A prospective study was conducted examining the association between blood lipid levels and bone mineral density in preschool-aged children.

Healthy preschool-aged children (n=411) were included in this 12-month cohort study. The bone mineral density and bone mineral content of the non-dominant forearm and calcaneus were measured using dual-energy X-ray absorptiometry (DXA). Additionally, the children's fasting blood was drawn at baseline to measure blood lipids.

The sample comprised 411 healthy preschool-aged children, 208 girls and 203 boys, with a mean age of 4.80±0.70 years. After one year of observation, the bone mineral density of the non-dominant calcaneus in preschool children increased by 30.37 mg/cm2, bone mineral content increased by 29.85 mg, and triglyceride levels increased by 0.05 mmol/L. A significant inverse assocation was observed between serum triglyceride levels within the normal physiological range and the changes in bone mineral density (BMD) at the non-dominant calcaneus in preschool children, whereas no such association was detected with BMD changes in the non-dominant forearm. A 1 mmol/L increase in triglycerides within the physiological normal range was associated with a 6.73 mg/cm2 decrease in bone mineral density (95 % CI: -12.90, -0.56) and a 5.98 mg decrease in bone mineral content (95 % CI: -11.77, -0.19). There was no significant relationship between other lipids and bone mineral density.

Serum triglyceride concentrations within the physiological normal range showed a significant negative correlation with the 12-month increment of calcaneal bone mineral density in preschool children (p<0.05).

Advanced glycation end products (AGEs) are associated with osteoporosis (OP) in the diabetic population. However, their relationship with OP in the non-diabetic population remains unclear. This study aimed to investigate cross-sectional associations of AGEs levels in the skin and lens with OP in the non-diabetic population. A retrospective analysis of clinical data of 652 participants was conducted. Bone mineral density (BMD) was quantified by dual-energy X-ray absorptiometry. Lens and skin AGEs were assessed by lens and skin autofluorescence (LAF and SAF). This study included 652 individuals, 280 males (42.9%) and 372 females (57.1%), with a mean age of (55.5 ± 6.9) years. The population with osteopenia exhibited significantly higher levels of SAF-AGEs than those with normal BMD, while the population with OP had significantly higher levels of both SAF- and LAF-AGEs. After adjusting for age and body mass index, LAF-AGEs were negatively correlated with BMD at the femoral neck and total hip. In contrast, SAF-AGEs were negatively correlated with BMD at the lumbar1-4 spine. Furthermore, multiple linear stepwise regression analysis demonstrated that LAF-AGEs were negatively associated with BMD at both the femoral neck and total hip. However, SAF-AGEs showed no association with BMD at any of the three measured sites. Additionally, after adjusting for other covariates, the logistic regression analysis emphasized that LAF-AGEs were associated with OP in the non-diabetic population, but SAF-AGEs do not. The results revealed a significant correlation between LAF-AGEs and OP in the non-diabetic population and their potential clinical utility warrants further validation. Therefore, we urge for larger longitudinal analyses and experimental research to validate and extend these cross-sectional findings.

Despite the well-established regulatory role of vitamin D in maintaining bone health, little is known about the shared genetics and causality of the association between serum 25-hydroxyvitamin D (25OHD) and bone mineral density (BMD).

We aimed to investigate the shared genetic architecture and causal relationship between serum 25OHD and BMD, providing insights into their underlying biological mechanisms.

Leveraging individual-level data from the UK Biobank (UKB) cohort and summary-level data from the genome-wide association studies (GWASs) conducted on European individuals for serum 25OHD (N = 417 580) and estimated heel BMD (eBMD, N = 426 824), we systematically elucidated the shared genetic architecture underlying serum 25OHD and eBMD through a comprehensive genome-wide cross-trait design.

Despite a lack of global genetic correlation (rg=-0.001; P = .95), a statistically significant local signal was discovered at 5p11-5q11.9. Two-sample mendelian randomization (MR) indicated no causal association in the overall population (β=.003, 95% CI, -0.04 to 0.03; P = .93), while positive causal effects were observed in males (β=.005, 95% CI, 0.00 to 0.01; P = .03) and older individuals (β=.009, 95% CI, 0.00∼0.02; P = .01) according to one-sample MR. A total of 49 pleiotropic single-nucleotide variations (SNVs), with 4 novel SNVs (rs1077151, rs79873740, rs12150353, and rs4760401), were identified, and a total of 95 gene-tissue pairs exhibited overlap, predominantly enriched in the nervous, digestive, exocrine/endocrine, and cardiovascular systems. Protein-protein interaction analysis identified RPS9 and RPL7A as hub genes.

This study illuminates the potential health benefits of enhancing serum 25OHD levels to mitigate the risk of osteoporosis among men and individuals older than 65 years. It also unveils a shared genetic basis between serum 25OHD and eBMD, offering valuable insights into the intricate biological pathways.

A case involving the incidental diagnosis of multiple myeloma (MM) due to interference in the 25-hydroxy-vitamin D (25(OH) vitamin D) immunoassay is presented. The patient, under the care of rheumatology and receiving treatment with alendronic acid and vitamin D supplements, was referred to endocrinology for investigation of acromegaly. Acromegaly was subsequently ruled out; however, during the investigations, consistently elevated levels of 25(OH) vitamin D were noted, raising suspicion of vitamin D resistance syndrome. The laboratory and endocrinology teams engaged in discussions, and following the cessation of medication, repeated analyses for 25(OH) vitamin D and a single analysis of 1,25-dihydroxy-vitamin D levels were requested, yielding high and normal results, respectively. The laboratory conducted a three-step interference investigation, ultimately identifying a high molecular weight molecule responsible for the initially elevated 25(OH) vitamin D levels. Due to the clinical presentation of back pain, a proteinogram was requested, revealing a monoclonal band of 36 g/L. Subsequent free light chain analysis indicated an elevated ratio. With three risk factors identified, this was classified as an established MM and urgently referred to haematology for correct management. Laboratory assay interferences have the potential to disrupt the accurate diagnostic workup of patients. Collaborative discussions between laboratory and clinical teams regarding such cases aid in directing the diagnostic pathway appropriately, facilitating prompt and proper diagnosis and management.

