Parathyroid Hormone and Cardiometabolic Outcomes in Obesity: Role of Magnesium and Vitamin D Supplementation
Obesity is one of the leading risk factors for cardiovascular disease (CVD), and several hormonal alterations may contribute this higher risk. For example, obesity is associated with higher levels of serum parathyroid hormone (sPTH) that is an independent risk factor for CVD. This study is examining whether dietary interventions to decrease sPTH levels will be associated with reductions in CVD risk. One hundred and twenty three participants aged 30-60 years will be enrolled in a 12-week clinical trial, and participants will be randomized to one of the three treatment groups consisting of vitamin D, magnesium or placebo. This approach will provide a non-pharmacological, non-surgical, cost effective and simple means to reduce sPTH levels in the obese population, thereby lowering their cardiovascular risk.
Magnesium as a Mediator of Bone and Vitamin D Metabolism in Patients on Antiepileptic Drug Therapy
Antiepileptic drug (AED) therapy in patients with seizure disorders is often associated with changes in bone metabolism. Patients with epilepsy have a two- to six-times greater risk of fracture than the
general population that is typically accompanied by lower 25 hydroxy vitamin D (25OHD) and higher parathyroid hormone (PTH) levels. Vitamin D and calcium supplementation is recommended to patients
on AEDs, however clinical studies do not consistently report reductions in fracture risk and/or improvements in bone mineral density (BMD) with these. Magnesium (Mg), an intracellular cation, is an important cofactor for several metabolic reactions in the body.
This study will examine Mg status (Serum Ionized Mg concentrations, Red Blood cell Mg concentrations) in patients on EIAEDs and Non EIAEDs, and we propose that magnesium status is an important contributor of vitamin D and bone metabolism in patients on AEDs and should be routinely monitored in patients on AED therapy.
Determinants of Bone Mineral Density and Metabolic Syndrome in South Asian Indian Men
South Asian Indians (SAI) comprise the largest subgroup of the increasing minority population in the United States. Metabolic syndrome (MetS) and low bone mineral density (BMD) are important health concerns in the minority population, especially the SAI group. Hormones, bone proteins and cytokines that play an important role in bone metabolism are also altered in MetS, suggesting that both of these conditions share a common etiology. The primary goal of this study is to assess whether bone metabolism is altered in the South Asian population, specifically the SAI population, in the United States and whether hormones or other proteins regulating bone influence MetS outcomes in SAIs. We propose to examine SAI men between the ages of 30 and 50 years, using resident white men as controls. We further propose that common biochemical and metabolic alterations will underlie both low BMD and MetS outcomes in the SAI population but not in the white population. Identification of common determinants will help us design a single interventional trial that will target both MetS and bone health in the SAI population.
Pop LC, Sukumar D, Schneider SH, Schlussel Y, Stahl T, Gordon C, Wang X, Papathomas TV, Shapses SA. Three doses of vitamin D, bone mineral density, and geometry in older women during modest weight control in a 1-year randomized controlled trial. Osteoporos Int. 2016 Aug 17.
Volpe SL, Sukumar D, Milliron BJ. Obesity Prevention in Older Adults. Curr Obes Rep. 2016 Apr 23. Review.
Cheung M, Sukumar D. Vitamin D in Health and Disease. PSGCAS Search: A Journal of Science and Technology, PSGCAS Search: A Journal of Science and Technology 2015, Volume: 3 N : 2 pp 01-26.
Chang B, Schlussel Y, Sukumar D, Schneider S, Shapses SA, Influence of vitamin D and estrogen receptor gene polymorphisms on calcium absorption: BsmI predicts a greater decrease during energy restriction. Bone. 2015 Jul 9;81:138-144.
Sukumar D, Shapses SA, Schneider SH. Vitamin D supplementation during short-term caloric restriction in healthy overweight/obese older women: effect on glycemic indices and serum osteocalcin levels. Journal of Molecular and Cellular Endocrinology. 2015 Jul 15;410:73-7.
