The Effect of Vitamin C on Bone Mineral Density (A Randomized Clinical Trial)

Background and Objective: The decline of bone mineral density (BMD) and prevalence of osteoporosis is a silent epidemic of the century. World Health Organization announced osteoporosis following cancer, heart attack and cerebral stroke as the fourth human enemy. The objective of the current study was to estimate the effect of vitamin C on BMD in menopausal women with balanced diet. Materials and Methods: The study was a randomized clinical trial in which ۱۵۰ postmenopausal women with osteoporosis were chosen based on convenience purposive sampling method. Using a randomized block design, subjects were divided into two groups: one group received vitamin C and the other group received placebo. After homogenizing groups, the experimental group was given vitamin C ۱۰۰۰ mg daily in two doses for ۶ months and the control group received a placebo with the same method. After ۶ months, bone densitometry was done and the results were analyzed using independent and paired t-tests and ANOVA. SPSS۱۶ software was used to analyze the collected data. Significant level of ۵% was considered. Results: Comparison of index mean of femoral BMD in two groups (independent t-test) and inside the groups (paired t-test) did not show any significant difference before and after the treatment (p>۰.۰۵). Comparison of the index mean of BMD in vertebral bones of trial and control groups (using independent t-test), did not show any significant difference before and after the treatment (P= ۰.۵۴۱ and P= ۰.۴۹۹, respectively) but intra groups results (using paired t-test), indicated a significant difference both in the test group (p=۰.۰۰۱) and in the control (p=۰.۰۰۱). Conclusion: Consumption of antioxidants can be effective for prevention and treatment of osteoporosis. References ۱- Parsay S, Rezasoltani P. Child and woman health. Tehran: sanjesh ۲۰۰۷. [persian] ۲- Gibs R, Karlan B, Haney A, Nygard I, Valadan M. Danforth, s obstetric and gynecology. Tehran: arjomand ۲۰۰۸. [persian] ۳- Gordon JD. Handbook for clinical gynaecology and endocrinology and fertility. Tehran: Abasaleh ۲۰۰۲. [persian] ۴- Masse PG, Jougleux JL, Dosy J, Caissie M. Enhancement of calcium/vitamin d supplement efficacy by administering concomitantly three key nutrients essential to bone collagen matrix for the treatment of osteopenia in middle-aged women: a one-year follow-up. J Clin Biochem Nutr. ۲۰۱۰ ۴۶: ۲۰-۲۹. ۵- Andre A, Krikes K, Loskalz V, Reesi M, Ghaziani M, Khavaran K. Principle of internal medicine cecil.muscle and eskeletal disease. ۶ ed. Tehran: teymoorzade ۲۰۰۴. ۶- Taheri P. Woman in GP: muscle and skeletal and bedsore disease. ۲۰۱۱ [cited ۲۰۱۱ ۱۷ Jun] Available from: URL: http://www.asmehriz.org. ۷- Azargashsab A, Shafee F. Principle and health service. ۱ ed. Tehran: Ladan ۱۹۹۳. [persian] ۸- Kanis JA, Melton LJ, Christiansen C, Johnston CC, Khaltaev N. The diagnosis of osteoporosis. J Bone Miner Res. ۱۹۹۴ ۹: ۱۱۳۷-۴۱. ۹- Derakhshan S, Salehi R, Rashadmanesh N. Osteopenia and their related factors in post-menopausal women referring to Kurdistan densitometry center. Sci J Kurdistan Univ Med Sci. ۲۰۰۶ ۱۱: ۵۹-۶۷. [persian] ۱۰- Mazhari Z. Men in GP: osteoporosis,silent epidemi of century. ۲۰۱۱ [cited ۲۰۱۱ ۳۰oct] Available from: http:www.salamat news.com. ۱۱- Rasooli F, Hajamiri P, Mahmoodi MS. Assessment of the application for preventive factors of osteoporosis in menopausalwomen referred to the health care centers in Tehran university of medical science. J Hayat. ۲۰۰۱ ۲۴: ۴-۱۱.