Intervertebral disc degeneration is a multifactorial degenerative disease that poses a significant threat to the health of the elderly population. Current treatments primarily focus on physical therapy, medication, and surgery to alleviate symptoms associated with disc compression but do not address the progression of degeneration. Therefore, this review aimed to explore the potential of extracellular vesicle therapy as a novel preventive strategy to delay degeneration and enhance tissue repair in intervertebral discs. We cover the pathogenic mechanisms underlying intervertebral disc degeneration, including inflammation, apoptosis, pyroptosis, ferroptosis, autophagy dysregulation, and the roles of non-coding RNAs. Subsequently, we discussed the therapeutic potential of extracellular vesicles and their molecular components, such as proteins, RNAs, and lipids, in modulating these pathways to counter intervertebral disc degeneration. We provides a comprehensive review of the significant role of extracellular vesicle cargo in mediating repair mechanisms. It discusses the functional enhancement advantages exhibited by extracellular vesicles under current bioengineering modifications and drug loading. The challenges and future prospects of utilizing extracellular vesicle therapy to treat this degenerative condition are also summarized.

The Middle East and North Africa region are traditionally known as regions with a high prevalence of vitamin D deficiency. However, serum 25-hydroxyvitamin D (25OHD) levels seem to be increasing lately. We developed guidelines on the screening and supplementation of adult Lebanese patients with vitamin D. These guidelines address community-dwelling and institutionalized individuals.

Our guideline panel consisted of clinical and methodology experts that formulated the guidelines questions. We conducted a systematic review to gather global data on fracture (CRD42019129540), regional data on vitamin D trials (CRD42014010488), and on patients' values and preferences (CRD42022320022). We also complemented the latter with results from a cross-sectional local study. We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to assess the quality and certainty of evidence, and to develop recommendations.

For community-dwelling and institutionalized Lebanese adult population, the panel suggests no screening for vitamin D deficiency, over screening for vitamin D deficiency (conditional recommendation, based on very low certainty evidence). For community-dwelling Lebanese adult population, the panel suggests no supplementation with calcium and vitamin D, over supplementation (conditional recommendation, based on moderate certainty evidence). For institutionalized Lebanese adult population, the panel suggests supplementation with calcium and vitamin D, over no supplementation (conditional recommendation, based on moderate certainty evidence). The guidelines also identify high-risk subgroups, more likely to benefit from screening and supplementation. In community dwelling and institutionalized Lebanese adult individuals, for whom there is a decision to supplement with calcium and vitamin D, the panel suggests supplementation with a daily vitamin D equivalent of 600-2000 IU, as compared to doses higher than 2000 IU (conditional recommendation, very low certainty evidence).

The Lebanese GRADE-based vitamin D guidelines recommend against population screening and vitamin D supplementation. Subgroups at high risk are identified. The guidelines take into account contextual factors, and allow their adoption or adaptation in countries in the region.

Pulmonary fibrosis is a fatal interstitial disease characterized by diffuse alveolitis, abnormal fibroblast proliferation, and extracellular matrix (ECM) accumulation, resulting in structural lung destruction and impaired lung function. Numerous studies have demonstrated that vitamins appear to play a crucial role in regulating inflammatory responses, cell differentiation, redox homeostasis, and collagen synthesis. Beyond their conventional nutritional functions, specific vitamins have recently been found to modulate various biological processes involved in pulmonary fibrosis. This study aims to provide a comprehensive overview of the current understanding regarding the impact of vitamins on pulmonary fibrotic disease.

Hyperactivation of osteoclasts has been identified as a significant etiological factor in several bone resorption-related disorders, including osteoporosis, periodontitis, arthritis, and bone metastasis of tumors. It has been demonstrated that the severity of these diseases is influenced by lipids that regulate osteoclast differentiation and activity through specific signaling pathways and cytokine levels. The regulatory mechanisms of different types of lipids on osteoclastogenesis vary across diverse disease contexts in bone resorption regulated by osteoclasts. This review presents an overview of the mechanisms underlying osteoclast formation and summarizes the pathways through which various lipids regulate osteoclastogenesis in different pathological contexts. We also discuss effective therapeutic strategies for osteolytic diseases based on modulation of lipid metabolism.

With life expectancy for people living with HIV (PLWH) approaching that of the general population, age-related conditions like osteoporosis are increasingly common. Both HIV infection and long-term antiretroviral therapy (ART), particularly tenofovir disoproxil fumarate (TDF), are associated with early-onset osteoporosis. Bisphosphonates are commonly used for treatment, but the optimal strategy for improving bone health in PLWH remains unclear.

We conducted a network meta-analysis (NMA) with component analysis of randomized controlled trials (RCTs) identified from Medline, EMBASE, Cochrane CENTRAL, Scopus, Web of Science and CINAHL EBSCO databases, from inception to December 1, 2024. The study included RCTs comparing zoledronate, alendronate, calcium and vitamin D, and their combinations in PLWH with osteoporosis. The primary outcomes were changes in lumbar spine and total hip bone mineral density (LS-BMD and TH-BMD). Secondary outcomes included changes in bone turnover markers (BTMs)-C-terminal telopeptide of type 1 collagen (CTx) and osteocalcin (OC)-as well as major adverse events associated with anti-osteoporosis medication (AOMs). Data were analyzed using a component NMA approach to compare treatment strategies. The study was prospectively registered on PROSPERO: CRD42023475160.

A total of 11 RCTs involving 816 participants were included. In mixed PLWH populations, zoledronate-based regimens significantly improved LS-BMD [weighted mean difference (wMD): 0.0821-0.0985 g/cm2; certainty of evidence (CoE): very low to low] and TH-BMD (wMD: 0.0372-0.0606 g/cm2; CoE: low to moderate), with the highest treatment rankings (SUCRA: LS-BMD = 93.2%, TH-BMD = 87.4%). Alendronate-based regimens showed significant reductions in CTx (wMD: -0.3347 ng/ml; CoE: very low) and ranked highest for reducing CTx (SUCRA = 95.7%) but did not significantly improve BMD. No substantial differences were found in changes in OC or the incidence of major adverse events related to AOMs. Component NMA confirmed that intravenous zoledronic acid provided significant incremental benefits across both BMDs and BTMs. Sensitivity analyses by ART status revealed that in ART-experienced patients, zoledronate with calcium and higher-dose vitamin D ranked highest for LS-BMD (SUCRA = 94.4%) and zoledronate with calcium and standard-dose vitamin D for TH-BMD (SUCRA = 87.2%). However, in ART-naïve patients, no treatment demonstrated superiority, with comparable effects across three interventions.

While zoledronate-based treatments appear to offer the greatest improvements in bone mineral density in both mixed PLWH populations and ART-experienced PLWH, their effectiveness in ART-naïve populations remains uncertain. The limited evidence and substantial heterogeneity between populations highlight the need for additional trials, particularly in ART-naïve individuals, to establish definitive treatment strategies.

This research was funded by the National Science and Technology Council through grant number NSTC 113-2314-B-006-090, as well as by the National Cheng Kung University Hospital under grant number NCKUH-11303051 and NCKUH-11404024.