Pop CL, Sukumar D, Tomaino K, Schlussel Y, Schneider S.H, Gordon CL, Wang X, Shapses SA “Moderate weight loss in obese/overweight men preserves bone quality” American Journal of Clinical Nutrition. 2015 Mar;101(3):659-67
Sukumar D, Kanjana K, Chettri M “Accessibility and Effectiveness of Formulated Low Cost Enteral Feed on Selected Patients under Enteral Nutrition Support”. PSGCAS Search: A Journal of Science and Technology. Volume: 2 No. : 1 pp 25-33
Von Thun N. L, Sukumar D, Heymsfield SB, Shapses SA “Does bone loss begin after weight loss ends? Results two years after weight loss or regain in postmenopausal women.” Menopause 2014, May;21(5):501-8
Shapses SA, Sukumar D, Schneider SH, Schlussel Y, Sherrell R, Field P, Ambia-Sobhan H “Vitamin D supplementation increases calcium absorption, but not during caloric restriction: a randomized double blind trial.” American Journal of Clinical Nutrition. 2013 Mar;97(3):637-45.
Shapses SA, Lee EJ, Sukumar D, Durazo-Arvizu R, Schneider SH The effect of obesity on the relationship between serum parathyroid hormone and 25-hydroxyvitamin D in women. Journal of Clinical Endocrinology and Metabolism, 2013 May E886-90.;98(5):
Wang X, Shapses SA, Wei S, Sukumar D, Ghosh J “Vitamin D Binding Protein Levels in Female Patients with Primary Hyperparathyroidism.” Endocrine Practice. 2013 Jul-Aug;19(4):609-13.
Shapses SA, Sukumar D, Schneider SH, Schlussel Y, Brolin RE, Taich L Hormonal and dietary influences on true fractional calcium absorption in women: Role of obesity. Osteoporosis International. 2012 Nov;23(11):2607-14.
Sukumar D, Partridge N, Xiangbing X, Shapses SA “The high serum monocyte chemoattractant protein-1 in obesity is influenced by high parathyroid hormone and not adiposity.” Journal of Clinical Endocrinology and Metabolism. 2011 Jun; 96(6):1852-8.
Sukumar D, Ambia- Sobhan H, Zurfluh R, Schlussel Y, Stahl T, Gordon CL, Shapses SA “Areal and volumetric bone mineral density at two levels of protein intake during caloric restriction.” Journal of Bone and Mineral Research. 2011 Jun; 26(6):1339-48.
Sukumar D, Schlussel Y, Riedt CS, Gordon C, Stahl T, Shapses SA “Obesity Alters cortical and trabecular bone density and geometry in women” Osteoporosis International. 2011 Feb;22(2):635-45
Sukumar D, Partridge NC, Schneider SH,. Shapses SA. Inter-variability among serum intact parathyroid hormone assays - A need for standardization, Osteoporosis International. 2008 Dec; 19(12): 1805
Invited Articles
Shapses SA and Sukumar D “ Obesity, Weight Reduction and Bone Metabolism” Invited Review “ Annual Review of Nutrition” 2012 Aug 21: 32:287-309
Book Chapters
Shapses SA and Sukumar D “Obesity and Skeletal mass” Rosen, C. J. (ed) (2013), in Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, Eighth Edition, John Wiley & Sons, Inc., Ames. 2013 pp 993-997
Shapses SA and Sukumar D “ The Hormonal Milieu in Obesity and Influences on the Trabecular, Cortical and Geometric Properties of Bone” 8th edition. Nutritional Influences on Bone health. Springer London pp 43-67, 2013
Shapses SA and Sukumar D “Protein Intake during Weight Loss: Effects on Bone”. In Nutritional Influences on Bone health. Chapter 4, pp 27-33 Springer London 2010: 27-33