Vitamin D status and bone mineral density in the Chinese population: a review.

UNLABELLED: Low vitamin D status is associated with low bone mass which, in turn, is an important predictor of fracture. However, data on this relationship in non-Caucasian populations are scarce. This review shows such an association in the Chinese population in five of the 11 included studies. INTRODUCTION: In the elderly population, the serum 25-hydroxyvitamin D [25(OH)D] concentration is often inadequate. This may cause a lower bone mineral density (BMD), which is an important predictor of fracture. It is estimated that by 2050 more than half of all hip fractures worldwide will occur in Asia. However, data on the relationship between vitamin D status and BMD in a non-Caucasian population are scarce. Therefore, this study reviews the literature on the relationship between serum 25(OH)D and BMD in the Chinese population. METHODS: A search was made in PubMed, EMBASE, Web of Science and Cochrane Library (up to December 2014) to identify relevant studies using the terms vitamin D status, bone mineral density, and Chinese. RESULTS: Of the 293 studies identified, 11 fulfilled the inclusion and exclusion criteria and were analyzed. Mean serum 25(OH)D concentrations ranged from 29-82 nmol/L. In 5 of the 11 studies, an association was found between vitamin D status and BMD in the Chinese population. CONCLUSION: The evidence for a relationship between the serum 25(OH)D concentration and BMD in the middle-aged and elderly Chinese population living in Asia appears to be limited and inconsistent.

Location of the mechanism of the clonidine withdrawal tachycardia in rats.

Withdrawal of chronic infusion of clonidine elicits severe tachycardia and short-lasting blood pressure elevations (upswings). Withdrawal of clonidine in low dosage (30 micrograms kg-1 day-1 i.c.v., 7 days) elicited a maximum of 10.9 +/- 0.5 upswings h-1. Cessation of s.c. infusion of clonidine (30 micrograms kg-1 day-1 7 days) evoked a maximum of 1.9 +/- 0.5 upswings h-1. After cessation of the two clonidine infusions no overshoot of heart rate occurred. Withdrawal of a higher dose of clonidine (300 micrograms kg-1 day-1 s.c., 7 days), however, induced tachycardia (from 302 +/- 8 to 433 +/- 8 beats min-1) and 7.6 +/- 1.4 upswings h-1. The administration of the alpha 2-adrenoceptor antagonist yohimbine precipitated withdrawal tachycardia in animals treated with oxymetazoline, a hydrophilic alpha-adrenoceptor agonist. Yohimbine (3 mg kg-1 i.p.) precipitated a severe rise in heart rate from 285 +/- 14 to 520 +/- 5 beats min-1 in oxymetazoline (300 micrograms kg-1 day-1 s.c., 7 days) treated rats and from 320 +/- 13 to 420 +/- 11 beats min-1 in saline-treated animals. Upswings were not induced by yohimbine treatment. It is concluded, that the blood pressure upswings after clonidine withdrawal are due to a central mechanism, whereas the mechanism of the overshoot of heart rate is located peripherally, probably at the cardiac presynaptic level.

Beta 2-adrenoceptor antagonists intensify clonidine withdrawal syndrome in conscious rats.

Sudden cessation of prolonged treatment with clonidine in conscious rats evokes a cardiovascular withdrawal syndrome, characterized by severe tachycardia and brief blood pressure (BP) increases, so-called "upswings." Previously, adenylate cyclase-coupled alpha 2-adrenoceptors were shown to be involved in this phenomenon. In the present study, the effect on the intensity of clonidine withdrawal symptoms of concomitant treatment with various beta-adrenoceptor antagonists during clonidine infusion (100 micrograms/kg/24 h, 7 days) was investigated. Propranolol (18 mg/kg/24 h, beta 1 and beta 2 blocker) and ICI 118.551 (12 mg/kg/24 h, beta 2 blocker) clearly aggravated the withdrawal symptoms, whereas metoprolol (18 mg/kg/24 h, beta 1 blocker) did not affect the severity of the withdrawal syndrome. Accordingly, intensification of the withdrawal syndrome appears to be mediated by beta 2- rather than by beta 1-adrenoceptors. These results point to an interaction at the level of the second-messenger adenylate cyclase (AC) system in development of clonidine withdrawal syndrome.