Calcium supplementation either in the diet (Emmenthal) or as a drug (Calcium carbonate) reduces the biochemical markers of bone resorption in post menopausal women

Abstract We examined the response of different biochemical markers of bone resorption to bisphosphonate therapy (400 mg of etidronate daily for 6 months) in mild Paget disease (n = 14). Urinary markers included hydroxyproline (OHP), total (T) and free (F) pyridinolines (Pyds) determined by HPLC, immunoreactive FPyds, immunoreactive TPyds, and the N- and C-terminal telopeptides of type I collage (NTx, CL). Serum measurements included tartrate-resistant acid phosphatase (TRAcP) and the C-terminal telopeptide of type I collagen (ICTP). ICTP and TRAcP showed a minimal response to therapy (% change at 6 months, -13.1 +/- 6.8 and -6.7 +/- 3.4, respectively). The response was greatest for urinary telopeptides (NTx and CL; % change -75.7 +/- 7.5 and -73.4 +/- 8.9, respectively). The response was somewhat greater for TPyds than for FPyds. We conclude that: (a) ICTP and TRAcP are unreliable indicators of changes in bone turnover; (b) oligopeptide-bound Pyds and telopeptide fragments of type I collagen in urine show a somewhat greater response to therapy than do FPyds and may be more sensitive indicators of bone resorption; and (c) as yet no evidence suggests that these markers are substantially better predictors of the clinical response to therapy than serum total alkaline phosphatase or urinary OHP. There are several problems with the interpretation of these measurements in Paget disease, and the clinical utility of these measurements remains uncertain.

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The effect of short-term calcium supplementation on biochemical markers of bone metabolism in healthy young adults

British Journal Of Nutrition ◽

10.1017/s0007114598001500 ◽

1998 ◽

Vol 80 (5) ◽

pp. 437-443 ◽

Cited By ~ 22

Author(s):

Fiona Ginty ◽

Albert Flynn ◽

Kevin D. Cashman

Keyword(s):

Young Adults ◽

Bone Resorption ◽

Bone Mass ◽

Biochemical Markers ◽

Calcium Supplementation ◽

Short Term ◽

Serum Samples ◽

Bone Specific Alkaline Phosphatase ◽

Short Term Study ◽

Usual Diet

The influence of Ca supplementation of the usual diet for 14d on biochemical markers of bone turnover was investigated in healthy young adults aged 21–26 years. In a crossover study, eighteen subjects (five male and thirteen female) were randomly assigned to their self-selected diet (about 22 mmol Ca/d) or their self-selected diet with a 20 mmol/d Ca supplement (about 40 mmol Ca/d) for 14d followed by crossover to the alternative diet for a further 14d. During each dietary period fasting morning first void urine samples (last 3d) and fasting blood serum samples (morning of twelfth day) were collected. Ca supplementation reduced urinary excretion of pyridinoline (14%) and deoxypyridinoline (16%) (biochemical markers of bone resorption) but had no effect on biochemical markers of bone formation (serum osteocalcin and bone-specific alkaline phosphatase;EC3.1.3.1). It is concluded that Ca supplementation of the usual diet in young adults suppresses bone resorption over a 2-week period. If sustained, this could result in suppression of the bone remodelling rate and an increase in bone mass over time. The findings of this short-term study with a relatively small number of young adults highlight the need for a longer-term intervention study of the effect of increased Ca intake on bone mass in this age group.

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