Expression of Concern: Bone turnover in preeclampsia‐complicated pregnancy in North Indian women

Kumar, Ashok; Devi, Salam Gyaneshwori; Prasad, Sudha; Kapoor, Sanjana; Sharma, Shashi

doi:10.1111/j.1447-0756.2011.01664.x

Cited by 9 publications

(5 citation statements)

References 40 publications

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“…In our study, biochemical markers of bone turnover are found to be greater in preeclampsia compared with normal pregnancy [11]. This may be due to the multisystem involvement of the disease that occurs in response to circulating factors released during the development of preeclampsia.…”

Section: Preeclampsiamentioning

confidence: 50%

“…Increased levels of proinflammatory cytokines and occurrence of endothelial dysfunction in preeclampsia have been implicated in stimulating osteoclast activity and hence increased bone resorption. The levels of NTx (N-telopeptide of type 1 collagen), marker of bone resorption are increased significantly during pregnancy in women with preeclampsia (P \ 0.02) [11]. This further necessitates the supplementation of elemental calcium during pregnancies complicated with preeclampsia, for preservation of maternal skeleton.…”

Section: Preeclampsiamentioning

confidence: 99%

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Calcium: A Nutrient in Pregnancy

Kumar

Kaur

2017

J Obstet Gynecol India

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Maternal and newborn health and nutrition status are the significant indicators of the burden of any disease. Calcium is the most abundant mineral in the body and is essential for many diverse mechanisms and reactions such as muscle contraction, bone formation and enzyme and hormone functioning. Calcium in extracellular fluid maintains its physiologic equilibrium is in three forms namely ionic, protein bound and complexed. Calcium Metabolism During Pregnancy During the course of pregnancy, a remarkable series of physiologic changes occur, aimed at preserving maternal homeostasis while at the same time providing for fetal growth and development. These changes which have direct implications on calcium metabolism include falling albumin level, expansion of extracellular fluid volume, increase in renal function and placental calcium transfer. Calcium homeostasis is a complex process involving calcium and three calcitropic hormones-parathyroid hormone, calcitonin and 1,25-dihydroxyvitamin D 3 (1, 25(OH)2D). Total serum concentrations fall during pregnancy due to hemodilution. This fall mainly occurs in albumin bound

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Section: Preeclampsiamentioning

confidence: 50%

Section: Preeclampsiamentioning

confidence: 99%

Calcium: A Nutrient in Pregnancy

Kumar

Kaur

2017

J Obstet Gynecol India

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“…A slight decrease of all these markers in the initial phases of pregnancy (due to physiologic hemodilution) and a progressive increase (probably related to physiological bone resorption during pregnancy) has been demonstrated. However, the increasing trend of these markers has been shown to be higher in pre-eclamptic women compared to normal pregnancies [26,30].…”

Section: Proposal: Hypothesis and Rationalementioning

confidence: 97%

“…The compensatory mechanism to restore an adequate calcemia in the absence of dietary supplementation is based on both PTH release (to mobilize calcium from bone reservoir) and renin-angiotensin cascade (to reduce glomerular calcium loss) [2,14,25]. Kumar et al demonstrated that in a large part of cases this maternal compensation appears to be able to restore an adequate calcium serum level despite bone metabolism being strongly shifted with osteoclastic activity [26]. Previous reports investigating calcium metabolism pathway in pre-eclamptic women demonstrated that Ca 2+ serum levels is reduced if compared to healthy ones only when calcium intake is very low and pre-eclampsia is overt [27,28].…”

Section: Literature Review and Analysis Of Evidencementioning

confidence: 99%

Could molecular assessment of calcium metabolism be a useful tool to early screen patients at risk for pre-eclampsia complicated pregnancy? Proposal and rationale

Gizzo

Noventa

Gangi

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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One of the most frequent causes of maternal and perinatal morbidity is represented by hypertensive disorders during pregnancy. Women at high risk must be subjected to a more intensive antenatal surveillance and prophylactic treatments. Many genetic risk factors, clinical features and biomarkers have been proposed but none of these seems able to prevent pre-eclampsia onset. English literature review of manuscripts focused on calcium intake and hypertensive disorders during pregnancy was performed. We performed a critical analysis of evidences about maternal calcium metabolism pattern in pregnancy analyzing all possible bias affecting studies. Calcium supplementation seems to give beneficial effects on women with low calcium intake. Some evidence reported that calcium supplementation may drastically reduce the percentage of pre-eclampsia onset consequently improving the neonatal outcome. Starting from this evidence, it is intuitive that investigations on maternal calcium metabolism pattern in first trimester of pregnancy could represent a low cost, large scale tool to screen pregnant women and to identify those at increased risk of pre-eclampsia onset. We propose a biochemical screening of maternal calcium metabolism pattern in first trimester of pregnancy to discriminate patients who potentially may benefit from calcium supplementation. In a second step we propose to randomly allocate the sub-cohort of patients with calcium metabolism disorders in a treatment group (calcium supplementation) or in a control group (placebo) to define if calcium supplementation may represent a dietary mean to reduce pre-eclampsia onset and to improve pregnancy outcome.

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“…Women with a history of preeclampsia (PE), who have estrogen exposure that is comparable to the general population, can be seen as an intermediate group in both estrogen exposure and BD. Studies have shown that women with a history of PE have a normal BD ( 18 , 19 , 20 , 21 ).…”

Section: Introductionmentioning

confidence: 99%

Trabecular bone density in middle-aged women with reproductive disorders

van Zwol-Janssens,

Hage,

van der Ham

et al. 2023

Endocrine Connections

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Besides age, estrogen exposure plays a crucial role in changes in bone density (BD) in women. Premature ovarian insufficiency (POI) and polycystic ovary syndrome (PCOS) are conditions in reproductive-aged women in which the exposure to estrogen is substantially different. Women with a history of preeclampsia (PE) are expected to have normal estrogen exposure. Within the CREw-IMAGO study, we investigated if trabecular BD is different in these women because of differences in the duration of estrogen exposure. Trabecular BD was measured in thoracic vertebrae on coronary CT scans. Women with an reduced estrogen exposure (POI) have a lower BD compared to women with an intermediate exposure (PE) (mean difference (MD) -26.8, 95% confidence interval (CI) -37.2 - -16.3). Women with a prolonged estrogen exposure (PCOS) have the highest BD (MD 15.0, 95% CI 4.3 – 25.7). These results support the hypothesis that the duration of estrogen exposure in these women is associated with trabecular BD.

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Expression of Concern: Bone turnover in preeclampsia‐complicated pregnancy in North Indian women

Abstract: Biochemical markers of bone turnover are greater in preeclampsia compared with normal pregnancy only when the disease is clinically evident (at delivery).

Cited by 9 publications

References 40 publications

Calcium: A Nutrient in Pregnancy

Calcium: A Nutrient in Pregnancy

Could molecular assessment of calcium metabolism be a useful tool to early screen patients at risk for pre-eclampsia complicated pregnancy? Proposal and rationale

Trabecular bone density in middle-aged women with reproductive disorders

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