liver and serum selenium were determined, as well as muscle, liver and urinary zinc, copper, manganese and iron and liver GPX activity and liver malondialdehyde. Selenium addition led to decreased liver copper, increased muscle copper, increased copper excretion and increased liver iron, whereas zinc and manganese parameters were essentially unaltered. Muscle, liver and serum selenium were all significantly correlated with liver GPX activity.
    Biological trace element research 03/2014; · 1.92 Impact Factor
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    ABSTRACT: Sclerostin inhibits osteoblast functions, differentiations, and survival rates. As an endogenous inhibitor of the Wnt/β-catenin pathway, the sclerostin should be related to decreased bone masses, although several studies indicate opposite results. In addition, it may be related to insulin resistances and carbohydrate metabolisms, a relation shared with other markers of bone metabolisms, such as osteocalcin. Hepatitis C virus (HCV) infected patients may present osteoporosis, and frequently show liver steatosis, which is a consequence of insulin resistance. The behaviour of sclerostin in these patients is yet unknown. The aim of this work is to analyse the relationships between serum sclerostin and osteocalcin levels and bone mineral density (BMD), liver functions, the intensity of liver steatosis and biochemical markers of bone homeostasis and insulin resistance in HCV-infected patients. Forty HCV patients with 20 years of age and gender-matching controls were included in this study and underwent bone densitometry. Serum sclerostin, osteocalcin, collagen telopeptide, adiponectin, leptin, insulin, resistin, tumor necrosis factor (TNF)-α, and interleukin (IL)-6 were determined. Liver fat was histomorphometrically assessed. Sclerostin levels were slightly higher in patients than in controls, and were directly related to BMD at different parts of the skeleton, also to the serum telopeptide, and to the liver steatosis and TNF-α. On the contrary, osteocalcin showed a significant direct relationship with serum adiponectin, and an inverse one with IL-6. Serum sclerostin levels were within the normal range in HCV patients, and correlated directly with BMD and serum telopeptide. In addition, the relationships of sclerostin and osteocalcin with variables associated with insulin resistance suggested the role of bones for intermediary metabolisms.
    Journal of bone metabolism. 02/2014; 21(1):69-75.
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    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
  • Medicina Clínica. 01/2014;
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    ABSTRACT: Assessment of skeletal robusticity is an important tool for the archaeologist and anthropologist, since it may be related to the intensity and type of activity performed by ancient population groups. Development of computed tomography (CT) allows determination of biomechanical properties of long bones. However, CT technology may not be easily available and is a relatively expensive procedure. Therefore, it is pertinent to estimate whether any of the parameters which can be easily measured in bare bones by simple anthropometry are useful to assess the torsional strength and bending strength of these bones. We included twenty one well preserved tibiae corresponding to prehispanic adult individuals (13 men) of El Hierro. These bones were anthropometrically measured following classical methods, and also subjected to CT analysis, and further calculation of minimum and maximum second moments and polar second moment of area, both at midshaft and at the nutrient foramen levels, using the software (www.hopkinsmedicine.org/FAE/mmacro.htm). The diaphyseal robusticity index showed a close relationship with minimum second moment of area at the nutrient foramen (r=0.824, p<0.001) and polar second moment of area at the nutrient foramen (r=0.824, p<0.001), whereas correlations with the epiphyseal robusticity index were weaker (r=0.628, p=0.005, and r=0.618, p=0.007, respectively). The variable which allows the best estimation of the torsional strength is the perimeter at the nutrient foramen, by the formula Polar second moment of area (in mm3) = -700.30 + 11.77 * perimeter at the nutrient foramen (in mm) for the whole population (standard error of the estimation=56.91; absolute range from-114.26 to 140.29), or Polar second moment of area (in mm3) = -897.93 + 13.74 * perimeter at the nutrient foramen (in mm) when only men were analyzed, with a standard error of the estimation of 32.17 (absolute range= from -44.53 to 50.32 mm3).
    European Journal of Anatomy 01/2014; 18(1):8-15.
  • Esther Martin-Ponce, Emilio González-Reimers, Francisco Santolaria
    Clinical nutrition (Edinburgh, Scotland) 01/2014; · 3.27 Impact Factor
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    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
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    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
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    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
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    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.
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    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
  • Majorensis ISSN: 1697-5529. 01/2013; 9.
  • Trace Elements and Electrolytes 01/2013; · 0.50 Impact Factor
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    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
    European Journal of Anatomy 01/2013; 17(1):9-16.
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    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
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    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
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    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.
    Alcohol (Fayetteville, N.Y.) 03/2012; 46(5):433-40. · 2.41 Impact Factor
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    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.
    Nutrition 01/2012; 28(6):616-22. · 2.86 Impact Factor
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    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

Publication Stats

1k Citations
343.70 Total Impact Points

Institutions

  • 1989–2014
    • Hospital Universitario de Canarias
      San Cristóbal de La Laguna, Canary Islands, Spain
  • 1990–2013
    • Universidad de La Laguna
      • • Department of Internal Medicine, Dermatology and Psychiatry
      • • Department of Pre-history, Anthropology and Ancient History
      San Cristóbal de La Laguna, Canary Islands, Spain
  • 1999–2005
    • Universidad de Las Palmas de Gran Canaria
      • Departamento de Ciencias Clínicas
      Las Palmas de Gran Canaria, Canary Islands, Spain