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      Linking the relationship between dietary folic acid intake and risk of osteoporosis among middle‐aged and older people: A nationwide population‐based study

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          Abstract

          Among middle‐aged and older people, balanced and nutritious diets are the foundation for maintaining bone health and preventing osteoporosis. This study is aimed at investigating the link between dietary folic acid intake and the risk of osteoporosis among middle‐aged and older people. A total of 20,686 people from the National Health and Nutritional Examination Survey (NHANES) 2007–2010 are screened and included, and 5312 people aged ≥45 years with integral data are ultimately enrolled in evaluation. Demographics and dietary intake‐related data are gathered and analyzed, and the odds ratio (OR) and 95% confidence interval (CI) of each tertile category of dietary folic acid intake and each unit increase in folic acid are assessed via multivariate logistic regression models. On this basis, the receiver operating characteristic (ROC) curve is used to identify the optimal cutoff value of dietary folic acid intake for indicating the risk of osteoporosis. Of 5312 people with a mean age of 62.4 ± 11.0 years old, a total of 513 people with osteoporosis are screened, and the dietary folic acid intake amount of the osteoporosis group is significantly lower than that of the non‐osteoporosis group ( p < .001). The lowest tertile category is then used to act as a reference category, and a higher dietary folic acid intake amount is observed to be positively related to lower odds for risk of osteoporosis. This trend is also not changed in adjustments for combinations of different covariates ( p all < .05). Based on this, a dietary folic acid intake of 475.5 μg/day is identified as an optimal cutoff value for revealing osteoporosis. Collectively, this nationwide population‐based study reveals that a higher daily dietary folic acid intake has potential protective effects on osteoporosis in middle‐aged and older people.

          Abstract

          This study is aimed at investigating the link between dietary folic acid intake and the risk of osteoporosis among middle‐aged and older people, and a total of 20,686 people from the National Health and Nutritional Examination Survey (NHANES) 2007–2010 were screened and included. The results indicate that a higher daily dietary folic acid intake has potential protective effects on osteoporosis in middle‐aged and older people.

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          Prevalence of Osteoporosis and Fracture in China : The China Osteoporosis Prevalence Study

          Linhong Wang, Wei Yu, Xiangjun Yin … (2021)
          This cross-sectional study evaluates the prevalence of and factors associated with osteoporosis, clinical fractures, and vertebral fractures among adults 40 years or older in mainland China by sex, age group, and urban vs rural residence. Question What is the prevalence of osteoporosis and clinical and vertebral fracture in the adult population of mainland China? Findings In this cross-sectional study of 20 416 individuals, the prevalence of osteoporosis among adults 40 years or older was 5.0% among men and 20.6% among women, and the prevalence of vertebral fracture was 10.5% among men and 9.7% among women. Meaning These findings suggest that recommendations for screening and treatment of fractures should include both men and women in China. Importance The aging of the population is associated with an increasing burden of fractures worldwide. However, the epidemiological features of fractures in mainland China are not well known. Objective To assess the prevalence of and factors associated with osteoporosis, clinical fractures, and vertebral fractures in an adult population 40 years or older in mainland China. Design, Setting. and Participants This cross-sectional study, the China Osteoporosis Prevalence Study, was conducted from December 2017 to August 2018. A random sample of individuals aged 20 years or older who represented urban and rural areas of China were enrolled, with a 99% participation rate. Main Outcomes and Measures Weighted prevalence of osteoporosis, clinical fracture, and vertebral fracture by age, sex, and urban vs rural residence as determined by x-ray absorptiometry, questionnaire, and radiography. Results A total of 20 416 participants were included in this study; 20 164 (98.8%; 11 443 women [56.7%]; mean [SD] age, 53 [13] years) had a qualified x-ray absorptiometry image and completed the questionnaire, and 8423 of 8800 (95.7%) had a qualified spine radiograph. The prevalence of osteoporosis among those aged 40 years or older was 5.0% (95% CI, 4.2%-5.8%) among men and 20.6% (95% CI, 19.3%-22.0%) among women. The prevalence of vertebral fracture was 10.5% (95% CI, 9.0%-12.0%) among men and 9.7% (95% CI, 8.2%-11.1%) among women. The prevalence of clinical fracture in the past 5 years was 4.1% (95% CI, 3.3%-4.9%) among men and 4.2% (95% CI, 3.6%-4.7%) among women. Among men and women, 0.3% (95% CI, 0.0%-0.7%) and 1.4% (95% CI, 0.8%-2.0%), respectively, with osteoporosis diagnosed on the basis of bone mineral density or with fracture were receiving antiosteoporosis treatment to prevent fracture. Conclusions and Relevance In this cross-sectional study of an adult population in mainland China, the prevalence of osteoporosis and vertebral fracture were high and the prevalence of vertebral fracture and clinical fracture was similarly high in men and women. These findings suggest that current guidelines for screening and treatment of fractures among patients in China should focus equally on men and women and should emphasize the prevention of vertebral fractures.
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            Weight change across adulthood in relation to all cause and cause specific mortality: prospective cohort study

