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Vitamina A como Causa de Daño Oseo, Fragilidad y Osteoporosis La Evidencia Ocultada Juan Ariel Jara Guerrero Doctorando Neurociencias Universidad Complutense.

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Presentation on theme: "Vitamina A como Causa de Daño Oseo, Fragilidad y Osteoporosis La Evidencia Ocultada Juan Ariel Jara Guerrero Doctorando Neurociencias Universidad Complutense."— Presentation transcript:

1 Vitamina A como Causa de Daño Oseo, Fragilidad y Osteoporosis La Evidencia Ocultada Juan Ariel Jara Guerrero Doctorando Neurociencias Universidad Complutense Madrid Comité Nacional Nutrición Médica Colegio Médico del Perú- 2004

2 The Framingham Osteoporosis Study Colasbeverages are associated with low bone mineral density in older women: The Framingham Osteoporosis Study Katherine L Tucker, Kyoko Morita, Ning Qiao, Marian T Hannan.. American Journal of Clinical Nutrition, 2006; Vol. 84, No. 4, 936-942 Elevado contenido de ácido fosfórico (aparte de azúcares fructosa-diet o sacarosa) reduce absorción de Calcio y aumenta pérdida de Magnesio Amato, Rev Invest Clin 1998; 50: 185–9

3 Fatty acid consumption and risk of fracture in the Women's Health Initiative aumentan poderosamente la Osteoporosis Grasas Saturadas (en especial con Dieta Occidental rica en proteína Animal acidificante que resorbe hueso) aumentan poderosamente la Osteoporosis y el riesgo de Fractura de Cadera Tonia S Orchard, AJCN, 2010 © 2010 American Society for Nutrition

4 causes bone and joint changes An excess of vitamin A (also known retinol) and related compounds (retinoids) causes bone and joint changes Decades ago, it has been already observed that a high intake of vitamin A bone fractures in rodents Moore T, Wang Y, Hypervitaminosis A. Biochem J 1945;39:222 – 8.

5 thinning of long bones in growing rodents It was demonstrated that even a more moderate vitamin A intake markedly increased bone fragility thinning of long bones in growing rodents Armstrong R, Ashenfelter K, Eckoff C, Levin A, Shapiro S. General and reproductive toxicology of retinoids Sporn M,Roberts A, Goodman D, editors. The Retinoids, vol. 1. New York Raven; 1994. p. 545 – 72

6 Adelgazamiento Huesos Largos (y aumento de su fragilidad): Confirmado exvivo peripheral quantitative computed tomography measurements on the long bones Johansson S, Lind P, Hakansson H, Oxlund Hoeberg J, Melhus H. Subclinical hypervitaminosis A causes fragile bones in rats. Bone 2002;31:685 – 9

7 Vitamin A excess induces generalized bone loss Wu B, Xu B, Huang TY, Wang JR. A model of osteoporosis induced by retinoic acid in male Wistar rats. Yao Xue Xue Bao 1996;31: 241 – 5 Aumenta poderosamente resorción de hueso Dhem A, Goret-Nicaise M. Effects of retinoic acid on rat bone. Food Chem Toxicol 1984;22:199 – 206 Disminuye Formación Hueso (en todos los compartimentos óseos) Hough S. Effects of hypervitaminosis A on the bone and mineral metabolism of the rat. Endocrinology 1988;122:2933 – 9 Frankel TL, Hypervitaminosis A, and calcium-regulated hormones in the rat. J Nutr 1986;116:578 – 87

8  Elevada Ingesta Vitamina A causa o precipita Fracturas en población mayor Feskanich D, Singh V, Willett WC, Colditz GA. Vitamin A intake and hip fractures among postmenopausal women. JAMA 2002;287: 47 – 54 Michaelsson K, Lithell H, Vessby B, Melhus H. Serum retinol levels and the risk of fracture. N Engl J Med 2003;23(348):287 – 94 A pesar de la evidencia experimental, epidemiológica y Clínica, hasta Hoy se sigue promocionando consumo excesivo de vitamina A animal Binkley N, Krueger D. Hypervitaminosis A and bone. Nutr Rev 2000;58:138 – 44 Michaela Kneissel, Anne Studer, Bone 36 (2005) 202 – 214

9 Michaela Kneissel Excess of Vitamin A (retinol) and related compounds (retinoids) induces bone fragility and is associated with increased hip fracture incidence in humans Michaela Kneissel, Anne Studer, Reo Cortesi, Mira Susa Bone 36 (2005) 202 – 214 Four Days retinoid Bone Mass Loss Histomorphometric evaluation revealed: increased subperiosteal osteoclastic bone resorption caused the cortical bone destruction

10 Exceso Vitamina A induce Mayor Destrucci ó n ó sea Aumenta Adelgazamiento de Hueso en Adultos Michaela Kneissel, Anne Studer, Bone 36 (2005) 202 – 214  Subclinical hypervitaminosis A causes fragile bones in rats (Johansson, Bone, 2002)

11 Destrucción Metáfisis Proximal de Tibia con Retinol (B, D) Destrucción Metáfisis Proximal de Tibia con Retinol (B, D) comparados con Roedores Adultos Controles (A,C)

12 The subperiosteal bone loss resulted in a reduction of cortical bone mineral content (and in a slight reduction in density of cortical bone)  Long-bone thinning is due to subperiosteal osteoclastic bone resorption  Actividad Resorci ó n Subperi ó stica osteocl á stica (destrucci ó n ó sea) aumenta R á pidamente con Retinoides Michaela Kneissel, Anne Studer, Bone 36 (2005) 202 – 214


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