Effect of Calcium Supplementation on Bone Loss in Postmenopausal Women

Reid, Ian R.; Ames, Ruth; Evans, Margaret C.; Gamble, Gregory D.; Sharpe, Susan J.

doi:10.1056/nejm199302183280702

Cited by 469 publications

(183 citation statements)

References 22 publications

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“…It may be that Ca intake cannot suppress the high rate of bone turnover associated with severe caloric restriction. Other high bone turnover conditions, such as pregnancy and lactation, show either a beneficial effect of Ca supplementation to reduce mobilization of skeletal mineral stores (Reid et al, 1993;Prince et al, 1995;Cepollaro et al, 1996;Ricci et al, 1998;Shapses et al, 2001) and BPb levels (Hernandez-Avila et al, 2003;Ettinger et al, 2006) or no effect on BPb levels (Hertz-Picciotto et al, 2000;Gulson et al, 2004Gulson et al, , 2006. We found a weak association amongst all women between higher Ca intakes and lower bone resorption (PYD cross-links) and BPb levels during caloric restriction.…”

Section: Discussionmentioning

confidence: 56%

Blood lead levels and bone turnover with weight reduction in women

Riedt

Buckley

Brolin

et al. 2008

J Expo Sci Environ Epidemiol

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High bone turnover states are known to raise blood lead levels (BPb). Caloric restriction will increase bone turnover, yet it remains unknown if weight reduction increases BPb due to mobilization of skeletal stores. We measured whole blood Pb levels ( 206 Pb) by inductively coupled plasma mass spectrometry in 73 women (age 24-75 years; BMI 23-61 kg/m 2 ) before and after 6 months of severe weight loss (S-WL), moderate weight loss (M-WL), or weight maintenance (WM). Baseline BPb levels were relatively low at 0.2-6.0 mg/dl, and directly associated with age (r ¼ 0.49, Po0.0001). After severe WL (À37.4 ± 9.3 kg, n ¼ 17), BPb increased by 2.1 ± 3.9 mg/dl (Po0.05), resulting in BPb levels of 1.3-12.5 mg/dl. M-WL (À5.6 ± 2.7 kg, n ¼ 39) and WM (0.3±1.3 kg, n ¼ 17) did not result in an increase in BPb levels (0.5±3.2 and 0.0±0.7 mg/dl, M-WL and WM, respectively). BPb levels increased more with greater WL (r ¼ 0.24, Po0.05). Bone turnover markers increased only with severe WL and were directly correlated with WL. At baseline, higher calcium intake was associated with lower BPb (r ¼ À0.273, Po0.02), however, this association was no longer present after 6 months. Severe weight reduction in obese women increases skeletal bone mobilization and BPb, but values remain well below levels defined as Pb overexposure.

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Section: Discussionmentioning

confidence: 56%

Blood lead levels and bone turnover with weight reduction in women

Riedt

Buckley

Brolin

et al. 2008

J Expo Sci Environ Epidemiol

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“…Still, the present study and these previous reports indicate that there may be a difference between the effects of endogenous calcium and the effects of exogenous calcium intake. Previous studies show that increasing dietary calcium does not seem to be an important regulator of the serum level of calcium [26,27]. As the studies mentioned above included only women and as the present study includes only men, we cannot rule out the possibility of sex differences in the effects of dietary intake of calcium.…”

Section: Comparison With the Literaturementioning

confidence: 67%

Serum calcium is independently associated with insulin sensitivity measured with euglycaemic–hyperinsulinaemic clamp in a community-based cohort