            Chen Chen, Yi Quan Ye, Yanbo Zhang … (2019)
            To investigate the association between weight changes across adulthood and mortality. Prospective cohort study. US National Health and Nutrition Examination Survey (NHANES) 1988-94 and 1999-2014. 36 051 people aged 40 years or over with measured body weight and height at baseline and recalled weight at young adulthood (25 years old) and middle adulthood (10 years before baseline). All cause and cause specific mortality from baseline until 31 December 2015. During a mean follow-up of 12.3 years, 10 500 deaths occurred. Compared with participants who remained at normal weight, those moving from the non-obese to obese category between young and middle adulthood had a 22% (hazard ratio 1.22, 95% confidence interval 1.11 to 1.33) and 49% (1.49, 1.21 to 1.83) higher risk of all cause mortality and heart disease mortality, respectively. Changing from obese to non-obese body mass index over this period was not significantly associated with mortality risk. An obese to non-obese weight change pattern from middle to late adulthood was associated with increased risk of all cause mortality (1.30, 1.16 to 1.45) and heart disease mortality (1.48, 1.14 to 1.92), whereas moving from the non-obese to obese category over this period was not significantly associated with mortality risk. Maintaining obesity across adulthood was consistently associated with increased risk of all cause mortality; the hazard ratio was 1.72 (1.52 to 1.95) from young to middle adulthood, 1.61 (1.41 to 1.84) from young to late adulthood, and 1.20 (1.09 to 1.32) from middle to late adulthood. Maximum overweight had a very modest or null association with mortality across adulthood. No significant associations were found between various weight change patterns and cancer mortality. Stable obesity across adulthood, weight gain from young to middle adulthood, and weight loss from middle to late adulthood were associated with increased risks of mortality. The findings imply that maintaining normal weight across adulthood, especially preventing weight gain in early adulthood, is important for preventing premature deaths in later life.
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              Exosome-guided bone targeted delivery of Antagomir-188 as an anabolic therapy for bone loss

              Yan Hu, Xiaoqun Li, Qin Zhang … (2021)
              The differentiation shift from osteogenesis to adipogenesis of bone marrow mesenchymal stem cells (BMSCs) characterizes many pathological bone loss conditions. Stromal cell-derived factor-1 (SDF1) is highly enriched in the bone marrow for C-X-C motif chemokine receptor 4 (CXCR4)-positive hematopoietic stem cell (HSC) homing and tumor bone metastasis. In this study, we displayed CXCR4 on the surface of exosomes derived from genetically engineered NIH-3T3 cells. CXCR4+ exosomes selectively accumulated in the bone marrow. Then, we fused CXCR4+ exosomes with liposomes carrying antagomir-188 to produce hybrid nanoparticles (NPs). The hybrid NPs specifically gathered in the bone marrow and released antagomir-188, which promoted osteogenesis and inhibited adipogenesis of BMSCs and thereby reversed age-related trabecular bone loss and decreased cortical bone porosity in mice. Taken together, this study presents a novel way to obtain bone-targeted exosomes via surface display of CXCR4 and a promising anabolic therapeutic approach for age-related bone loss.
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                Author and article information

