Clinical Rheumatology

, Volume 16, Issue 3, pp 249–253 | Cite as

Acute changes in serum calcium and parathyroid hormone circulating levels induced by the oral intake of five currently available calcium salts in healthy male volunteers

  • R. Deroisy
  • M. Zartarian
  • L. Meurmans
  • N. Nelissenne
  • M. C. Micheletti
  • A. Albert
  • J. Y. Reginster
Originals

Summary

Several calcium supplements are currently available and many of them are marketed without proper comparison of the bioavailability of the actual preparations. The aim of the present trial was to evaluate and compare the acute changes in serum calcium (Ca) and parathyroid hormone (PTH) levels following the oral administration of a vehicle and of five calcium salts currently prescribed in Western Europe. No significant changes in serum Ca or PTH levels were observed after administration of the vehicle. All calcium salts induced significant increases in serum Ca and decreases in serum PTH compared to baseline values. Comparison of the six response curves revealed a significantly greater increase in serum Ca and a greater decrease in serum PTH after each of the calcium salts than observed after the vehicle. However, no statistically significant differences were observed between the different calcium salts for serum Ca increments. The decrease in serum PTH observed after administration of an ossein-hydroxyapatite complex was significantly less important than after the four other calcium salts, even if statistically different than after vehicle. When assessing the area under the curve (AUC) of PTH values, we observed that calcium carbonate and citrate induce a significantly greater decrease in serum PTH than the other calcium salts which are, however, statistically more active than the vehicle. Serum PTH is decreased under the lower limit of the normal range (10 pg/ml), between t60 and t120 for calcium carbonate and citrate and between t60 and t90 for calcium gluconolactate while the mean PTH values remain within the normal range throughout the study with calcium pidolate, the ossein-hydroxyapatite complex and the vehicle. In conclusion, all calcium preparations significantly increase serum calcium and decrease serum parathormone, compared to what is observed after oral intake of a vehicle. However, significant differences in suppression of parathormone are observed between the different calcium preparations and might be of importance for their clinical use.

