Vitamin D/Bone Mineral Density and Triglyceride Paradoxes Seen in African Americans: A Cross-Sectional Study and Review of the Literature.
Vitamin D/Bone Mineral Density and Triglyceride Paradoxes Seen in African Americans: A Cross-Sectional Study and Review of the Literature.
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DOI：
10.3390/ijms25021305
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发表时间：
2024-01-21
影响因子：
5.6
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中科院分区：
文献类型：
--
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众所周知，维生素D对骨骼健康有积极作用。尽管非裔美国人(AA)缺乏维生素D的频率更高，但他们的骨密度(BMD)比白人高，这表明AA的BMD和维生素D水平之间存在脱节。在再障中看到的另一个有趣的关系是甘油三酯(TG)悖论，这是一种不寻常的现象，在这种现象中，即使患者有已知的高TG水平的特征，如II型糖尿病，也能观察到正常的TG状态。就我们所知，还没有研究检验这两种矛盾的关系是否同时存在于患有II型糖尿病的AA受试者中。在这项研究中，我们比较了AA(n=56)和白人(n=26)患有II型糖尿病的受试者的血液标志物水平，包括糖化血红蛋白(HbA1c)、甘油三酯(TG)和维生素D，以测量血清25-羟基维生素D[25(OH)VD]微米/毫升、[25(OH)VD]/TG、钙和骨密度，以了解这些关系是否同时存在。我们发现，与白人受试者相比，再障受试者的甘油三酯和[25(OH)VD]水平显著降低，骨密度水平显著升高，即使两组患者的年龄、体重指数、糖尿病病程、糖化血红蛋白和钙水平相似。这表明，这两个矛盾的关系同时存在于II型糖尿病AA受试者中。除了这些发现之外，我们还讨论了目前文献中的假设，这些假设试图解释为什么这两个有趣的关系存在。本文还讨论了四个新的假说，如循环水平的改变，雌激素和硫化氢对骨密度的潜在作用，以及HMG-CoA还原酶可能是AA患者TG悖论的贡献者。这篇手稿表明，关于这两个自相矛盾的关系仍然有许多悬而未决的问题，需要进一步的研究来确定它们为什么存在以及如何实施它们来改善医疗保健。
Vitamin D is known to have a positive effect on bone health. Despite the greater frequency of vitamin D deficiency in African Americans (AA), they have a higher bone mineral density (BMD) compared to whites, demonstrating a disconnect between BMD and vitamin D levels in AA. Another intriguing relationship seen in AA is the triglyceride (TG) paradox, an unusual phenomenon in which a normal TG status is observed even when patients house conditions known to be characterized by high TG levels, such as Type II diabetes. To the best of our knowledge, no study has examined whether these two paradoxical relationships exist simultaneously in AA subjects with Type II diabetes. In this study, we compared levels of blood markers, including HbA1c, TG, and vitamin D, measured as serum 25-hydroxyvitamin D [25(OH)VD] µM/mL, [25(OH)VD]/TG, calcium, and BMD in AA (n = 56) and white (n = 26) subjects with Type II diabetes to see whether these relationships exist concurrently. We found that AA subjects had significantly lower TG and [25(OH)VD] levels and a significantly higher BMD status compared to white subjects, even when the ages, BMI, duration of diabetes, HbA1c, and calcium levels were similar between the two groups. This demonstrates that these two paradoxical relationships exist simultaneously in Type II diabetic AA subjects. In addition to these findings, we discuss the current hypotheses in the literature that attempt to explain why these two intriguing relationships exist. This review also discusses four novel hypotheses, such as altered circulating levels and the potential role of estrogen and hydrogen sulfide on BMD and HMG-CoA reductase as a possible contributor to the TG paradox in AA subjects. This manuscript demonstrates that there are still many unanswered questions regarding these two paradoxical relationships and further research is needed to determine why they exist and how they can be implemented to improve healthcare.
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