Background and Objectives: Adequate levels of vitamin D are vital for both growth and immunomodulation in children. To evaluate the levels of vitamin D in children from Western Romania and to identify significant age, seasonal, and geographical disparities. Materials and Methods: This study evaluates the level of 25-hydroxyvitamin D levels assessed on Cobas 6000's module e601 in 1698 children aged 1-18 years between 1 January 2018 and 31 December 2021 from Western Romania. Results: Children aged 1-6 years predominantly present sufficient levels (>30 ng/mL), while older age groups showed a marked decline. Adolescents aged 13-18 years were most affected, with over half displaying insufficient levels (20-30 ng/mL). Rural children were more likely to achieve sufficiency compared to urban peers. Males demonstrated significantly higher vitamin D levels when compared to females. Seasonal variations showed the highest vitamin D levels during late summer and early autumn (September: aOR = 5.47; 95% CI: 3.17-9.42, p < 0.001). Multivariate analysis revealed a significant improvement in vitamin D levels during 2019-2020. Conclusions: Our findings suggest the need for targeted screening programs and health policies to address vitamin D deficiency, particularly among older children, urban residents and during winter months.

Hydrostatic pressure in the periodontal ligament (PDL) plays a critical role in orthodontic treatment, influencing tooth movement and remodeling of periodontal tissue. The relationship between alveolar cortical bone density and the risk of root resorption due to excessive stress in the PDL has not been clearly defined.

This study aimed to analyze hydrostatic pressure in the periodontal ligament of the tooth roots during en-masse retraction of the maxillary incisors using temporary skeletal anchorage devices (TISADs) after the first premolar extractions, as well as during full arch retraction.

A numerical model was used, varying the Young's modulus of cortical bone from 12.5 GPa to 27.5 GPa in increments of 3.0 GPa. Extreme values for bone stiffness were derived from the literature. In all the cases analyzed, the hook height was fixed at 6 mm, and the cranial surface was constrained.

Doubling the stiffness of the cortical bone approximately reduced the hydrostatic pressure in the PDL by 1.5 times for both full-arch retraction and post-first premolar extraction retraction. A critical hydrostatic pressure of 4.7 kPa was exceeded in full-arch retraction for low Young's modulus of 12.5 Gpa values at forces as low as 600 g. On the contrary, for cortical bone with a high Young's modulus of 27.5 GPa, this critical pressure was reached only at forces around 960 g, approximately 1.6 times higher.

The density of the alveolar cortical bone significantly influences the hydrostatic pressure in the PDL of most tooth roots during orthodontic treatment. This parameter can be a critical factor in the risk of root resorption when optimal forces are exceeded. Further research is necessary to better understand these dynamics. Individual protocols for orthodontic treatment and CBCT imaging are necessary to minimize complications in the form of root resorption.

This systematic review (SR) highlights principles for nutrient clinical trials and explore the diverse physiological functions of vitamin D beyond its traditional role in the musculoskeletal system related to clinical study designs.

Thousands of published research articles have investigated the benefits of vitamin D (a nutrient example taken in this SR) beyond the musculoskeletal system, including the immune, pulmonary, and cardiovascular systems; pregnancy; autoimmune disorders; and cancer. They illustrated vitamin D's molecular mechanisms, interactions, and genomic and nongenomic actions.

This SR was designed to identify shortcomings in clinical study designs, statistical methods, and data interpretation that led to inconsistent findings in vitamin D-related publications. SR also highlights examples and insights into avoiding study design errors in future clinical studies, including randomized controlled clinical trials (RCTs). The SR adheres to the latest PRISMA statement, guidelines, and the PICOS process.

Inappropriate or flawed study designs were frequent in clinical trials. Major failures discussed here include too short clinical study duration, inadequate or infrequent doses, insufficient statistical power, failure to measure baseline and achieved levels, and recruiting vitamin D-sufficient participants. These design errors have led to misleading interpretations. Thus, conclusions from such studies should not be generalized or used in guidelines, recommendations, or policymaking.

Adequately powered epidemiological studies and RCTs with sufficient vitamin D and duration in individuals with vitamin D deficiency reported favorable clinical outcomes, enriching the literature, enabling to understand its physiology and mechanisms. Proper study designs with rigorous methodologies and cautious interpretation of outcomes are crucial in advancing the nutrient field. The principles discussed apply not only to vitamin D, but also other micro-nutrients and nutraceutical research. Adhering to them enhances the credibility and reliability of clinical trials, SRs, and meta-analysis outcomes. The study emphasizes the importance of focused, hypothesis-driven, well-designed, statistically powered RCTs to explore the diverse benefits of nutrients, conducted in index nutrient deficient participants, and avoidance of study design errors. Findings from such studies should be incorporated into clinical practice, policymaking, and public health guidelines, improving the health of the nation and reducing healthcare costs.

Air pollutants directly and indirectly cause vitamin D deficiency (VDD). In addition, smoking increases oxidative stress and accelerates skin aging, thereby reducing the body's vitamin D concentration. Previous study reported that VDD increases total cholesterol concentration by reducing vitamin D receptor activity. We hypothesized that high air pollution exposure, smoking, and VDD would increase hypercholesterolemia. We investigated associations between long-term exposure to air pollutants, smoking status, VDD, and their combination with hypercholesterolemia using data from the 2008-2014 Korea National Health and Nutrition Examination Survey (KNHANES). We used linked data from the KNHANES to the daily moving average of air-pollution data from 730 days before the examination date, using participants' addresses in latitude and longitude coordinates. Results were analyzed using a survey logistic regression model for complex sample analyses. We included 28,134 adults with data on serum vitamin D, cholesterol concentrations, smoking status, and air pollutant concentrations. After adjusting for potential covariates, adults with exposure to high concentrations of air pollutants and ever smokers showed significantly higher risks of VDD (odds ratios [ORs], 1.70; 95 % confidence intervals [CIs], 1.44-2.00). In the group with high air-pollutant exposure, adults with low vitamin D status and ever smokers had significantly higher risks of hypercholesterolemia (ORs, 1.55; 95 % CIs, 1.09-2.19) than adults with high vitamin D status and never smokers. We found that high air-pollutant exposure, ever smokers, and VDD may increase hypercholesterolemia prevalence in Korean adults. Therefore, to reduce hypercholesterolemia risk, adults living in areas with high air-pollution exposure may need adequate vitamin D intake and to avoid smoking.

