Serum osteoprotegerin/osteoclastogenesis-inhibitory factor during pregnancy and lactation and the relationship with calcium-regulating hormones and bone turnover markers

Uemura, Hirokazu; Yasui, Toshiyuki; Kiyokawa, Machiko; Kuwahara, Akira; Ikawa, Hiromichi; Matsuzaki, Takashi; Maegawa, Mayumi; Furumoto, Hiroyuki; Irahara, Minoru

doi:10.1677/joe.0.1740353

Cited by 58 publications

(47 citation statements)

References 34 publications

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“…8 Additionally, the even greater calcium losses during lactation (approximately 300 mg calcium/day) further increase the risk of PLO. 9,10 During the first month of lactation, bone resorption markedly rises and subsequently normalizes, while bone formation increases and remains elevated for at least one more month. Interestingly, loss of calcium induced by lactation may not be the only cause of the loss of bone density in lactating women.…”

Section: Discussionmentioning

confidence: 99%

“…Lactating women have lower oestrogen levels, higher prolactin levels, higher parathormone-related peptide (PTH-related peptide) levels and lower 1,25(OH)2D levels than non-lactating women. 9,11 During lactation women experience a BMD loss of approximately 3-7%. The reversal of physiological oestrogen fall, increased PTH-related peptide and the maternal calcium loss in breast milk during lactation lead to recovery of bone loss in most of the patients.…”

Section: Discussionmentioning

confidence: 99%

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Case Report: Teriparatide treatment in a case of severe pregnancy -and lactation- associated osteoporosis

Lampropoulou-Adamidou¹,

Trovas²,

Stathopoulos³

et al. 2012

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OBJEcTIVE: Pregnancy-and lactation-associated osteoporosis (PLO) is an uncommon disease. The majority of cases are seen in the third trimester or early post-partum in primagravid women and the prominent clinical feature of PLO is severe and prolonged back pain and height loss. The prevalence and aetiology of this disorder are as yet unclear and there are no guidelines for its treatment. cAsE rEPOrT: We report the outcomes of teriparatide (TrP) treatment in a woman suffering from severe PLO with 6 vertebral fragility fractures, severe back pain and very low BMD. rEsULTs: Thirteen months after the initiation of therapy, the patient was almost free of back pain. There was no new clinical vertebral fracture. Her laboratory tests were all normal. BMD increased by 24.4% at the lumbar spine, 9.9% and 4.6% at the left and the right total hip and 12.6% and 7.8% at the left and right femur neck, respectively. cONcLUsION: TrP treatment simultaneously with weaning and calcium and vitamin D supplementation seems to considerably increase BMD, improve severe back pain and quality of life and prevent further occurrence of vertebral fractures, making TrP a helpful tool in restoring bone strength in PLO patients. Key words: Lactation, Osteoporosis, Pregnancy, Premenopausal osteoporosis, TeriparatideCase report HORMONES 2012, 11(4):495-500 Address for correspondence: Kalliopi Lampropoulou-Adamidou, MD, MSc, Laboratory for the Research of the Musculoskeletal System "Th. Garofalidis", KAT General Hospital of Athens, 10 Athinas Str., 14561, Kifissia, Athens, Greece, Tel.: +306984229202, +302108018123, Fax: +302108018122, E-mail: kilampropoulou@gmail.com of PLO was made by Nordin et al in 1955. 1 It is characterised by the occurrence of fragility fracture(s), most commonly involving the lower thoracic and/ or lumbar vertebral bodies. The majority of cases are seen in the third trimester or early post-partum in primagravid women and the prominent clinical feature of PLO is severe and prolonged back pain and height loss. The prevalence and the ae tiology of this disorder are unclear. To date, more than 120 cases have been reported, mostly as individual case reports.2 Due to the lack of controlled trials and the rarity of the disease there are no formal guidelines.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Case Report: Teriparatide treatment in a case of severe pregnancy -and lactation- associated osteoporosis

Lampropoulou-Adamidou¹,

Trovas²,

Stathopoulos³

et al. 2012

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“…The plasma concentration of 1,25(OH) 2 D is also either unchanged (67,107) or slightly decreased (113,191) compared with pre-pregnancy or those of NPNL women. Increases in 1,25(OH) 2 D concentration during the first months postpartum in both BF and NBF mothers have been reported (84) .…”

