The study respected the Declaration of Helsinki and was approved by the local Ethical Committee (677/2021). The exclusion criteria were the following: (a) T stage > 3 (b) age < 50 years (c) evidence of major concurrent diseases (d) patients undergoing treatment with corticosteroids, immunoglobulin or immunosuppressive drugs, and chemotherapy (e) previous fragility fractures (f) previous vitamin D3 supplementation. The inclusion criteria were the following: (a) women in post-menopausal status, with a diagnosis of BC ER+ (b) hormone therapy (c) surgery performed at least 12 months earlier. Patients were recruited over a 12-month period, from April 2021 to March 2022. Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy. This observational cross-sectional study recruited women with BC referred to the Outpatient Service for Cancer Rehabilitation of the Physical Medicine and Rehabilitation Unit of the Azienda Ospedaliera “SS. This unsuccessful inhibition of reactive oxygen species might in turn lead to stress-induced apoptosis, via B-cell lymphoma 2 ( BCL-2), MYeloCytomatosis ( Myc), and Chromodomain-Helicase DNA-binding (CHD) pathways, as depicted in Figure 1. Moreover, the up-stream 1,25(OH)2D3-upregulated protein 1 attaches the disulfide-reducing protein thioredoxin and represses its capacity to inhibit reactive oxygen species. High parathyroid hormone levels and hypercalcemia induce 1,25(OH)2D3 synthesis, stimulating the transcription of CYP27B1 and increasing 1,25(OH)2D3 activity, with consequent down-stream action of CYP27B1 and suppression of parathyroid hormone. The list of target genes that is common across cell models seems to be short, and the most clearly shared target is Cytochrome P (CYP24A1). According to our cluster model, we may conclude that the assessment and management of bone health and vitamin D3 status are crucial in BC survivors.ĭespite the mechanisms underpinning CITBL in BC survivors being far from full understanding, vitamin D3 could represent a molecular target in the complex pathological framework of BC osteoporosis. Thus, in a cohort of women with BC undergoing Ais, we identified a very low prevalence (5.6%) of patients with adequate bone health and a normal vitamin D3 status. Given a significantly low correlation with the LS BMD value (r 2 = 0.30, p = 0.025), we assessed the role of vitamin D3 via multiple factor analysis and found that BMD and vitamin D3 contributed to the arrangement of clusters, reported as vectors, providing similar trajectories of influence to the construction of the machine learning model. The study included 54 women with BC, mean age 67.3 ± 8.16 years. This observational cross-sectional study collected the following data regarding bone health: osteoporosis and osteopenia diagnosis, lumbar spine (LS) and femoral neck bone mineral density (BMD), serum levels of 25-hydroxyvitamin D3 (25(OH)D3), calcium and parathyroid hormone. This study aimed to evaluate the role of vitamin D3 deficiency in women with breast cancer and its correlation with osteoporosis and BMD modifications. AIs, by inhibiting the enzyme that converts androgens into estrogen, cause a decrement in bone mineral density (BMD), with a consequent increased risk of fragility fractures. Breast cancer (BC) is the most frequent malignant tumor in women in Europe and North America, and the use of aromatase inhibitors (AIs) is recommended in women affected by estrogen receptor-positive BCs.
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