Ca2+ and Mg2+ are essential nutrients, and deficiency can cause serious health problems. Thus, lack of Ca2+ and Mg2+ can lead to osteoporosis, with incidence rising both in absolute and age-specific terms, while Mg2+ deficiency is associated with type II diabetes. Prevention via vitamin D or estrogen is controversial, and the bioavailability of Ca2+ and Mg2+ from supplements is significantly lower than that from milk products. Problems are likely to increase as populations age and the number of people on vegan diets surges. Developing new therapeutic strategies requires a better understanding of the molecular mechanisms involved in absorption by intestinal epithelia. The vitamin-D dependent, active pathway for the uptake of Ca2+ from the upper small intestine involving TRPV6 is highly efficient but only accounts for about 20% of total uptake. Instead, most Ca2+ uptake is thought to occur via passive paracellular diffusion across the ileum, although sufficiently high luminal concentrations are difficult to achieve.. Interestingly, colon and caecum also have a considerable capacity for the active absorption of Ca2+ and Mg2+, the molecular mechanisms of which are unclear. Intriguingly, stimulating fermentation by prebiotics enhances colonic absorption, which can rise from ~10% to ~30% of the total. Notably, fermentation releases protons, which inhibits channels highly selective for Ca2+ and Mg2+ (TRPV6 and TRPM6/TRPM7). Conversely, the non-selective cation channel TRPV3 is stimulated by both intracellular acidification and by numerous herbal compounds. Spicy, fiber-rich food, as traditionally consumed in many cultures, might enhance the uptake of Ca2+ and Mg2+ via this pathway.

Vitamin D3 (cholecalciferol) has demonstrated potential anticancer properties, but its clinical application is limited by associated toxicity at effective doses. This study investigated the use of liposomal encapsulation to increase the therapeutic efficacy of vitamin D3 while mitigating its toxicity.

Liposomal vitamin D3 (VD-LP) was prepared via the film-hydration method and characterized for particle size, polydispersity index, encapsulation efficiency, and long-term stability. In vitro gene expression modulation was evaluated in monocytic THP-1 cells, and antiproliferative effects were assessed in HT29 (colorectal), BT474 (breast), and TRAMP-C1 (prostate) cancer cell lines. In vivo antitumor efficacy and toxicity were tested in a mouse model with subcutaneously implanted MC38 tumors. Tumor growth, survival rates, and serum calcium and phosphate levels were analyzed.

VD-LP demonstrated high encapsulation efficiency and stability over 90 days, with a consistent particle size of approximately 83 nm. VD-LP modulated immune-related and metabolic gene expression in THP-1 cells, including upregulation of antimicrobial peptides and vitamin D receptor genes. VD-LP showed superior antiproliferative effects compared to free vitamin D3 in all tested cancer cell lines. In vivo, VD-LP delayed tumor growth and improved survival without causing hypercalcemia, highlighting its favorable toxicity profile.

Liposomal encapsulation of vitamin D3 significantly improves its anticancer efficacy while mitigating toxicity, making it a promising strategy for future cancer therapies. VD-LP shows potential for enhanced therapeutic applications with reduced adverse effects, warranting further clinical exploration.

Osteoporosis is a degenerative disease of bone metabolism. The epidemiology of osteoporosis varies by age, sex, and geography. There is a lack of information on the prevalence of osteoporosis among Chinese adults. In this study, we aimed to estimate the prevalence of osteoporosis among Chinese adults by age, sex, and skeletal sites and explore the main associated factors.

We searched six bibliographic databases to identify epidemiological studies that reported the prevalence of osteoporosis among Chinese adults published between January 1990 and February 2022. We applied a multilevel mixed-effects meta-regression to estimate the age-specific prevalence of osteoporosis. We presented the age-specific prevalence of osteoporosis by sex, diagnostic criteria (World Health Organization (WHO) and Chinese (CHN) diagnostic criteria), and specific skeletal site (the lumbar spine, femoral neck, and ward's triangle). We used the population data from the seventh National Census of Mainland China to estimate the number of Chinese adults with osteoporosis in 2020. Major associated factors for osteoporosis were pooled by a random-effects meta-analysis. We also estimated the regional prevalence and cases of osteoporosis among 31 provinces in mainland China in 2020 using an 'associated factor-based model.'

We included 129 articles in this systematic review and modelling study. 32 were based on the WHO diagnostic criteria and 17 on the CHN diagnostic criteria. Additionally, we included 83 articles in the associated factor analysis. The prevalence of osteoporosis increased with age and was consistently higher in females than males, regardless of diagnostic criteria and skeletal sites. Whether based on the WHO criteria (13.54%, 95% confidence interval (CI) = 10.25, 18.11) or the CHN criteria (29.49%, 95% CI = 18.29, 43.5), the prevalence of osteoporosis among Chinese adults aged 20-89 years in 2020 was highest when measuring the ward's triangle, which translated to 145.86 million (95% CI = 110.41, 195.03) and 317.54 million (95% CI = 196.95, 468.47) affected adults, respectively. The prevalence of osteoporosis was the highest in Northeast China under both the WHO criteria (15.50%, 95% CI = 11.78, 20.59) and the CHN criteria (32.36%, 95% CI = 20.33, 46.8), with the ward being the measured skeletal site. Marital status, current smoking, underweight, hypertension, fracture history, longer menopause years and menopause were positively associated with osteoporosis.

Osteoporosis remains a significant public health concern in China, particularly among females and the elderly. Meanwhile, the prevalence of osteoporosis varies considerably by region, skeletal site and diagnostic criteria. It is essential to establish clear and unified diagnostic criteria and implement high-quality epidemiological studies for osteoporosis in China. Additionally, targeted preventive strategies that focus on individuals with characteristics associated with osteoporosis are required to mitigate the impact of this condition.

PROSPERO: CRD42024564441.

At present, it is well known that oral health is essential for the well-being of the body as a whole, thanks to the increasing awareness of how various oral diseases, including periodontal disease, oral carcinomas, and other conditions, have a close connection with various systemic disorders. In recent decades, studies on the oral microbiome have increasingly emphasized how the balance between the host and the microbial species that coexist there is essential for oral health at all stages of life. However, there are many factors capable of interfering with that balance, and diet is precisely one of them. The real influence of diet on the oral microbiota, and consequently on oral health, has been much debated. In this context, the observation of two key periods in human history, the Neolithic and the Industrial Revolution, has proved to be diriment. The foods and processing techniques that emerged in these two historical periods, in association with changes in customs and habits, significantly altered the central constituents of the human diet, including macronutrient proportions, glycemic load, fatty acid composition, sodium and potassium levels, micronutrient levels, dietary pH, and fiber content taken in by human beings. The introduction of these foods into the daily human routine has been linked to a decline in oral health and an increase of several other diseases, including cardiovascular diseases, inflammatory bowel disease, rheumatic diseases, many cancers, and obesity. The aim of this chapter is to update the current knowledge and further discuss the role of diet and nutrition on oral health.