Section: Lactation and Postpartummentioning

confidence: 90%

Calcium economy in human pregnancy and lactation

et al. 2012

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Pregnancy and lactation are times of additional demand for Ca. Ca is transferred across the placenta for fetal skeletal mineralisation, and supplied to the mammary gland for secretion into breast milk. In theory, these additional maternal requirements could be met through mobilisation of Ca from the skeleton, increased intestinal Ca absorption efficiency, enhanced renal Ca retention or greater dietary Ca intake. The extent to which any or all of these apply, the underpinning biological mechanisms and the possible consequences for maternal and infant bone health in the short and long term are the focus of the present review. The complexities in the methodological aspects of interpreting the literature in this area are highlighted and the inter-individual variation in the response to pregnancy and lactation is reviewed. In summary, human pregnancy and lactation are associated with changes in Ca and bone metabolism that support the transfer of Ca between mother and child. The changes generally appear to be independent of maternal Ca supply in populations where Ca intakes are close to current recommendations. Evidence suggests that the processes are physiological in humans and that they provide sufficient Ca for fetal growth and breast-milk production, without relying on an increase in dietary Ca intake or compromising long-term maternal bone health. Further research is needed to determine the limitations of the maternal response to the Ca demands of pregnancy and lactation, especially among mothers with marginal and low dietary Ca intake, and to define vitamin D adequacy for reproductive women.

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“…Serum total alkaline phosphatase (ALP) is a nonspecific indicator of osteoblast activity, and therefore, bone alkaline phosphatase (BAP) can be used to assess bone formation. BAP levels are reliable markers of bone formation in the perinatal period (Uemura et al 2002).…”

Section: Introductionmentioning

confidence: 99%

Fetal Bone Formation Is Decreased from Middle Pregnancy to Birth

Nitta

Suzumura

Arisaka

et al. 2016

Tohoku J. Exp. Med.

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Fetal bone development is a complex process that is regulated and maintained by minerals, hormones, and growth factors delivered from the mother via the placenta. Various biochemical markers of fetal bone development have been identified. However, many aspects of this process remain unclear. The aim of the study was to measure the activities of serum tartrate-resistant acid phosphatase type 5b (TRACP 5b) as a bone resorption marker and bone alkaline phosphatase (BAP) as a bone formation marker in preterm and term neonates, and to investigate fetal bone development in middle and late pregnancy. The study included 111 neonates (87 preterm and 24 term) born at Dokkyo Medical University Hospital. Neonates with illnesses and maternal diseases were excluded. Serum samples were collected within 3 hours after birth and stored at −80°C. Univariate and multivariate linear regression analyses were performed. The 111 neonates (median birth weight, 1,510 g) were born at a median of 31.3 weeks of gestation, and had TRACP 5b and BAP activities of 10.9 ± 4.0 U/L and 127.5 ± 49.2 U/L, respectively. TRACP 5b activity showed a tendency to be higher in term neonates, while BAP activity tended to be lower in term neonates. Importantly, TRACP 5b activity was positively correlated with gestational age and birth weight, and BAP activity was negatively correlated with gestational age, rate of born small-for-gestational-age neonates, and birth weight. These results suggest that bone formation during fetal growth is gradually decreased from middle pregnancy to birth, whereas bone resorption is gradually increased.Keywords: bone alkaline phosphatase; fetal bone development; preterm neonate; tartrate-resistant acid phosphatase type 5b; term neonate Tohoku J.

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Serum osteoprotegerin/osteoclastogenesis-inhibitory factor during pregnancy and lactation and the relationship with calcium-regulating hormones and bone turnover markers

Cited by 58 publications

References 34 publications

Case Report: Teriparatide treatment in a case of severe pregnancy -and lactation- associated osteoporosis

Case Report: Teriparatide treatment in a case of severe pregnancy -and lactation- associated osteoporosis

Calcium economy in human pregnancy and lactation

Fetal Bone Formation Is Decreased from Middle Pregnancy to Birth

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