About the role of vitamins in bone metabolism

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Osteoporosis is a concern for public health in developed countries and has a major impact on quality of life. Osteoporosis is characterized by micro-architectural deterioration of bone tissue – bone matrix – through the loss of bone density, which leads to increased bone fragility and fracture risk. Ostoporoza is primarily a disorder of protein metabolism of bone and is favored by some nutritional deficiencies. Deficiencies of vitamins – mainly B6, D3, C and K1 – can cause disruptions in the organic matrix of bone formation and may lead to reduced calcium binding. The risk of osteoporotic fracture, higher in women Over a lifetime, women lose about 30% – 50% of the bone mass. The risk of suffering an osteoporotic fracture is 40% female and 15% male (A). Women of the postmenopausal patient are classic because of low levels of estrogen. The symptoms begin to manifest only after bone loss exceeds 20% – 30% (B). Figures published since the ’90s show the social and economic impact of the condition (C, D). In the United States recorded annually over 1 million osteoporotic fractures, of which 54% are fractures of the vertebrae, femoral head fractures 23% and 17% bone fractures forearm. Osteoporosis affects at least 20% of people over 70 years. The gender ratio is 2: 1. Only 3.5% of women aged 50-54 years are post-menopausal women are diagnosed with osteoporosis.

bone metabolism
bone metabolism

The true incidence of osteoporosis in this age group, however, is approx. 30%. Only 1% of men suffer from osteoporosis in the elderly. After the age of 70 years, over 25% of women experience some evidence of vertebral fractures and the incidence increases further with age, reaching 50% of women over 80 years. In women older than 70 years recorded 90% of fractures of the femoral head. And men suffering from osteoporosis! Figures show that women are at greater risk of developing this disease, but men can be affected, as they age: about 3-6% of men older than 50 years suffer from osteoporosis and 28-47% show a loss of bone called osteopenia. Bone loss and osteoporosis are considered part of the aging process. Current therapeutic approaches can not restore bone mass once the bone matrix was destroyed, the process is largely irreversible (E). In these circumstances, it is particularly important that the bone matrix and bone meal to be maintained through preventive measures including proper nutrition and exercise. Osteoporosis: Nutritional Approach Most approaches rely on dietary calcium because it is the main constituent of bone. Unfortunately, calcium alone is ineffective in preventing deterioration of bone matrix and helps far too little to reduce the loss of bone mass. In the context of bone degeneration caused by aging and hormonal profile modification, vitamin D3, C, B6, and K benefit out of biochemically and physiologically, pointing that these micronutrients are essential in preventing osteoporosis in the long term. Vitamin D3 and maintaining the integrity of bone mass Vitamin D3 has been much studied in recent years and demonstrated an adequate level of vitamin D3 it is crucial to maintaining the integrity of the skeleton and bone mass. Calcium homeostasis depends on the presence of vitamin D3. With age, the metabolism of vitamin D3 is conducted harder and the level of vitamin D3 available in the blood decreases. Studies showing the effects of supplementing vitamin D3 highlight positive effects on calcium metabolism, by reducing the rate of bone loss and osteoporotic fracture reduction. Vitamin C improves bone quality There is clear and convincing evidence that an optimal level of vitamin C improves the mechanical and biochemical parameters of bone to reduce the appearance of abnormal bone tissue. Vitamin C is essential for the conversion of vitamin D3 to form the active metabolite, cholecalciferol. Vitamin C supplementation in people with a normal status or even below-normal vitamin D3 leads to improved bone quality. The protective role of vitamin C on connective tissue – especially on collagen type I – is already known and accepted. Vitamin C acts on functional proteins and stimulates collagen synthesis, bone strength and giving better support mineralization.

The human body does not produce vitamin C, it must be ensured from food or supplements. Subclinical deficiencies of vitamin C are relatively common. Vitamin C supplementation is necessary for the elderly in order to reach an optimal level necessary to carry out metabolic processes related to the formation of calcium homeostasis and bone structure. Vitamin B6 role in maintaining bone matrix Collagen synthesis and bone structure shows significant pathological morphological changes in the event of default of vitamin B6. Among the functions of vitamin B6 less known is her role in maintaining bone matrix, in particular by maintaining the structural integrity of collagen type I. Vitamin B6 is essential for the formation of collagen structures. Only a properly formed bone matrix can serve as a basis for submission of mineral crystals and gives strength and elasticity of the bone. Recent research has noted the link between vitamin B6 and vitamin K in their involvement in bone metabolism. Vitamin B6 is an essential cofactor in over 100 enzymatic reactions. Clinical symptoms of deficiency are rare and therefore the importance of this vitamin is undervalued. The usual diet but does not cover more than 70% of vitamin B6. The elderly are most at risk of developing a deficiency, all these people being the most at risk of osteoporosis. Attention in the vitamin K in osteoporosis! At the end of the 90 proteins were identified bone which requires vitamin K as co-factor essential for their enzyme system functional. In patients diagnosed with osteoporosis and the fractures were found low serum levels of vitamin K.

A low level of vitamin K results in reducing the rate of loss of mass and bone remodelled – bone density. It is reversible: vitamin K supplementation leads to normalization of bone remodeling processes, increase mineralization and decreases the risk of fractures. Proteins involved in bone remodeling processes are more susceptible to deficiency of vitamin K higher than the coagulation factor. The risk groups – such as the elderly – the level of vitamin K is apparently enough to ensure normal blood clotting. This level is, however, insufficient for the proper conduct of remodeling processes – bone mineralization. Supplementation of vitamin K represents a valuable opportunity for prevention of osteoporosis and reduce its complications. Bone is more than an accumulation of hydroxyapatite crystals. Bone cells need more nutrients to balance resorption and new bone formation. Osteoporosis is characterized by an imbalance in these processes. Nutritional deficiencies should be considered as a possible factor. The role of nutrition in the etiology of osteoporosis is usually reduced to calcium and vitamin D3. Collagen synthesis and bone remodeling, however, depend on vitamin C and vitamin B6, and sub-optimal levels of Vitamin K affects the process of remodeling – bone mineralization. To support bone metabolism supplementation is recommended: Vitamin D3 5 mcg Vitamin B6 2 mg Vitamin C 60 mg Vitamin K 200 mcg Calcium 200 mg.

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