L-arginine (Arg) is a semi-essential amino acid that can be used as a key mediator for the release of growth hormone (GH), insulin-like growth factor-1(IGF-1), and other growth factors. In this study, we comprehensively evaluated the effect of Arg intake on bone growth and associated markers.

The study involved 24 Sprague-Dawley rats (12 males, 12 females) divided into two groups (Age = 24 days). One group received a standard diet, while the other was injected with 10 mg/kg of Arg daily for 90 days. Serum bone markers like calcium (Ca), phosphorous(P), and alkaline phosphatase (ALP) were analyzed via colorimetric assays. stereological study and bone mineral density (BMD) were conducted via dissector method and Hologic Dual-energy x-ray absorptiometry (DXA) system; respectively.

Biochemical assays showed no significant differences in Ca, P, and ALP levels between groups. Male rats in the case group exhibited lower testosterone levels (p.value = 0.009). Stereological and bone mineral density (BMD) analyses revealed contrasting gender-specific outcomes. Female rats in the case group had higher BMD (p.value = 0.001), while males had lower BMD compared to controls (p.value = 0.018). Arg consumption affects trabecula volume values differently in females compared to males (p.value = 0.022). Furthermore, the study observed decreased osteocytes and osteoblasts in male case rats. The gender-based differences in BMD were attributed to Arg's paradoxical impact on testosterone levels in males.

Overall, Arg supplementation was found to influence BMD and trabecular bone volume, with outcomes varying depending on gender. The study highlights the intricate interplay between Arg, sex hormones, and bone health, offering insights into these complex relationships.

Metabolic Bone Disease (MBD) is common in patients with short bowel syndrome (SBS). This study was to investigate the incidence and risk factors of osteopenia in adult SBS patients.

Hospital records from January 2010 to December 2019 were used to identify all eligible patients. Logistic regression and a nomogram were used to analyze the data.

A total of 120 patients with SBS were included in this study, and 76 patients (63.3%) developed osteopenia during the 10-year observation period, The multivariate analysis using the logistic regression model demonstrated that age (OR = 1.070; 95%CI: 1.016-1.126, p = 0.010), female (OR = 5.098; 95%CI: 1.211-21.456, p = 0.026), tumor history (OR = 4.481; 95%CI: 1.125-17.854, p = 0.033), duration of SBS (OR = 1.0862; 95%CI: 1.022-1.103, p = 0.002) and remnant ileum (OR = 4.260; 95%CI: 1.210-15.002, p = 0.024) were independent risk factors for osteopenia in adults with SBS. The area under the curve (AUC) for the joint model (age, female, tumor history, duration of SBS, remnant ileum) was 0.848 and the corresponding sensitivity and specificity were 0.855 and 0.705, respectively. The C-index was 0.849 (95% CI: 0.778-0.917); thus, the predictions made by the model were close to the actual outcomes. In the decision curve analysis, the nomogram performed well and was feasible to make beneficial clinical decisions.

This study reveals the high prevalence of osteopenia in SBS patients and highlights the importance of early identification and treatment of osteopenia. A nomogram may provide personalized prediction and guidance for medical intervention.

Vitamin D deficiency may influence dental implant osseointegration unfavourably. The aim of this study was to compare dental implant stabilities of patients with different levels of vitamin D and investigate the effects of vitamin D supplementation.

One hundred and twenty-nine patients who underwent dental implantation were grouped regarding vitamin D levels and supplement use: Group A; vitamin D deficiency and supplement usage, Group B; insufficiency with supplement usage, Group C; insufficiency without supplements and Group D; vitamin D sufficiency. Resonance frequency analysis (RFA) measurements were performed at baseline and 3 months. Patients with vitamin D deficiency (Group A) and insufficiency (Group B) were prescribed supplements by specialists. Pearson correlation analysis was used to examine an association between vitamin D levels and implant stability.

Primary stability of Group D (76.34 ± 6.55) was significantly higher than Groups A, B and C at baseline (p < 0.05). At 3 months, Group C scored significantly lower than the other groups (p < 0.05). The results revealed a correlation between serum levels of vitamin D and RFA measurements at 3 months (p < 0.05).

It was observed that high vitamin D levels influenced implant stabilities positively, as evidenced by higher Implant Stability Quotient values. Low levels of vitamin D may be associated with a decrease in implant stability.

Vitamin D, concerning its impact on bone metabolism, is currently of particular interest in implant dentistry. The lower stability scores in patients with vitamin D deficiency reinforce the recommendation of Vitamin D supplementation when treating those patients with dental implants.

Obesity is associated with vitamin D (VitD) deficiency. However, previous studies showed mixed effects of VitD (25-hydroxyVitD/calcidiol) supplementation on body weight. The biological actions of VitD require the hydroxylation of inactive VitD into active VitD (1.25-dihydroxyVitD/calcitriol). This step is highly regulated; therefore, supplementing with inactive VitD might not be sufficient to overcome the potential adverse health effects of VitD deficiency. The objective of this study was to conduct a systematic review and individual participant data (IPD) meta-analysis of data acquired from randomised placebo-controlled calcitriol trials (RCTs) to determine the effects of calcitriol on body weight and weight-related parameters.

Studies were identified from MEDLINE, EMBASE, and CENTRAL databases up to January 27, 2024, and excluded those involving dialysis or cancer patients. We obtained IPD from eligible trials and assessed bias using the Cochrane Collaboration risk-of-bias tool and methodological quality using the Heyland Methodological Quality Score. The study was prospectively registered with PROSPERO (CRD42017076202).

Although none of the studies reported information regarding our primary objective, we obtained IPD for 411 patients, with 206 randomised to receive calcitriol and 205 to placebo. This dataset enabled us to conduct an IPD meta-analysis with 17,084 person-months of follow-up (median: 11 months). Meta-analysis showed that calcitriol does not alter body weight, BMI, waist circumference, fat mass or lean body mass compared to placebo. Adjusting for age and sex did not alter the outcomes.

In conclusion, this systematic review and IPD meta-analysis indicate that calcitriol does not affect body weight in normal-weight postmenopausal women and lean patients with type 1 diabetes nor in people suffering from obesity, type 2 diabetes and chronic kidney disease. Whether calcitriol lowers body weight in VitD-sufficient people with obesity remains to be elucidated.