et al. 2006

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Aims/hypothesis Diabetes mellitus type 2 is associated with altered calcium metabolism. Moreover, in diseases with supranormal serum calcium levels, such as primary hyperparathyroidism, the prevalence of diabetes is increased. Relatively little is known about the relationship between serum calcium concentration and the underlying causes of diabetes-insulin resistance and defective insulin secretionin the normocalcaemic general population. Materials and methods We investigated associations between serum calcium concentration and insulin sensitivity and secretion in a population-based cohort of elderly men (Uppsala Longitudinal Study of Adult Men, n=961). Insulin sensitivity index (M/I; glucose disposal rate [M] divided by mean insulin concentration [I]) was assessed using euglycaemic-hyperinsulinaemic clamp, and insulin secretion was estimated from the early insulin response (EIR) during an OGTT.Results In a multivariable linear regression model adjusting for BMI, physical activity, smoking, consumption of tea, alcohol, coffee and dietary calcium, serum phosphate and serum creatinine, 1 SD increase in serum calcium was associated with 0.17 mg kg −1 min −1 (mU/l) −1 × 100 (0.024 mg kg −1 min −1 [pmol/l] −1 ×100) decrease in M/I (p=0.01). The results remained robust in individuals with normal fasting glucose, normal glucose tolerance and serum calcium within the normal range (n=413, regression coefficient for 1 SD increase −0.45, p=0.001). Serum calcium was not associated with EIR. Dietary intake of calcium was not independently associated with insulin sensitivity or EIR. Conclusion/interpretation Our data support the notion that endogenous calcium may be involved early in the development of diabetes and that this effect is mediated mainly through effects on insulin sensitivity rather than defective insulin secretion. Dietary intake of calcium does not seem to influence insulin sensitivity.

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“…The effects on bone mineral density have been less extensively studied. A few reports have suggested that alfacalcidol and calcitriol exert a direct action on muscle strength and decreases the likelihood of falling in elderly subjects 110111. The major problem with the use of the vitamin D derivatives is the risk of hypercalcaemia and hypercalciuria.…”

Section: Other Pharmacological Interventionsmentioning

confidence: 99%

Updated Recommendations for the Diagnosis and Management of Osteoporosis: A Local Perspective

Raef

Al-Bugami

Balharith

et al. 2011

Annals of Saudi Medicine

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Postmenopausal osteoporosis and osteoporosis in elderly men are major health problems, with a significant medical and economic burden. Although osteopenia and osteoporosis are more common locally than in the West, fracture rates are generally less than in Western countries. Vitamin D deficiency is common in the region and contributes adversely to bone health. Vitamin D deficiency should be suspected and treated in all subjects with ostopenia or osteoporosis. The use of risk factors to determine fracture risk has been adopted by the World Health Organization and many international societies. Absolute fracture risk methodology improves the use of resources by targeting subjects at higher risk of fractures for screening and management. The King Faisal Specialist Hospital Osteoporosis Working Group recommends screening for women 65 years and older and for men 70 years and older. Younger subjects with clinical risk factors and persons with clinical evidence of osteoporosis or diseases leading to osteoporosis should also be screened. These guidelines provide recommendations for treatment for postmenopausal women and men older than 50 years presenting with osteoporotic fractures for persons having osteoporosis—after excluding secondary causes—or for persons having low bone mass and a high risk for fracture. The Working Group has suggested an algorithm to use at King Faisal Specialist Hospital that is based on the availability, cost, and level of evidence of various therapeutic modalities. Adequate calcium and vitamin D supplement are recommended for all. Weekly alendronate (in the absence of contraindications) is recommended as first-line therapy. Alternatives to alendronate are raloxifene or strontium ranelate. Second-line therapies are zoledronic acid intravenously once yearly, when oral therapy is not feasible or complicated by side effects, or teriparatide in established osteoporosis with fractures.

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Effect of Calcium Supplementation on Bone Loss in Postmenopausal Women

Abstract: Calcium supplementation significantly slowed axial and appendicular bone loss in normal post-menopausal women.

Cited by 469 publications

References 22 publications

Blood lead levels and bone turnover with weight reduction in women

Blood lead levels and bone turnover with weight reduction in women

Serum calcium is independently associated with insulin sensitivity measured with euglycaemic–hyperinsulinaemic clamp in a community-based cohort

Updated Recommendations for the Diagnosis and Management of Osteoporosis: A Local Perspective

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