                Contributors
                Wei‐Zong Weng: drwengweizong@163.com
                Wen‐Cai Zhang: zhwc@sohu.com
                Yuan Chen: 2503852815@qq.com
                Jia‐Can Su:
                ORCID: https://orcid.org/0000-0001-7080-263X
                drsujiacan@163.com
                Journal
                Journal ID (nlm-ta): Food Sci Nutr
                Journal ID (iso-abbrev): Food Sci Nutr
                Journal ID (doi): 10.1002/(ISSN)2048-7177
                Journal ID (publisher-id): FSN3
                Title: Food Science & Nutrition
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2048-7177
                Publication date (Electronic): 05 March 2024
                Publication date Collection: June 2024
                Volume: 12
                Issue: 6 ( doiID: 10.1002/fsn3.v12.6 )
                Pages: 4110-4121
                Affiliations
                [ 1 ] Department of Orthopaedics Xinhua Hospital Affiliated to Shanghai JiaoTong University School of Medicine Shanghai China
                [ 2 ] Institute of Translational Medicine Shanghai University Shanghai China
                [ 3 ] Organoid Research Center Shanghai University Shanghai China
                [ 4 ] National Center for Translational Medicine (Shanghai) SHU Branch Shanghai University Shanghai China
                [ 5 ] Department of Orthopaedics Shanghai Zhongye Hospital Shanghai China
                [ 6 ] Department of Orthopaedics The First Affiliated Hospital of Jinan University Guangzhou Guangdong China
                [ 7 ] Department of Orthopaedics and Traumatology, Nanning Hospital of Traditional Chinese Medicine Guangxi University of Chinese Medicine Nanning Guangxi China
                Author notes
                [*] [* ] Correspondence

                Jia‐Can Su, Department of Orthopaedics, Xinhua Hospital Affiliated to Shanghai JiaoTong University School of Medicine, No. 1665, Kongjiang Road, Shanghai 200092, China.

                Email: drsujiacan@ 123456163.com

                Yuan Chen, Department of Orthopedics and Traumatology, Nanning Hospital of Traditional Chinese Medicine, Guangxi University of Chinese Medicine, Nanning, Guangxi, China.

                Email: 2503852815@ 123456qq.com

                Wen‐Cai Zhang, Department of Orthopaedics, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, China.

                Email: zhwc@ 123456sohu.com

                Wei‐Zong Weng, Institute of Translational Medicine, Shanghai University, Shanghai 200444, China.

                Email: drwengweizong@ 123456163.com

                Author information
                https://orcid.org/0000-0001-7080-263X
                Article
                Publisher ID: FSN34070 Other ID: FSN3-2023-09-2071.R2
                DOI: 10.1002/fsn3.4070
                PMC ID: 11167173
                SO-VID: 1ca6ae8b-e63b-4281-b0ef-cda9b1fcf6ce
                Copyright © © 2024 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Date revision received : 08 February 2024
                Date received : 01 October 2023
                Date accepted : 23 February 2024
                Page count
                Figures: 3, Tables: 4, Pages: 12, Words: 9171
                Funding
                Funded by: Shanghai Hospital Development Center , doi 10.13039/501100008750;
                Award ID: SHDC2023CRT013
                Funded by: Shanghai Committee of Science and Technology Laboratory Animal Research Project
                Award ID: 23141900600
                Funded by: China Postdoctoral Science Foundation , doi 10.13039/501100002858;
                Award ID: 2023M742203
                Funded by: National Natural Science Foundation of China , doi 10.13039/501100001809;
                Award ID: 82230071
                Award ID: 82371603
                Funded by: Integrated Project of Major Research Plan of National Natural Science Foundation of China
                Award ID: 92249303
                Funded by: Interdisciplinary of Medicine and Engineering Foundation of Shanghai JiaoTong University
                Award ID: YG2024QNA20
                Award ID: YG2024QNA21
                Categories
                Subject: Original Article
                Subject: Original Articles
                Custom metadata
                source-schema-version-number 2.0
                cover-date June 2024
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.4.4 mode:remove_FC converted:12.06.2024

                Keywords: folic acid,middle‐aged and older people,osteoporosis,population‐based study
                Data availability:
                Keywords: folic acid, middle‐aged and older people, osteoporosis, population‐based study

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