Ginseng (Panax ginseng Meyer) is an herbal medicine used in traditional Chinese medicine (TCM), has the effects of treating colitis and other diseases. Ginsenoside Rb1 (GRb1), a major component of ginseng, modulates autoimmunity and metabolism. However, the mechanism underlying GRb1 treatment of ulcerative colitis (UC) has not yet been elucidated. UC is a refractory inflammatory bowel disease (IBD) with a high recurrence rate, and researches on new drugs for UC have been in the spotlight for a long time.

Mice with DSS-induced UC were treated with GRb1 or 0.9% saline for 10 days. Colon tissue of UC mice was collected to detect the levels of intestinal inflammatory cytokines and integrity of the intestinal barrier. RNA-seq and network pharmacology were used to predict the therapeutic targets of GRb1 during UC treatment.

GRb1 treatment alleviated intestinal inflammation and improved intestinal barrier dysfunction in UC mice. Specifically, GRb1 downregulated the levels of pro-inflammatory cytokines such as TNF-α and IL-6, while upregulating the level of the anti-inflammatory cytokine IL-10. Additionally, GRb1 treatment increased the levels of tight junction proteins including ZO-1, Occludin, and E-cadherin, which are crucial for maintaining intestinal barrier integrity. Further analyses using RNA-seq and network pharmacology suggested that these effects might involve the regulation of GRb1 in the signal transduction network of VDR, PPARγ, and NF-κB.

The study demonstrated that GRb1 effectively alleviated UC by modulating intestinal inflammation and protecting the integrity of the intestinal barrier through the signal transduction network of VDR, PPARγ, and NF-κB.

This study aimed to explore the causal relationship between trace elements and osteoarthritis (OA). The results showed a relatively weak association between copper and OA, while vitamin D showed a significant positive association with OA. Mendelian randomization (MR) analysis was used to investigate the causal relationship between copper and vitamin D and OA. A variety of MR methods including inverse variance weighting, weighted median, MR-Egger, simple model, and multi-text mixed model were analyzed to confirm the consistency of these results. Sensitivity analysis further confirmed the reliability of these causal relationships and excluded the interference of pleiotropy. These findings add to the understanding of the potential role of micronutrients in the prevention and treatment of OA and support the idea of vitamin D as a potential therapy for the prevention and treatment of OA. Future studies should further explore the specific biological mechanisms of these trace elements and the differences in their effects in different populations in order to develop more effective treatment strategies to reduce the health burden of degenerative joint diseases.

Age-related hearing loss (ARHL) is a sensorineural disease that is associated with a number of factors. In addition to age, sex, environment, lifestyle, and comorbidities are all known to be related to ARHL as well. The prevalence of ARHL can be reduced by controlling the adjustable factors that cause it. Vitamin D levels are strongly related to calcium metabolism, which can affect ARHL. This study aimed to investigate the association between vitamin D and ARHL.

A total of 1,104 subjects aged >65 years were enrolled from the fifth Korean National Health and Nutrition Examination Survey, which was conducted from 2010-2012. Every participant received both an audiological assessment and a nutritional survey. The association between ARHL and serum vitamin D concentration was analyzed using logistic regression analyses with complex sampling adjusted for confounding factors such as alcohol consumption, smoking status, mobility, and bone mineral density.

Our multivariable analysis revealed that males in the group with lower serum levels of vitamin D (< 20 ng/mL) had a higher prevalence of ARHL (odds ratio, 1.638, 95% confidence interval, 1.058-2.538, p=0.027).

This finding suggests that lower serum levels of vitamin D are associated with ARHL in the older male population.

Previous studies underscore the protective role of physical activity (PA) in bone health, yet the relationship between different PA categories and osteoporosis risk remains less explored. Understanding the relationships helps tailor health recommendations and policies to maximize the effects of preventing osteoporosis.

The cross-sectional study involves 488,403 UK Biobank participants with heel quantitative ultrasound-estimated bone mineral density (eBMD) data. The longitudinal cohort involves 471,394 UK Biobank participants without initial osteoporosis and with follow-up records. PA exposure categories in our study included sedentary behavior (SB), total PA (TPA), and different category-specific PA including household, leisure, and work PA. The cases of osteoporosis were assessed using the International Classification of Diseases, 10th revision (ICD-10). The linear, logistic, and Cox proportional hazard regression models were used in our study.

In the cross-sectional study, 15,818 (3.28 %) participants had osteoporosis. TPA levels have a positive correlation with eBMD and a negative correlation with osteoporosis prevalence. Among different categories of PA, higher levels of leisure PA were correlated with increased eBMD and a lower osteoporosis risk (leisure PA: OR: 0.83, 95 % CI: 0.79 to 0.86;). In the longitudinal study, 16,058 (17.6 % male, 82.4 % female) (3.41 %) individuals developed osteoporosis during an average follow-up of 13 years. We observed consistent protective effects of high levels of PA on osteoporosis incidence risk, particularly within the category of leisure PA (TPA: HR: 0.78, 95 % CI: 0.74 to 0.82; leisure PA:HR: 0.83, 95 % CI: 0.80 to 0.87). Such associations are independent of genetic predisposition, with no evidence of gene-PA interactions, and keep steady among individuals using drugs affecting bone-density. Moreover, among different leisure PA items, strenuous sports, other exercises, and walking for pleasure conferred a substantial protective effect against osteoporosis. Additionally, non-elderly individuals and males exhibited lower osteoporosis risk from PA.

This study highlights activity categories differently associated with the risk of osteoporosis. Adherence to frequent leisure PA may have a protective effect against osteoporosis. Such associations are independent of genetic susceptibility to osteoporosis and keep steady among individuals using drugs affecting bone-density. This highlights that leisure PA could be suggested as a more effective intervention in the primary prevention of osteoporosis.

The question of how local adaptation takes place remains a fundamental question in evolutionary biology. The variation of allele frequencies in genes under selection over environmental gradients remains mainly theoretical and its empirical assessment would help understanding how adaptation happens over environmental clines. To bring new insights to this issue we set up a broad framework which aimed to compare the adaptive trajectories over environmental clines in two domesticated mammal species co-distributed in diversified landscapes. We sequenced the genomes of 160 sheep and 161 goats extensively managed along environmental gradients, including temperature, rainfall, seasonality and altitude, to identify genes and biological processes shaping local adaptation. Allele frequencies at putatively adaptive loci were rarely found to vary gradually along environmental gradients, but rather displayed a discontinuous shift at the extremities of environmental clines. Of the 430 candidate adaptive genes identified, only 6 were orthologous between sheep and goats and those responded differently to environmental pressures, suggesting different putative mechanisms involved in local adaptation in these two closely related species. Interestingly, the genomes of the 2 species were impacted differently by the environment, genes related to signatures of selection were most related to altitude, slope and rainfall seasonality for sheep, and summer temperature and spring rainfall for goats. The diversity of candidate adaptive pathways may result from a high number of biological functions involved in the adaptations to multiple eco-climatic gradients, and a differential role of climatic drivers on the two species, despite their co-distribution along the same environmental gradients. This study describes empirical examples of clinal variation in putatively adaptive alleles with different patterns in allele frequency distributions over continuous environmental gradients, thus showing the diversity of genetic responses in adaptive landscapes and opening new horizons for understanding genomics of adaptation in mammalian species and beyond.