Key words

Parathyroid Hormone Calcium Osteoporosis Bone Menopause 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Reginster JY. Osteoporose postmenopausique. Traitement prophylactique. ed, Paris, Milan, Barcelone: Masson, 1993.Google Scholar
  2. 2.
    Nordin BEC, Heaney RP. Calcium supplementation of the diet; justified by present evidence. BMJ 1990;300:1056–60.Google Scholar
  3. 3.
    Kanis JA, Passmore R. Calcium supplementation of the diet: not justified by present evidence. BMJ 1989;298:137–40.Google Scholar
  4. 4.
    Johnston CC, Miller JZ, Slemenda CW, Reister TK, Hui S, Christian JC, Peacock M. Calcium supplementation and increases in bone mineral density in children. N Engl J Med 1992;327:82–7.Google Scholar
  5. 5.
    Baran D, Sorensen A, Grimes J, Lew R, Karellas A, Johnson B, Roche J. Dietary modification with dairy products for preventing vertebral bone loss in premenopausal women: a three-year prospective study. J Clin Endocrinol Metab 1990;70:264–70.Google Scholar
  6. 6.
    Elders PJM, Netelenbos JC, Lips P, Van Gingel FC, Khoe E, Leeuwenkamp OR, Hackeng WHL, Vanderstelt PF. Calcium supplementation reduces vertebral bone loss in perimenopausal women: a controlled trial in 248 women between 46 and 55. J Clin Endocrinol Metab 1991;73:533–40.Google Scholar
  7. 7.
    Dawson-Hughes B, Dallal G, Krall EA, Sadowski L, Sahyoun N, Tannenbaum S. A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. N Engl J Med 1990;323:878–83.Google Scholar
  8. 8.
    Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, Delmas PD, Meunier PJ. Vitamin D and calcium to prevent hip fractures in elderly women. N Engl J Med 1992;327:1637–42.Google Scholar
  9. 9.
    Reginster JY, Denis D, Bartsch V, Deroisy R, Zegels B, Franchimont P. Acute biochemical variations induced by four different calcium salts in healthy male volunteers. Osteoporosis Int 1993;3:271–5.Google Scholar
  10. 10.
    Kochersberger G, Westlund R, Lyles KW. The metabolic effects of calcium supplementation in the elderly. J Am Geriatr Soc 1991;39:192–6.Google Scholar
  11. 11.
    Zerbe GO. Randomization analysis of randomized blocks design extended to growth and response curves. Commun Stat 1979;A8:191–205.Google Scholar
  12. 12.
    Godfrey K. Statistics in practice: comparing the means of several groups. N Engl J Med 1985;313:1450–56.Google Scholar
  13. 13.
    Yang RS, Liu TK, Tsai KS. The acute metabolic effects of oral tricalcium phosphate and calcium carbonate. Calcif Tissue Int 1990;55:335–41.Google Scholar
  14. 14.
    Nicar MJ, Pak CY. Calcium bioavailability from calcium carbonate and calcium citrate. J Clin Endocrinol Metab 1985;61:391–3.Google Scholar
  15. 15.
    Ekman M, Reizenstein P, Teigen SW, Ronneberg R. Comparative absorption of calcium from carbonate tablets, lactogluconate/carbonate effervescent tablet and chloride solution. Bone 1991;12:93–7.Google Scholar
  16. 16.
    Reid IR, Schooler BA, Hannan SF, Ibbertson HK. The acute biochemical effects of four proprietary calcium preparations. Aust NZ J Med 1986;16:193–7.Google Scholar
  17. 17.
    Sheikh MS, Santa Ana CA, Nicar MJ, Schiller LR, Fordtran JS. Gastrointestinal absorption of calcium from milk and calcium salts. N Engl J Med 1987;317:532–6.Google Scholar
  18. 18.
    Woo J, Swaminathan R, Lau E, Mac Donald D, Pang CP, Nordin BEC. Biochemical effects of a single dose of oral calcium on bone metabolism in elderly Chinese women. Calcif Tissue Int 1991;48:157–60.Google Scholar
  19. 19.
    Need AG, Horowitz M, Philcox JC, Nordin BEC. Biochemical effects of a calcium supplement in osteoporotic postmenopausal women with normal absorption and malabsorption of calcium. Miner.Electrolyte Metab 1987;13:112–6.Google Scholar
  20. 20.
    Reginster JY, Denis D, Albert A, Gaspar S, Heynen G, Deroisy R, Franchimont P. Influence of the nature of calcium salts on serum calcium, phosphorus, calcitonin, growth hormone, and somatomedin C. Res Exp Med 1988;188:131–7.Google Scholar
  21. 21.
    Stellon A, Davies A, Webb A, Williams R. Microcristalline hydroxyapatite compound in prevention of bone loss in corticsteroidtreated patients with chronic active hepatitis. Postgrad Med J 1985;61:791–6.Google Scholar
  22. 22.
    Birge SJ, Peck WA, Berman M, Whedon GD. Study of calcium absorption in man: a kinetic analysis and physiologic model. J Clin Invest 1969;48:1705–13.Google Scholar
  23. 23.
    Heaney RP. Calcium supplements: practical considerations. Osteoporosis Int 1991;1:65–71.Google Scholar
  24. 24.
    Aloia JF, Vaswani A, Yeh JK, Ross PL, Flaster E, Dilmanian FA. Calcium supplementation with and without hormone replacement therapy to prevent postmenopausal bone loss. Ann Intern Med 1994;120:97–103.Google Scholar
  25. 25.
    Kochersberger G, Bales C, Lobaugh B, Lyles KW. Calcium supplementation lowers serum parathyroid hormone levels in elderly subjects. J Gerontol 1990;45:159–62.Google Scholar
  26. 26.
    Horowitz M, Morris HA, Hartley TF, Need AG, Wishart J, Ryan P, Nordin BEC. The effect of an oral calcium load on plasma ionized calcium and parathyroid hormone concentrations in osteoporotic postmenopausal women. Calcif Tissue Int 1987;40:133–6.Google Scholar
  27. 27.
    Marchandise X, Pagniez D, Ythier H, Gilquin B, Duquesnoy B, Wemeau JL. Influence of accompanying anion on intestinal radiocalcium absorption. Calcif Tissue Int 1987;40:8–11.Google Scholar
  28. 28.
    Rico H, Revilla M, Villa LF, Alvarez De Buergo M, Arribas I. Longitudinal study of the effect of calcium pidolate on bone mass in eugonadal women. Calcif Tissue Int 1994;54:477–80.Google Scholar
  29. 29.
    Heaney RP, Recker RR, Weaver CM. Absorbability of calcium sources: the limited role of solubility. Calcif Tissue Int 1990;46:300–4.Google Scholar
  30. 30.
    Buclin T, Jacquet AF, Burckhardt P. Absorption intestinale de gluconate de calcium et de complexe osseino-mineral: evaluation par des dosages conventionnels. Schweiz Med Wschr 1986;116:1780–3.Google Scholar

Copyright information

© Clinical Rheumatology 1997

Authors and Affiliations

  • R. Deroisy
    • 1
  • M. Zartarian
    • 2
  • L. Meurmans
    • 1
  • N. Nelissenne
    • 1
  • M. C. Micheletti
    • 2
  • A. Albert
    • 1
  • J. Y. Reginster
    • 3
  1. 1.From the Centre Universitaire d'Investigation du Metabolisme Osseux et du Cartilage ArticulaireUniversity of LiegeLiegeBelgium
  2. 2.Laboratoire TheramexMonaco
  3. 3.Georgetown University Medical CenterWashington DCUSA

Personalised recommendations