Measurement of calcium balance and bone turnover by new techniques

Bullamore, J.R.; Marshall, D. H.; Nordin, B. E. C.; Oldefield, W. A.; Wilkinson, Robert H.

doi:10.1007/bf02152370

Cited by 7 publications

(4 citation statements)

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“…Davies et aL (33) studied the acute effects (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) days) of therapy with 1,25(OH)2D3 (1 ,ug daily) on calcium balance in five osteoporotic patients. Four of these were in positive calcium balance at base line and did not change significantly with treatment.…”

Section: Discussionmentioning

confidence: 99%

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1,25-Dihydroxyvitamin D3: short- and long-term effects on bone and calcium metabolism in patients with postmenopausal osteoporosis.

Gallagher¹,

Jerpbak²,

Jee³

et al. 1982

Proc. Natl. Acad. Sci. U.S.A.

163

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We evaluated the effects of therapy with a small dose (0.5 Iug/day) of 1,25-dihydroxyvitamin D3 in 12 previously untreated patients with postmenopausal osteoporosis. Combined radiocalcium kinetic and balance studies showed that at base line, net calcium absorption (mean ± SEM) was low (7 + 3%), calcium balance was negative (-59 ± 22 mg/day), and bone resorption rate (297 ± 40 mg/day) exceeded bone formation rate (239 ± 36 mg/day). After short-term therapy (6-8 months), calcium absorption was normal (27 ± 3%, P < 0.001 for difference from base line), calcium balance had improved (+2 + 26 mg/day, P < 0.05), and bone resorption rate (195 ± 35 mg/day, P < 0.01) had decreased more than bone formation rate (197 ± 26 mg/day, NS). Compared with base-line values, after long-term therapy (2 years) the increased level of calcium absorption was maintained (27 ± 3%, P < 0.001), but calcium retention declined to a level intermediate (-27 ± 24 mg/day, NS) between base-line and shortterm treatment values, and both bone resorption rate (294 ± 33 mg/day, NS) and bone formation rate (267 + 34 mg/day, NS) increased. Urinary hydroxyproline excretion was lower than before treatment (26.3 ± 2.0 mg/day) after both short-term (21.1 ± 1.6 mg/day, P < 0.001) and long-term (22.0 ± 1.8 mg/day, P < 0.01) treatments. Trabecular bone volume was 11.3 ± 1.0% at base line and increased to 16.0 ± 1.2% (P < 0.01) after long-term treatment. By contrast, the eight patients studied before and after 6-8 months of placebo treatment had no significant change in any variable.Many investigators have found that a substantial proportion of patients with postmenopausal osteoporosis have impaired intestinal calcium absorption as assessed either by metabolic balance or by absorption ofradiocalcium (1-6). We have previously reported (6) that patients with postmenopausal osteoporosis have a significant decrease in mean serum 1,25-dihydroxyvitamin D [1,25(OH)2D], the major hormonal factor controlling calcium absorption. Some (7-9) but not all (10) investigators also have found that serum 1,25(OH)2D was low normal or low in patients with osteoporosis. Another group (11) reported that, when patients with osteoporosis were stratified on the basis of calcium absorption, those with calcium malabsorption had serum 1,25(OH)2D levels that were significantly lower than normal. In that same study, the women with osteoporosis had no change in serum 1,25(OH)2D levels in response to a low-calcium diet, whereas the normal control subjects had significant increases.It is not known whether the impaired calcium absorption contributes to the negative calcium balance characteristic of osteoporosis. We have previously reported that treatment with a small dose of 1,25(OH)2D3 for 7 days normalizes calcium absorption in patients with this disorder (6). The current study was undertaken to determine whether this result could be maintained with continued treatment and, if so, whether it would have a beneficial effect on abnormal bone and calcium metabolism characteristic of untrea...

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Section: Discussionmentioning

confidence: 99%

“…Calcium balances were determined by a daily balance technique (16). The patient's habitual calcium intake was estimated by a dietitian by interview and by inspection of a 7-day food record kept by the patient.…”

mentioning

confidence: 99%

1,25-Dihydroxyvitamin D3: short- and long-term effects on bone and calcium metabolism in patients with postmenopausal osteoporosis.