The 6th International Conference, "Controversies in Vitamin D," was convened to discuss controversial topics, such as vitamin D metabolism, assessment, actions, and supplementation. Novel insights into vitamin D mechanisms of action suggest links with conditions that do not depend only on reduced solar exposure or diet intake and that can be detected with distinctive noncanonical vitamin D metabolites. Optimal 25-hydroxyvitamin D (25(OH)D) levels remain debated. Varying recommendations from different societies arise from evaluating different clinical or public health approaches. The lack of assay standardization also poses challenges in interpreting data from available studies, hindering rational data pooling and meta-analyses. Beyond the well-known skeletal features, interest in vitamin D's extraskeletal effects has led to clinical trials on cancer, cardiovascular risk, respiratory effects, autoimmune diseases, diabetes, and mortality. The initial negative results are likely due to enrollment of vitamin D-replete individuals. Subsequent post hoc analyses have suggested, nevertheless, potential benefits in reducing cancer incidence, autoimmune diseases, cardiovascular events, and diabetes. Oral administration of vitamin D is the preferred route. Parenteral administration is reserved for specific clinical situations. Cholecalciferol is favored due to safety and minimal monitoring requirements. Calcifediol may be used in certain conditions, while calcitriol should be limited to specific disorders in which the active metabolite is not readily produced in vivo. Further studies are needed to investigate vitamin D effects in relation to the different recommended 25(OH)D levels and the efficacy of the different supplementary formulations in achieving biochemical and clinical outcomes within the multifaced skeletal and extraskeletal potential effects of vitamin D.

Our study showed that B vitamins did not have significant effect on fracture incidence, bone mineral density, and bone turnover markers. However, the research data of B vitamins on bone mineral density and bone turnover markers are limited, and more clinical trials are needed to draw sufficient conclusions.

The objective of this study was to identify the efficacy of B vitamin (VB) (folate, B6, and B12) supplements on fracture incidence, bone mineral density (BMD), and bone turnover markers (BTMs).

A comprehensive search was performed in PubMed, MEDLINE, EMBASE, Cochrane databases, and ClinicalTrials.gov up to September 4, 2023. The risk of bias was assessed according to Cochrane Handbook and the quality of evidence was assessed according to the GRADE system. We used trial sequential analysis (TSA) to assess risk of random errors and Stata 14 to conduct sensitivity and publication bias analyses.

Data from 14 RCTs with 34,700 patients were extracted and analyzed. The results showed that VBs did not significantly reduce the fracture incidence (RR, 1.06; 95% CI, 0.95 - 1.18; p = 0.33; I2 = 40%) and did not affect BMD in lumbar spine and femur neck. VBs had no significant effect on bone specific alkaline phase (a biomarker for bone formation), but could increase the serum carboxy-terminal peptide (a biomarker for bone resorption) (p = 0.009; I2 = 0%). The TSA showed the results of VBs on BMD and BTMs may not be enough to draw sufficient conclusions due to the small number of sample data included and needed to be demonstrated in more clinical trials. The inability of VBs to reduce fracture incidence has been verified by TSA as sufficient. Sensitivity analysis and publication bias assessment proved that our meta-analysis results were stable and reliable, with no significant publication bias.

Available evidence from RCTs does not support VBs can effectively influence osteoporotic fracture risk, BMD, and BTMs.

PROSPERO registration number: CRD42023427508.

Clinical investigations have highlighted disruptions in bone metabolic processes and abnormal fluctuations in serum indicator levels during the onset of leg disease (LD) in broilers. However, the presence of a genetic causal relationship for this association remains undetermined. Therefore, the aim of this study is to discern the risk factors underlying LD development using 1235 sequenced white-feathered broilers. We employed Mendelian randomization (MR) analysis to assess the associations of bone strength (BS), bone mineral density (BMD), tibial bone weight (TBW), tibial bone length (TBL), tibial bone diameter (TBD), bone ash (BA), ash calcium (Ash Ca), ash phosphorus (Ash P), serum calcium (Ca), serum phosphorus (P), serum alkaline phosphatase (ALP), and serum osteoprotegerin (OPG) with the incidence of LD. Compelling evidence underscores a causal link between the risk of developing LD and decreased BMD (odds ratio (OR) = 0.998; 95% CI: 0.983, 0.993; P < 0.001) and narrower TBD (OR = 0.985, 95% CI: 0.975, 0.994, P = 0.002). Additionally, serum OPG concentrations (OR: 0.995, 95% CI: 0.992, 0.999, P = 0.008) were associated with BMD (OR = 0.0078, 95% CI = 0.0043 to 0.0140, P < 0.001), indicating a robust genetic relationship between ALP concentrations (OR: 0.988, 95% CI: 0.984, 0.993, P < 0.001) and TBD (OR = 0.0046, 95% CI = 0.0026, 0.0083, P < 0.001). Moreover, elevated serum Ca (OR: 0.564, 95% CI: 0.487, 0.655, P < 0.001) and P (OR: 0.614, 95% CI: 0.539, 0.699, P < 0.001) levels were associated with a narrower TBD. Elevated serum levels of Ca, P, ALP, and OPG contribute to disturbances in bone metabolism, while decreased BMD and narrower TBD are associated with a greater risk of developing LD in broilers. This discovery elucidates the metabolic risk factors for LD in broilers and could provide information on LDs, such as osteoporosis, in humans.

In people with chronic kidney disease (CKD), the physiology of vitamin D is altered and leads to abnormalities in bone and mineral metabolism which contribute to CKD mineral and bone disorder (CKD-MBD). Observational studies show an association between vitamin D deficiency and increased risk of mortality, cardiovascular disease and fracture in CKD. Although vitamin D therapy is widely prescribed in people with CKD, clinical trials to date have failed to demonstrate a clear benefit of either nutritional vitamin D supplementation or active vitamin D therapy in improving clinical outcomes in CKD. This review provides an updated critical analysis of recent trial evidence on vitamin D therapy in people with CKD.

