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Parathyroid hormone or vitamin D, which parameter is in fact associated with osteosarcopenia?

Grant number: 18/03903-5
Support type:Scholarships abroad - Research Internship - Doctorate
Effective date (Start): May 01, 2018
Effective date (End): October 31, 2018
Field of knowledge:Health Sciences - Nutrition - Nutritional Analysis of Population
Principal researcher:Lígia Araújo Martini
Grantee:Natasha Aparecida Grande de França
Supervisor abroad: Gustavo Duque
Home Institution: Faculdade de Saúde Pública (FSP). Universidade de São Paulo (USP). São Paulo , SP, Brazil
Research place: University of Melbourne, Australia  
Associated to the scholarship:14/26787-0 - Physiological and genetic aspects interrelated to vitamin D in the osteosarcopenic obesity: health survey of the City of São Paulo - ISA capital, BP.DR


Ageing is associated to changes in body composition. There is a natural decline in skeletal muscle mass and bone mineral density from the age of 30. Thus, it is not surprising that the elderly present both reduced parameters (low bone mineral density -BMD- plus low skeletal muscle mass and strength), which characterizes the osteosarcopenia. Osteosarcopenic individuals are at greater risk of falling, fracturing, having disability and frailty, compared with those with osteopenia/osteoporosis or sarcopenia alone. Much attention has been given to hypovitaminosis D as an important risk factor for both conditions. However, there is a close relationship between vitamin D metabolism and the parathyroid hormone (PTH), which in turn directly affects the bone and seems to be also detrimental to muscle mass. Therefore, it is hypothesized that higher PTH concentrations are positively associated with concomitant low BMD (osteoporosis), low muscle mass, and strength (sarcopenia) in elderly, independently of renal function and vitamin D status. The present study will include data from three Australian databases: 1) patients attended to Frail and Fracture Clinic (Sunshine Hospital, Melbourne, VIC), 2) Circulating Osteoprogenitor (COP) Study (Penrith, NSW), and 3) The Nepean Osteoporosis and Frailty (NOF) Study (Sydney, NSW). Participants will be included if 65 or more years of age, no serious memory deficits, ability to mobilize independently, and with sufficient information of body composition, bone mass, renal function, and blood levels of vitamin D and PTH. Aiming to test the hypothesis of the study, the osteosarcopenia will be considered the dependent variable, and the risk category will be set as "to be osteosarcopenic". The association between PTH (continuous and/or categorical) and osteosarcopenia (categorical) will be evaluated using multiple regression models adjusted for appropriate socio-demographic and lifestyle confounders, vitamin D concentrations and renal function. The analyses will be performed in Stata, version 13.0. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
MURTHY, LAVANYA SRINIVASA; DE FRANCA, NATASHA A. GRANDE; DUVAL, GUILLAUME; VOGRIN, SARA; ANNWEILER, CEDRIC; DUQUE, GUSTAVO. Higher Concentrations of Parathyroid Hormone (PTH) are Associated with Reduced Gait Velocity in Adults: A Systematic Review. ARCHIVES OF GERONTOLOGY AND GERIATRICS, v. 98, . (18/03903-5)
GRANDE DE FRANCA, NATASHA APARECIDA; MURTHY, LAVANYA SRINIVASA; PHU, STEVEN; LIBERTS, ELIZABETH; VOGRIN, SARA; MARTINI, LIGIA ARAUJO; DUQUE, GUSTAVO. High parathyroid hormone levels are associated with poor balance in older persons: A cross-sectional study. MATURITAS, v. 121, p. 57-62, . (18/03903-5)

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