Biochemical markers for assessment of calcium economy and bone metabolism: application in clinical trials from pharmaceutical agents to nutritional products

Bonjour, Jean‐Philippe; Kohrt, Wendy M.; Levasseur, Régis; Warren, Michelle P.; Whiting, Susan J.; Kraenzlin, Marius E.

doi:10.1017/s0954422414000183

Cited by 42 publications

(36 citation statements)

References 181 publications

(231 reference statements)

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“…Although BMD is primary the therapeutic target of osteoporosis medications, measurable changes in BMD can be detected only after 12 months of treatment. BTM are clinically useful because they respond much more quickly than BMD to interventions and also predict long-term changes in BMD and fracture risk [49]. From a research perspective, BTM are also useful in understanding the effects of an intervention on bone resorption versus bone formation.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of resistance training or jumping-exercise to increase bone mineral density in men with low bone mass: A 12-month randomized, clinical trial

Hinton

Nigh

Thyfault

2015

Bone

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Purpose To examine the effects of 12 mo of resistance training (RT, 2x/wk, N= 19) or jump training (JUMP, 3x/wk, N= 19) on bone mineral density (BMD) and bone turnover markers (BTM) in physically active (≥4 hr/wk) men (mean age: 44 ± 2 y; median: 44 y) with osteopenia of the hip or spine. Methods Participants rated pain and fatigue following each RT or JUMP session. All participants received supplemental calcium (1200 mg/d) and vitamin D (10 μg/d). BMD was measured at 0, 6, and 12 mo using DXA scans of the whole body (WB), total hip (TH) and lumbar spine (LS). BTM and 25 OHD were measured by ELISA. The effects of RT or JUMP on BMD and BTM were evaluated using 3×2 repeated measures ANOVA (time, group). This study was conducted in accordance with the Declaration of Helsinki and was approved by the University of Missouri IRB. Results At baseline, 36 of 38 participants were vitamin D sufficient (25OHD>50 nmol/L); at 12 mo, all participants were 25OHD sufficient. 25OHD did not differ between groups. WB and LS BMD significantly increased after 6 months of RT or JUMP and this increase was maintained at 12 mo; TH BMD increased only in RT. Osteocalcin increased significantly after 12 mo of RT or JUMP; CTx decreased significantly after 6 mo and returned to baseline concentrations at 12 mo in both RT and JUMP. Pain and fatigue ratings after RT or JUMP sessions were very low at 0, 6, and 12 mo. Conclusion RT or JUMP, which appeared safe and feasible, increased BMD of the whole body and lumbar spine, while RT also increased hip BMD, in moderately active, osteopenic men.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of resistance training or jumping-exercise to increase bone mineral density in men with low bone mass: A 12-month randomized, clinical trial

Hinton

Nigh

Thyfault

2015

Bone

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“…Since vitamin D is a well‐established nutrient in relation to bone, markers of bone formation and turnover (osteocalcin, bone specific ALP and urine N‐telopeptide crosslinks) have been considered as markers of long‐term status of vitamin D (Bonjour et al., ). Low urinary calcium excretion and an increased bone specific ALP activity have been used as biomarkers in the diagnosis of vitamin D deficiency (Section 2.2.2.1).…”

Section: Definition/categorymentioning

confidence: 99%

Dietary reference values for vitamin D

2016

EFSA Journal

215

135

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Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) derived dietary reference values (DRVs) for vitamin D. The Panel considers that serum 25(OH)D concentration, which reflects the amount of vitamin D attained from both cutaneous synthesis and dietary sources, can be used as a biomarker of vitamin D status in adult and children populations. The Panel notes that the evidence on the relationship between serum 25(OH)D concentration and musculoskeletal health outcomes in adults, infants and children, and adverse pregnancy-related health outcomes, is widely variable. The Panel considers that Average Requirements and Population Reference Intakes for vitamin D cannot be derived, and therefore defines adequate intakes (AIs), for all population groups. Taking into account the overall evidence and uncertainties, the Panel considers that a serum 25 (OH)D concentration of 50 nmol/L is a suitable target value for all population groups, in view of setting the AIs. For adults, an AI for vitamin D is set at 15 lg/day, based on a meta-regression analysis and considering that, at this intake, the majority of the population will achieve a serum 25(OH)D concentration near or above the target of 50 nmol/L. For children aged 1-17 years, an AI for vitamin D is set at 15 lg/day, based on the meta-regression analysis. For infants aged 7-11 months, an AI for vitamin D is set at 10 lg/day, based on trials in infants. For pregnant and lactating women, the Panel sets the same AI as for non-pregnant non-lactating women, i.e. 15 lg/day. The Panel underlines that the meta-regression was done on data collected under conditions of assumed minimal cutaneous vitamin D synthesis. In the presence of cutaneous vitamin D synthesis, the requirement for dietary vitamin D is lower or may even be zero. In line with EFSA's policy on declarations of interest, Panel member Harry McArdle did not participate in the development and adoption of this scientific opinion.Acknowledgements: The Panel wishes to thank the members of the Working Group on dietary reference values for vitamins: Christel Lamberg-Allardt, Monika Neuh € auser-Berthold, Gra _ zyna Nowicka, Kristina Pentieva, Hildegard Przyrembel, Inge Tetens, Daniel Tom e and Dominique Turck for the preparatory work on this scientific opinion and EFSA staff members: Laura Ciccolallo, C eline Dumas, Lucia Fabiani and Laura Martino for the support provided to this scientific opinion.

