Sociedad Española de Investigacion Ósea y Metabolismo Mineral

Revista de Osteoporosis y Metabolismo Mineral

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Citescore: 1,06 |  Academic Accelerator: 0,194 
SCImago Journal Rank : 0,12 | Google Scholar: 0,0172

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The Journal follows the Uniform Requirements standards Manuscripts Submitted to Biomedical for Journals www.icmje.org

The Journal embraces the principles and procedures dictated by the Committee on Publication Ethics (COPE) www.publicationethics.org

Author: Romm

Description of the patients treated at the Fracture and Fall Prevention Unit in the context of a Fracture Liaison Service. FLS Anoia

Worldwide, 1 in 3 women and 1 in 5 men will experience a fragility fracture in their lifetime. Every 3 seconds there is 1 fragility fracture in the world. The most frequent fractures associated with osteoporosis are located in the hip, spine and wrist [1,2].
Hip fracture has become an international barometer of osteoporosis, associated with low bone mineral density, high health care costs, and greater disability than other types of osteoporotic fracture [3]. Only 30% of people with a hip fracture regain their pre-fracture level of physical function, and many are left with reduced mobility, loss of functional independence, and requiring long-term care. For this reason, among other reasons, the International Osteoporosis Foundation (IOF) has developed the Capture the Fracture program, aimed at reducing secondary and posterior fractures by facilitating the implementation of Fracture Liaison Services (FLS) [1,2].

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Vitamin D Update

Vitamin D is recently in the news. Until not many years ago, it was almost exclusively related to bone mineralization. However, the increasingly widespread knowledge that the actions of vitamin D extend to practically all our body cells has led to the discovery and research into the so-called “extra-osseous effects of vitamin D.” This research is increasing and becoming better known[1-8]. In fact, vitamin D should be termed hormone D, since its structure, functioning, control and self-regulation mechanisms are more typical of a hormone than a vitamin9.
Precisely one of these extra-osseous effects is the direct relationship of hormone D with the functioning of the cells responsible for the body’s immunity. Thus, low levels of vitamin D have been associated with a higher prevalence of infections and autoimmune diseases and adequate levels have been related to a better clinical course of infectious diseases[1,10,11].

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SARS-CoV-2 infection and medical practice

In January 2020, when a group of researchers from the Chinese province of Wuhan published the outbreak caused by a novel corona virus, few of us imagined the storm that was looming[1]. The experience of epidemic outbreaks due to emerging viral infections that have occurred worldwide in the past twenty years should have warned us that something like this could happen[2-4]. But even the very serious situation of the Ebola virus outbreak in West Africa in 2014 did not alert us, until just a few tragic cases spread across borders, set off alarm bells in Europe[5]. But it seems more incomprehensible that, with the appearance of new viruses of zoonotic origin, such as SARS-CoV-1, MERS, avian influenza viruses (H5N1 and H7N9), or the 2009-H1N1 influenza virus that caused the first pandemic of the XXI century, in the year 2020 we were still ignoring the impending dangers[6].

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Infection, immunity and vitamin D

The vitamin D system has extraskeletal pleiotropic functions, including the modulation of the adaptive immune response and the enhancement of the innate response[1-3]. This explains why vitamin D influence on infections has been the subject of many analyses. The implication of vitamin D deficiency in tuberculosis has been known for decades. But it has also been associated with other infections, mainly respiratory tract infections and others such as the flu, exacerbations of chronic obstructive pulmonary disease or cystic fibrosis, sepsis or human immunodeficiency virus infection. More recently, there has been interest in knowing its influence on the pathogenesis and possible therapeutic use in SARS-CoV-2 infection[4]. In this article we will review the role of vitamin D in the immune system and its influence on infectious diseases.

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Vitamin D Supplements in COVID-19

Vitamin D is a fundamental hormone for the maintenance of musculoskeletal health and the proper functioning of the immune system[1]. The new coronavirus pandemic, SARS-CoV-2, which emerged in Wuhan at the end of 2019, has hit the world with extraordinary virulence[2]. Several lines of evidence support a potential role for vitamin D in COVID-19. First, a recent meta-analysis has shown a beneficial effect of vitamin D in preventing viral respiratory diseases, especially in those subjects with greater deficiency of this hormone[3]. In addition, vitamin D is crucial in modulating the innate immune system (production of antimicrobial peptides such as cathelicidin and activation of autophagy) and adaptive (inhibition of the activation of Th1 lymphocytes, activation of Th2 lymphocytes, decrease of cells Th17/Treg and inhibition of the proliferation and differentiation of B lymphocytes). Vitamin D deficiency is especially conspicuous in the elderly, in obese individuals and those with chronic diseases such as cancer, diabetes or cardiovascular diseases, which also represent the groups with the highest severity of COVID-19. Finally, vitamin D inhibits proinflammatory cytokine production and its deficiency can induce activation of the renin-angiotensin system (RAS), leading to the production of profibrotic factors and lung damage. This dysregulation of the RAS in COVID-19, mediated by the ACE2 receptor, through which SARS-CoV-2 penetrates the host cell, is responsible for the cytokine storm that precedes the characteristic acute respiratory distress syndrome. of the most serious form of infection by this coronavirus[4].

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120181004-en
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920191101-en
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Brief Original
Clinical Notes
Committees
Editorial
English
Index of Authors
Index of Communications
Letter to the Director
Letter to the Editor
Oral Communications
Original Articles
Osteology images
Position Paper
Poster Communications
Presentation
Reviews
SIBOMM News
Special Article
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