Abstract
Calcium (Ca) supplements have positive effects in growing children, reduce bone loss in late-postmenopausal women with a low calcium diet and, in association with vitamin D3 supplements, may reduce non-vertebral fracture rates in elderly women. However, for many formulated pharmaceutical products their relative beneficial effects have not been conclusively established. We have compared the acute (6 h) metabolic responses following oral administration of two preparations of calcium gluconolactate and carbonate (CG and CG′), tricalcium phosphate (TCP) and calcium citrate (CC), given on separate occasions in each of 10 healthy young male volunteers. The subjects fasted overnight for 12 h and continued to fast during the experimental procedure. A 1000 mg dose of each Ca salt was ingested at weekly intervals. Blood was drawn after 30, 60, 90, 120, 180, 240, 300 and 360 min for measurement of serum Ca, phosphorus (P), parathyroid hormone (PTH) and whole plasma calcitonin (iCT). All Ca supplements induced significant (+6.4% to +8.1%;p<0.01) increases in Ca and significant suppression of PTH (−37.4% to −57.4%;p<0.01). Comparison of response curves revealed significantly (p<0.01) more marked Ca increase and PTH suppression with CC than with the other three Ca salts. CG' and CC induced marginal decreases in serum P and the overall curve of P variations was different for TCP compared with CG, CG′ and CC. No significant variation of iCT was recorded during the test. We conclude that all four Ca supplements seem to be absorbed to some extent since they induce significant biochemical variations that may lead to a reduction in bone turnover and that CC induces a significantly larger increase in serum Ca and a significantly greater suppression of serum PTH.
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References
Nordin BEC, Heaney RP. Calcium supplementation of the diet: justified by present evidence. BMJ 1990;300:1056–60.
Kanis J, Passmore R. Calcium supplementation of the diet: not justified by present evidence. BMJ 1989;298:137–40.
Heaney RP, Weaver CM, Recker RR. Calcium absorbability from spinach. Am J Clin Nutr 1988;47:707–9.
Heaney RP, Recker RR, Weaver CM. Absorbability of calcium sources: the limited role of solubility. Calcif Tissue Int 1990;46:300–4.
Schaafsma G. The scientific basis of recommended dietary allowances for calcium. J Intern Med 1992;231:187–94.
Nagant de Deuxchaisnes C, Devogelaer JP. Increase in the incidence of hip fractures and of the ratio of trochanteric to cervical hip fractures in Belgium. Calcif Tissue Int, 1988;42:201–3.
Reginster-Haneuse G, Gosset C. L'alimentation des Beiges. Med Nutr 1988;24:143–50.
Caroll MD, Abraham S, Dresser CM. Dietary intake source data: United States 1976–1980. Hyattsville, Md.: National Center for Health Statistics, 1983 (DHHS publication no. (PHS) 83-1681).
Food and nutrient intakes of individuals in 1 day in the United States, spring 1977. Preliminary report no. 2 of the Nationwide Food Consumption Survey 1977–1978. Washington, DC: Department of Agriculture, 1980.
Johnston CC, Miller JZ, Slemenda CW, et al. Calcium supplementation and increases in bone mineral density in children. N Engl J Med 1992;327:82–7.
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.
Chapuy MC, Arlot ME, Duboeuf F, et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med 1992;327:1637–42.
Nicar MJ, Pak CYC. Calcium bioavailability from calcium carbonate and calcium citrate. J Clin Endocrinol Metab 1985;61:391–3.
Charles P. Calcium absorption and calcium bioavailability. J Intern Med 1992;231:161–8.
Kochersberger G, Westlund R, Lyles KW. The metabolic effects of calcium supplementation in the elderly. J Am Geriatr Soc 1991;39:192–6.
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.
Heaney RP. Calcium supplements: practical considerations. Osteoporosis Int 1991;1:65–71.
Heaney RP, Smith KT, Recker RR, Hinders SM. Meal effects on calcium absorption. Am J Clin Nutr 1989;49:372–6.
Zerbe GO. Randomization analysis of the completely randomized design extended to growth and response curves. J Am Stat Assoc 1979;74:215–21.
Woo J, Swaminathan R, Lau E, Macdonald D, Pang CP, Nordin BEC. Biochemical effects of a single oral dose of calcium on bone metabolism in elderly Chinese women. Calcif Tissue Int 1991;48:157–60.
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.
Shires R, Kessler GM. The absorption of tricalcium phosphate and its acute metabolic effects. Calcif Tissue Int. 1990;47:142–4.
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.
Pak CYC, Avioli LV. Factors affecting absorbability of calcium from calcium salts and food. Calcif Tissue Int 1988;43:55–60.
Recker RR. Calcium absorption and achlorhydria. N Engl J Med 1985;313:70–3.
Body JJ, Heath H III. Estimates of circulating monomeric calcitonin: physiological studies in normal and thyroidectomized man. J Clin Endocrinol Metab 1983;57:897–903.
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Reginster, J.Y., Denis, D., Bartsch, V. et al. Acute biochemical variations induced by four different calcium salts in healthy male volunteers. Osteoporosis Int 3, 271–275 (1993). https://doi.org/10.1007/BF01623832
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DOI: https://doi.org/10.1007/BF01623832