Calcium gluconate supplementation is effective to balance calcium homeostasis in patients with gastrectomy

Krause, Matthias; Keller, Johannes; Beil, Britta; Driel, Ian R. van; Zustin, Josef; Barvencik, Florian; Schinke, Thorsten; Amling, Michael

doi:10.1007/s00198-014-2965-1

Cited by 37 publications

(24 citation statements)

References 37 publications

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“…We speculate that this lack of mineralization makes this bone segment more prone to mechanical stress, which may result in subchondral insufficiency fractures. ** References 2,4,16,32,34,43,45,50,52. Vol. 43, No.…”

Section: Resultsmentioning

confidence: 99%

Intact Bone Vitality and Increased Accumulation of Nonmineralized Bone Matrix in Biopsy Specimens of Juvenile Osteochondritis Dissecans

et al. 2015

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Section: Resultsmentioning

confidence: 99%

Intact Bone Vitality and Increased Accumulation of Nonmineralized Bone Matrix in Biopsy Specimens of Juvenile Osteochondritis Dissecans

et al. 2015

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“…Of these, osteoporosis is regarded as an indication of malabsorption, and some lethal disorders, such as bone fracture, may occur in the absence of appropriate treatments. Previously, calcium gluconate, vitamin D, and bisphosphonate were widely used in the treatment of osteoporosis after gastrectomy [8][9][10] . Of these, bisphosphonate showed notable efficacy.…”

mentioning

confidence: 99%

A Comparative Study of Intravenous Injection Form and Oral Jelly Form of Alendronate Sodium Hydrate for Bone Mineral Disorder after Gastrectomy

Kunisaki

Tanaka²,

Kubo³

et al. 2017

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Background/Aims: Osteoporosis is found to have high prevalence after gastrectomy and therefore, it is important to prevent this condition by means of effective medication, such as alendronate sodium hydrate. Methods: A total number of 48 gastric cancer patients diagnosed with osteoporosis after R0 gastrectomy was registered in this study between December 2013 and August 2014. Twenty-three patients received intravenous (i.v.) alendronate sodium hydrate and 25 patients received the drug in an oral jelly form. Serological and urinary examinations related to bone metabolism and bone mineral density (BMD) were performed periodically and the results obtained from the 2 groups were compared. Results: BMD increased, serum levels of bone-specific alkaline phosphatase and tartrate-resistant acid phosphatase-5b, and the urine level of urine N-terminal telopeptide decreased with time in both groups. However, the serum Ca level did not change. Two-way analysis of variance revealed no significant differences in these factors between the 2 groups. Conclusion: It is essential to prevent both forms of osteoporosis by using alendronate sodium hydrate after gastrectomy for gastric cancer. A prospective, randomized, controlled trial in many patients following long duration should be conducted to clarify the benefits of i.v. alendronate sodium hydrate.

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“…These results are confirmed by the osteoporotic bone phenotype in Atp4b −/− mice that lack the H + –K + ‐ATPase on parietal cells required for gastric acid production . Calcium supplements with solubility at neutral pH, such as calcium gluconate, are able to abolish increased bone resorption in both hypochlorhydria mouse models and in gastrectomized individuals . Taken together, these findings demonstrate that functional gastric integrity that ensures intestinal calcium absorption plays a critical role in maintaining skeletal health.…”

mentioning

confidence: 62%

“…The resultant calcium deficiency leads to secondary hyperparathyroidism and excessive bone resorption, causing an osteoporotic bone phenotype . These results are confirmed by the osteoporotic bone phenotype in Atp4b −/− mice that lack the H + –K + ‐ATPase on parietal cells required for gastric acid production . Calcium supplements with solubility at neutral pH, such as calcium gluconate, are able to abolish increased bone resorption in both hypochlorhydria mouse models and in gastrectomized individuals .…”

mentioning

confidence: 82%

“…Therefore, patients with hypochlorhydria, which is defined by reduced stomach acid production due, for example, to the long‐term use of proton‐pump inhibitors (PPI), display a higher prevalence for osteoporosis and increased fracture risk . Additionally, gastrectomized patients with achlorhydria display increased bone turnover and mineralization defects . This was confirmed experimentally in Cckbr −/− mice mimicking gastric hypochlorhydria .…”

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confidence: 98%

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Hypochlorhydria‐induced calcium malabsorption does not affect fracture healing but increases post‐traumatic bone loss in the intact skeleton

Haffner‐Luntzer

Heilmann

Heidler

et al. 2016

Journal Orthopaedic Research

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Efficient calcium absorption is essential for skeletal health. Patients with impaired gastric acidification display low bone mass and increased fracture risk because calcium absorption is dependent on gastric pH. We investigated fracture healing and post‐traumatic bone turnover in mice deficient in Cckbr, encoding a gastrin receptor that affects acid secretion by parietal cells. Cckbr−/− mice display hypochlorhydria, calcium malabsorption, and osteopenia. Cckbr−/− and wildtype (WT) mice received a femur osteotomy and were fed either a standard or calcium‐enriched diet. Healed and intact bones were assessed by biomechanical testing, histomorphometry, micro‐computed tomography, and quantitative backscattering. Parathyroid hormone (PTH) serum levels were determined by enzyme‐linked immunosorbent assay. Fracture healing was unaffected in Cckbr−/− mice. However, Cckbr−/− mice displayed increased calcium mobilization from the intact skeleton during bone healing, confirmed by significantly elevated PTH levels and osteoclast numbers compared to WT mice. Calcium supplementation significantly reduced secondary hyperparathyroidism and bone resorption in the intact skeleton in both genotypes, but more efficiently in WT mice. Furthermore, calcium administration improved bone healing in WT mice, indicated by significantly increased mechanical properties and bone mineral density of the fracture callus, whereas it had no significant effect in Cckbr−/− mice. Therefore, under conditions of hypochlorhydria‐induced calcium malabsorption, calcium, which is essential for callus mineralization, appears to be increasingly mobilized from the intact skeleton in favor of fracture healing. Calcium supplementation during fracture healing prevented systemic calcium mobilization, thereby maintaining bone mass and improving fracture healing in healthy individuals whereas the effect was limited by gastric hypochlorhydria. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1914–1921, 2016.

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Calcium gluconate supplementation is effective to balance calcium homeostasis in patients with gastrectomy

Cited by 37 publications

References 37 publications

Intact Bone Vitality and Increased Accumulation of Nonmineralized Bone Matrix in Biopsy Specimens of Juvenile Osteochondritis Dissecans

Intact Bone Vitality and Increased Accumulation of Nonmineralized Bone Matrix in Biopsy Specimens of Juvenile Osteochondritis Dissecans

A Comparative Study of Intravenous Injection Form and Oral Jelly Form of Alendronate Sodium Hydrate for Bone Mineral Disorder after Gastrectomy

Hypochlorhydria‐induced calcium malabsorption does not affect fracture healing but increases post‐traumatic bone loss in the intact skeleton

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