Since the time of its discovery a century ago, there have been advances into what was erroneously called “vitamin” D. It is now acknowledged that it is not a vitamin, though we continue to use that term out of custom and tacit consensus. In fact, it is an endocrine system, the vitamin D endocrine system (VDES), similar to that of other steroid hormones. Cholecalciferol or “vitamin” D3, is the threshold (physiological) nutrient of the system, synthesized from 7-dehydrocholesterol, which is produced, and found, from single-celled organisms to the skin of higher animals, including human. This route represents around 90% of the physiological contribution to the body, the rest is obtained through diet. There is another isoform, of nutritional or pharmacological contribution, ergocalciferol, “vitamin” D2 or produced by ultraviolet irradiation of ergosterol contained in fungi, yeasts, etc….Read More
Osteoporosis poses a major health problem in modern societies, especially in women. Taking into account the aging of the Spanish population and the fact that osteoporosis and fractures increase with age, with an estimate for 2029 of more than 11 million people over 65 years of age, this problem may become of the first order. Currently it is estimated that there are more than 200 million patients with osteoporosis worldwide, with increasing prevalence. In Spain, the prevalence of osteoporosis in postmenopausal women over 50 years is 26.1% and in men 8.1%.
Therefore, in daily clinical practice, this condition should be diagnosed establishing the previous clinical suspicion and the patients labeled as such in order to avoid its progression and its consequences, which are fragility fractures.
In 1994, the WHO defined criteria for the diagnosis of osteoporosis using the measurement of bone mineral density (BMD). The DXA technique has established itself as the dominant technology for quantifying BMD due to:
a) strong correlation between BMD measured by DXA and bone strength in biomechanical studies,
b) Epidemiological studies that show a strong relationship between the risk of fracture and BMD,
c) For its use in clinical trials of treatments for the selection of subjects and monitoring based on its excellent precision and low radiation dose.
DXA is indicated to diagnose osteoporosis, assess fracture risk, and monitor changes in BMD over time. In recent years, there have been improvements to the initial DXA technology and it is used for other measurements beyond BMD (eg, femur geometry, vertebral fracture detection, body composition analysis).
The diagnosis of osteoporosis has evolved over the years along the disease’s conceptual development. The definition of osteoporosis comes from a description offered by Albright at the outset of the 1940s for postmenopausal and corticoid-induced osteoporosis. This is considered nowadays paradigm of primary and secondary osteoporosis. Its characteristics are reduced bone mass, micro-architectural disorders, unaltered mineralization and presence of fractures[1,2]. It is a histopathological definition with the secondary clinical event. Although osteoporosis is currently the most common metabolic bone disease, rickets and osteomalacia were the main metabolic bone disease from the time of Galen and well into the 20th century.Read More
The nucleus contains most of the genetic information, distributed throughout the approximately 3 billion nucleotides of human haploid DNA. The approximately 21,000 genes that encode the proteins necessary for the various organic functions are represented there, as well as an indeterminate number of genes that are transcribed into RNAs that do not encode proteins, but have regulatory functions.
Mitochondrial DNA is smaller, having about 16,000 nucleotides, with genes to encode 13 proteins and 24 non-coding RNAs (transfer and ribosomal).
DNA changes that lead to disease can be classified according to various criteria, including:
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