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“…In humans, data are mixed with some, but not all [8–10] studies, reporting an impact of maternal vitamin D status (25-hydroxyvitamin D [25(OH)D]) on fetal bone development [11–15] and maternal bone turnover [16,17]. These differences across studies may be secondary to diverse maternal intakes of calcium and phosphorus from food and supplements, which like vitamin D, play essential roles in bone biology and thus are important confounders [18–20]. …”

Section: Introductionmentioning

confidence: 99%

Maternal vitamin D biomarkers are associated with maternal and fetal bone turnover among pregnant women consuming controlled amounts of vitamin D, calcium, and phosphorus

Park

Brannon

West

et al. 2017

Bone

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Vitamin D plays a central role in calcium homeostasis; however, its relationship with bone turnover during pregnancy remains unclear due to a lack of studies that have rigorously controlled for other nutrients known to influence bone metabolism. Similarly, prior investigations of the effect of pregnancy on bone turnover relative to the nonpregnant state may have been confounded by varying intakes of these nutrients. Nested within a controlled intake study, the present investigation sought to quantify associations between maternal vitamin D biomarkers and biochemical markers of bone turnover among pregnant (versus nonpregnant) women and their fetuses under conditions of equivalent and adequate intakes of vitamin D and related nutrients. Changes in markers of bone turnover across the third trimester were also examined. Healthy pregnant (26–29 wk gestation; n=26) and nonpregnant (n=21) women consumed 511IU vitamin D/d, 1.6g calcium/d, and 1.9g phosphorus/d for 10 weeks while participating in a controlled feeding study featuring two choline doses. Based on linear mixed models adjusted for influential covariates (e.g., BMI, ethnicity, and season), pregnant women had 50–150% higher (P<0.001) concentrations of bone resorption markers than nonpregnant women. Among pregnant women, increases in maternal 25(OH)D across the study period were associated (P<0.020) with lower osteocalcin and deoxypyridinoline at study-end, and higher fetal osteocalcin. In addition, maternal free 25(OH)D, 1,25(OH)2D, and 24,25(OH)2D tended to be negatively associated (P≤0.063) with maternal NTx at study-end, and maternal free 25(OH)D and 24,25(OH)2D were positively associated (P≤0.021) with fetal CTx. Similarly, maternal 3-epi-25(OH)D3 was negatively related (P≤0.037) to maternal NTx and deoxypyridinoline at study-end. These declines in bone resorption markers resulting from higher vitamin D biomarker concentrations among pregnant women coincided with increases in their albumin-corrected serum calcium concentrations, indicating that calcium transfer to the fetus was uncompromised. Notably, none of these associations achieved statistical significance among nonpregnant women. Overall, our study findings suggest that achieving higher maternal concentrations of vitamin D biomarkers might attenuate third-trimester bone resorption while ensuring sufficient calcium delivery to the fetus.

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Biochemical markers for assessment of calcium economy and bone metabolism: application in clinical trials from pharmaceutical agents to nutritional products

Cited by 42 publications

References 181 publications

Effectiveness of resistance training or jumping-exercise to increase bone mineral density in men with low bone mass: A 12-month randomized, clinical trial

Effectiveness of resistance training or jumping-exercise to increase bone mineral density in men with low bone mass: A 12-month randomized, clinical trial

Dietary reference values for vitamin D

Maternal vitamin D biomarkers are associated with maternal and fetal bone turnover among pregnant women consuming controlled amounts of vitamin D, calcium, and phosphorus

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