Changes in serum markers of bone turnover during normal pregnancy

Kaur, Malveen; Godber, Ian M; Lawson, Nigel; Baker, Philip N.; Pearson, Derek; Hosking, David J.

doi:10.1258/000456303322326416

Cited by 23 publications

(22 citation statements)

References 20 publications

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“…Elevations in bone resorption markers (NTx, CTx, deoxypyridinoline) have been detected as early as the first trimester of pregnancy, well before fetal Ca accretion reaches its peak in the third trimester (12,13,39) . In contrast, no significant increases in markers of bone formation (P1CP, P1NP and bone-specific ALP) have been reported before the third trimester (12,13,39,50) . Markers of bone resorption and bone formation reach their highest concentration during the last trimester of pregnancy (12,13,39,43,50,62,71,75,104 --109) .…”

Section: Maternal Bone Mineral Mobilisation: Bone Turnover Studiesmentioning

confidence: 90%

“…However, no association between breast-milk Ca concentration and maternal vitamin D status (25OHD) was observed in a study of British and Gambian women (242) , and no differences in breast-milk Ca were observed between US mothers who consumed 50 (238) .…”

Section: Influence On the Mothermentioning

confidence: 94%

“…Albumin concentration has been used as a proxy measure to derive a correction factor for haemodilution (50,51) but such corrections are not universally applied. Pregnancy is also accompanied by an increase in glomerular filtration rate, which can affect the interpretation of urinary measures.…”

Section: Measures Of Bone Turnover Mineral Metabolism and Excretionmentioning

confidence: 99%

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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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Section: Maternal Bone Mineral Mobilisation: Bone Turnover Studiesmentioning

confidence: 90%

Section: Influence On the Mothermentioning

confidence: 94%

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Calcium economy in human pregnancy and lactation

et al. 2012

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“…Additional potential confounders include hemodilution affecting serum measurements (confirmed to affect osteocalcin and CTX, Ref. 461), increased GFR and altered creatinine excretion affecting urinary measurements, possible contributions from placenta and other tissues, increased degradation or clearance by the placenta (confirmed to affect osteocalcin, Ref. 769), and lack of fasted or diurnally timed specimens.…”

Section: Human Datamentioning

confidence: 99%

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Kovacs

2016

Physiological Reviews

384

524

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During pregnancy and lactation, female physiology adapts to meet the added nutritional demands of fetuses and neonates. An average full-term fetus contains ϳ30 g calcium, 20 g phosphorus, and 0.8 g magnesium. About 80% of mineral is accreted during the third trimester; calcium transfers at 300-350 mg/day during the final 6 wk. The neonate requires 200 mg calcium daily from milk during the first 6 mo, and 120 mg calcium from milk during the second 6 mo (additional calcium comes from solid foods). Calcium transfers can be more than double and triple these values, respectively, in women who nurse twins and triplets. About 25% of dietary calcium is normally absorbed in healthy adults. Average maternal calcium intakes in American and Canadian women are insufficient to meet the fetal and neonatal calcium requirements if normal efficiency of intestinal calcium absorption is relied upon. However, several adaptations are invoked to meet the fetal and neonatal demands for mineral without requiring increased intakes by the mother. During pregnancy the efficiency of intestinal calcium absorption doubles, whereas during lactation the maternal skeleton is resorbed to provide calcium for milk. This review addresses our current knowledge regarding maternal adaptations in mineral and skeletal homeostasis that occur during pregnancy, lactation, and post-weaning recovery. Also considered are the impacts that these adaptations have on biochemical and hormonal parameters of mineral homeostasis, the consequences for long-term skeletal health, and the presentation and management of disorders of mineral and bone metabolism.

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“…However, there is no evidence that Africans and present higher BMD levels. This population presents risk factors for osteoporosis, such as low calcium intake, high parity and prolonged breastfeeding [48][49][50] . The values summarized in Table 1 are most likely the result of the shorter life expectancy in these countries and coding errors, so that the data on Africa are not reliable.…”

Section: Incidence Of Hip Fracture In Africamentioning

confidence: 99%

Tendencia secular de la incidencia de la fractura de cadera en el mundo

Fernández-García

Martínez

Olmos

et al. 2015

Rev Osteoporos Metab Miner

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SummaryOsteoporosis is the most common metabolic bone disease and the main effector of the development of fractures in people over 50 years. When analyzing the evolution of the incidence of hip fracture it is important to consider the effects of the implementation of the strategies undertaken to prevent and treat early forms of disease and falls. In most chronic diseases with an environmental etiological component, identified or not, an interval of several decades occurs between initial exposure to the main causative agent and the clinical onset of the disease. The systematic study of the secular trend of a disease shows different phenomena that help to understand its pathogenesis. At the same time, it constitutes an activity of surveillance that allows warn about its future relevance. The evolution of the incidence rate of hip fractures has not been uniform over time in different countries. It is a matter of great interest to identify whether the observed temporal changes in rates are associated with an aging population or the result of a large number of circumstances of the same population over time. In this paper we review the main studies published around the world that explore, in greater or lesser extent, in the analysis of the secular trend in the incidence of hip fracture in order to bring this concept to the reader and offer an overview on the evolution of the incidence of hip fracture and the causes of this evolution.

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Changes in serum markers of bone turnover during normal pregnancy

Abstract: Background Maternal calcium homeostasis adapts during pregnancy to provide for the needs of the growing fetal skeleton. Wide selections of bone turnover markers are currently available to assess the changes taking place; here, data are presented on two serum-based markers.

Cited by 23 publications

References 20 publications

Calcium economy in human pregnancy and lactation

Calcium economy in human pregnancy and lactation

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Tendencia secular de la incidencia de la fractura de cadera en el mundo

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