Gallagher¹,

Jerpbak²,

Jee³

et al. 1982

Proc. Natl. Acad. Sci. U.S.A.

163

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“…Calcium and phosphorus balances were determined by a daily balance technique (Bullamore, Marshall, Nordin, Oldfield & Wilkinson, 1970 Indicates the first balance study performed. of a dietician and were gelatin-free.…”

Section: Balance Studiesmentioning

confidence: 99%

The Effect of Ethinyloestradiol on Calcium and Phosphorus Metabolism of Post-Menopausal Women with Primary Hyperparathyroidism

Gallagher

Wilkinson

1973

Clinical Science

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1. Eight post-menopausal women with primary hyperparathyroidism were given ethinyloestradiol (0.05 mg daily) and the effects on calcium and phosphorus metabolism were observed.2. In every patient ethinyloestradiol produced a fall in fasting plasma and urine calcium. Calcium balance improved in seven patients on treatment and there was a significant fall in 24 h urine calcium in all eight patients; however, there was no consistent change in net or true absorption of calcium.3. Ethinyloestradiol produced a small fall in the fasting plasma inorganic phosphorus and a fall in fasting urine phosphorus in seven cases. There was a decrease in 24 h urine phosphorus in seven of the eight cases, but there was no consistent effect on phosphorus absorption nor on phosphorus balance. 4. Bone mineralization rate and bone resorption rate were determined in seven of the patients. The administration of ethinyloestradiol produced a decrease in both these variables in all seven patients.5. The 24 h urine hydroxyproline, used as an independent measure of bone resorption, decreased in all eight patients during ethinyloestradiol therapy.6. It is concluded that ethinyloestradiol produces an improvement in calcium and phosphorus balance and a decrease in plasma calcium and phosphorus in primary hyperparathyroidism by decreasing bone resorption.7. It is suggested that ethinyloestradiol may be used as a medical treatment for primary hyperparathyroidism in post-menopausal women who are either unsuitable for surgery or on whom operative procedures have failed, or in those cases in whom primary hyperparathyroidism is mild.

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“…No patient had received treatment other than antibiotics prior to the study. Calcium balances were determined by a daily balance technique in a metabolic ward [12], Diets were prepared under the supervision of a dietitian and were gelatin-free. Any given subject ate a constant daily diet for the duration of the study and was given 500 mg of poly ethylene glycol 4000 (PEG) three times a day with meals as a non-absorbable faecal marker 2 Patient 1 had an epileptic convulsion associated with hypocalcaemia 3 weeks after the studies were completed.…”

Section: Methodsmentioning

confidence: 99%

Effect of Correction of Metabolic Acidosis on Bone Mineralisation Rates in Patients with Renal Osteomalacia

Cochran

Wilkinson

1975

Nephron

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The role of metabolic acidosis in the genesis of renal osteomalacia was investigated by studying bone mineralisation and resorption rates with a combined isotope and balance technique in six patients, before and after the administration of alkali. Correction of blood pH was achieved in five cases and was associated with a significant rise in the bone mineralisation rates and a significant positive trend in the calcium balances. It is suggested that acidosis contributes to the pathogenesis of osteomalacia in renal failure by slowing skeletal mineralisation, possibly by inhibiting bone alkaline phosphatase.

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Measurement of calcium balance and bone turnover by new techniques

Cited by 7 publications

References 2 publications

1,25-Dihydroxyvitamin D3: short- and long-term effects on bone and calcium metabolism in patients with postmenopausal osteoporosis.

1,25-Dihydroxyvitamin D3: short- and long-term effects on bone and calcium metabolism in patients with postmenopausal osteoporosis.

The Effect of Ethinyloestradiol on Calcium and Phosphorus Metabolism of Post-Menopausal Women with Primary Hyperparathyroidism

Effect of Correction of Metabolic Acidosis on Bone Mineralisation Rates in Patients with Renal Osteomalacia

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