To evaluate the association of serum 25-hydroxyvitamin D (25(OH) D) levels with bone mineral density (BMD), fracture risk, and bone metabolism.

This multicenter cross-sectional study recruited menopausal females and males greater than or equal to 50 year old with osteoporosis/fractures between September 2016 and September 2021. Assessment included clinical data, 25(OH)D, intact parathyroid hormone (iPTH), procollagen type 1 amino-terminal propeptide (P1NP), carboxy-terminal collagen crosslinks (CTX), lateral thoracolumbar spine x-rays, and BMD.

A total of 3003 individuals were stratified by 25(OH) D levels: 720 individuals (24%) <20 ng/mL, 1338 individuals (44.5%) 20 to 29 ng/mL, and 945 individuals (31.5%) ≥30 ng/mL. In unadjusted and multivariable models, BMD T-score, except spine, was significantly and positively associated with 25(OH)D levels. 25(OH) D levels were inversely associated with Fracture Risk Assessment Tool scores. Patients with 25(OH)D <20 ng/mL had significantly higher iPTH and bone turnover markers (P1NP and CTX) than patients with 25(OH)D ≧20 ng/mL in all models. When analyzing bone-related markers and BMD, total hip and femoral neck BMD T-scores were positively correlated with 25(OH)D concentrations and BMI but negatively correlated with iPTH, P1NP, CTX, and age. In multivariate models with all bone-related markers, only 25(OH)D levels were significantly associated with total hip and femoral neck BMD.

Vitamin D deficiency is significantly associated with decreased total hip and femoral neck BMD and increased fracture risk as assessed by Fracture Risk Assessment Tool. In those with osteoporosis/fractures, vitamin D is implicated in the causal relationship between bone remodeling and BMD. Assessing vitamin D status is imperative for those at risk for osteoporosis/fractures.

Vitamin D and K are believed to promote bone health, but existing evidence is controversial. This study aimed to measure several metabolites of both vitamins by liquid chromatography tandem mass spectrometry (LC-MS/MS) in a cohort of postmenopausal women with low and normal bone mineral density (BMD).

Vitamin metabolites (25-hydroxyvitamin D (25[OH]D), 24,25-dihydroxyvitamin D (24,25(OH)2D), phylloquinone (K1), menaquinone-4 (MK-4) and MK-7) were measured in 131 serum samples by LC-MS/MS. The vitamin D metabolite ratio (VMR) was calculated. Parathyroid hormone (PTH), type I procollagen-N-terminal-peptide (PINP) and C-terminal telopeptides of type I collagen (CTX-I) were measured by immunoassay. Dual X-ray absorptiometry was performed to identify participants with normal (T-score>-1) and low (T-score<-1) BMD.

Mean age was 58.2±8.5 years. BMD was normal in 68 and low in 63 women. Median (interquartile range) for 25(OH)D and total vitamin K concentrations were 53.5 (39.6-65.9) nmol/L and 1.33 (0.99-2.39) nmol/L. All vitamin metabolites were comparable in individuals with normal and low BMD. Furthermore, BMD and trabecular bone score were comparable in participants with adequate and inadequate vitamin status (at least one criterion was met: 25(OH)D <50 nmol/L, 24,25(OH)2D <3 nmol/L, VMR <4 %, total vitamin K <0.91 nmol/L). PTH, but not PINP or CTX-I, was inversely correlated with 25(OH)D, 24,25(OH)2D and VMR. Synergistic effects between vitamin D and K were not observed.

Vitamin D and K status is not related to BMD and trabecular bone quality in postmenopausal women. Inverse associations were only seen between vitamin D metabolites and PTH.

The main objective of this study is to assess the possibility of using radiomics, deep learning, and transfer learning methods for the analysis of chest CT scans. An additional aim is to combine these techniques with bone turnover markers to identify and screen for osteoporosis in patients.

A total of 488 patients who had undergone chest CT and bone turnover marker testing, and had known bone mineral density, were included in this study. ITK-SNAP software was used to delineate regions of interest, while radiomics features were extracted using Python. Multiple 2D and 3D deep learning models were trained to identify these regions of interest. The effectiveness of these techniques in screening for osteoporosis in patients was compared.

Clinical models based on gender, age, and β-cross achieved an accuracy of 0.698 and an AUC of 0.665. Radiomics models, which utilized 14 selected radiomics features, achieved a maximum accuracy of 0.750 and an AUC of 0.739. The test group yielded promising results: the 2D Deep Learning model achieved an accuracy of 0.812 and an AUC of 0.855, while the 3D Deep Learning model performed even better with an accuracy of 0.854 and an AUC of 0.906. Similarly, the 2D Transfer Learning model achieved an accuracy of 0.854 and an AUC of 0.880, whereas the 3D Transfer Learning model exhibited an accuracy of 0.740 and an AUC of 0.737. Overall, the application of 3D deep learning and 2D transfer learning techniques on chest CT scans showed excellent screening performance in the context of osteoporosis.

Bone turnover markers may not be necessary for osteoporosis screening, as 3D deep learning and 2D transfer learning techniques utilizing chest CT scans proved to be equally effective alternatives.

Osteoporosis is a common disorder with a strong genetic component. Bone mineral density (BMD), vitamin D, and calcium levels declining are a main contributor of osteoporosis and fragility fractures. This cross-sectional study designed to explore the possible link between CYP2R1 rs10741657 polymorphism and BMD of the total hip, lumbar spine and femoral neck, vitamin D, and calcium in Iranian children and adolescents. 247 children and adolescents (127 girls and 120 boys) between 9 and 18 years old from Kawar (an urban area located 50 km east of Shiraz, the capital city of the Fars province in the south of Iran) were randomly selected based on age-stratified systematic sampling and recruited for genetic analysis. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used for genotyping CYP2R1 rs10741657. Anthropometric, biochemical, and bone mineral density (BMD) parameters were also measured. The results specified that in the dominant [P < 0.0001, - 2.943 (- 4.357-1.529)] and over-dominant [P < 0.0001, 2.789 (1.369-4.209)] models, vitamin D concentration significantly differed between genotypes. The highest vitamin D levels were displayed for participants carrying the rs10741657 AG genotype (16.47 ng/ml). In regard to calcium, in a dominant model [P = 0.012, 0.194 (0.043-0.345)] and over-dominant model [P = 0.008, 0.206 (- 0.357-0.055), there was a significant association. AG genotype displayed the highest (9.96 mg/dl) and GG genotype the lowest (9.75 mg/dl) calcium values. This study reported the association of CYP2R1 rs10741657 polymorphisms with calcium and vitamin D levels in Iranian children and adolescents.