[persian] ۱۲- Zolfghari M, Taghizadeh Z, Maghbooli Z, Keshtkar A, Kazemnezhad A, Larijani B. Incident of fracture of hip osteoporotic in ۳ years follow up in comprehensive project for prevent, diagnosis and treatment osteoporosis in country. J Public Health. ۲۰۰۵ ۶: ۳۷-۴۲. [persian] ۱۳- Adibi H, Ebrahimof S, Mortaz S, Salehomom G, Arzaghi M, Hoseini S. Fruit and vegetable intake and bone mineral density in resident of village surrounding tehran. J Public Health. ۲۰۰۴ ۲: ۴۹-۵۶. [persian] ۱۴- Soltani A, haleghnezhad N, Pazhuhi M, Hamidi Z, Hosein nezhad A, B. L. Preferred skeletal site for osteoporosis screening in high risk population. J Puplic Health. ۲۰۰۶ ۹: ۸۶۳-۷۱. [persian] ۱۵- Lanham-New SA. Fruit and vegetables: the unexpected natural answer to the question of osteoporosis prevention? Am J Clin Nutr. ۲۰۰۶ ۸۳: ۱۲۵۴-۵. ۱۶- Adams G. Grew ford hambelen D, outline of orthopedics. ۱۳th ed: churchil livingstone ۲۰۰۱. [persian] ۱۷- Salehi M. Summery of nutrition science and health. ۳th ed. Tehran: pazhooheshgarane nashre daneshgahi ۲۰۰۹. [persian]. ۱۸- Salehi M, Elhami M. Humanity health, the health rescue. ۱ed. Tehran: puplished pazhooheshgarane nashre daneshgahi ۲۰۱۰. [persian] ۱۹- Hamidi M, Boucher BA, Cheung AM, Beyene J, Shah PS. Fruit and vegetable intake and bone health in women aged ۴۵ years and over: a systematic review. Osteoporos Int. ۲۰۱۱ ۲۲: ۱۶۱۸-۹۳. ۲۰- Salehi M. Nutrition and Health extract. Tehran: puplished pazhooheshgarane nashre daneshgahi ۲۰۱۰.[persian] ۲۱- Chuin A, Labonte M, Tessier D, et al. Effect of antioxidants combined to resistance training on BMD in elderly women: a pilot study. Osteoporos Int. ۲۰۰۹ ۲۰: ۱۲۵۳-۸. ۲۲- Lewiecki EM. Clinical application of bone density testing for osteoporosis. Minerva. ۲۰۰۵ ۹۶: ۳۱۷-۳۰. ۲۳- Salamat MR. Precision of bone mineral measurement by dual energy x-ray absorptiometry, ۲۹ th European symposium on calcified tissues. ۲۵-۲۹ May ۲۰۰۲ Zagreb Croatia. ۲۴- Braunwald E,Fauci A.Harrison,s principles of internal medicine.۱۷th ed. New York: Mc Graw-Hill ۲۰۰۹: ۲۲۲۶-۳۶. ۲۵- Ruiz-Ramos M, Vargas LA, Fortoul V, Cervantes-Sandoval A, Mendoza-Nunez VM. Supplementation of ascorbic acid and alpha-tocopherol is useful to preventing bone loss linked to oxidative stress in elderly. J Nutr Health Aging. ۲۰۱۰ ۱۴: ۴۶۷-۷۲. ۲۶- Sahni S, Hannan MT, Gagnon D, et al. High vitamin C intake is associated with lower ۴-year bone loss in elderly men. J Nutr. ۲۰۰۸ ۱۳۸: ۱۹۳۱-۸. ۲۷- Rivas A, Romero A, Mariscal-Arcas M, et al. Association between dietary antioxidant quality score (DAQs) and bone mineral density in Spanish women. Nutr Hosp. ۲۰۱۲ ۲۷: ۱۸۸۶-۹۳. ۲۸- Wolf RL, Cauley JA, Pettinger M, et al. Lack of a relation between vitamin andmineral antioxidants and bone mineral density: results from the women’s health initiative. Am J Clin Nutr. ۲۰۰۵ ۸۲: ۵۸۱-۸۸. ۲۹- Sugiura M, Nakamura M, Ogawa K, et al. Dietary patterns of antioxidant vitamin and carotenoid intake associated with bone mineral density: findings from post-menopausal Japanese female subjects. Osteoporos Int. ۲۰۱۱ ۲۲: ۱۴۳-۵۲. ۳۰- Rath M, Pauling L. Immunological evidence for the accumulation of lipoprotein(a) in the atherosclerotic lesion of the hypoascorbemic guinea pig. Proceedings of the national academy of sciences of the united states of america. ۸۷: ۹۳۸۸-۹۰.

Keywords:

Key words: Vitamin C , Bone mineral density , Menopausal women