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The remodeling transient and the calcium economy

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Abstract

Summary

The remodeling transient describes a change in bone mass that lasts one remodeling cycle following an intervention that disturbs the calcium economy. We demonstrated the transient in a study of the response of bone density to calcium/vitamin D3 supplementation and show the hazards of misinterpretation if the transient is not considered.

Introduction

The remodeling transient describes a change in bone mass that lasts for one remodeling cycle following an intervention that disturbs the calcium economy.

Methods

We report an intervention with calcium and vitamin D supplementation in 208 postmenopausal African-American women where the remodeling transient was considered a priori in the study design. Both groups (calcium alone vs. calcium + 20 μg (800 IU) vitamin D3) were ensured a calcium intake in excess of 1200 mg/day.

Results

There were no differences between the two groups in changes in BMD over time. These BMD changes were therefore interpreted to reflect increased calcium intake in both groups but not any influence of vitamin D. A transient increase in bone mineral density was observed during the first year of study, followed by a decline. The remodeling period was estimated at about 9 months, which is similar to histomorphometric estimates.

Conclusion

It is problematic to draw conclusions concerning interventions that influence the calcium economy without considering the remodeling transient in study design. Studies of agents that effect bone remodeling must be carried out for at least two remodeling cycles and appropriate techniques must be used in data analysis.

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Acknowledgments

We would like to thank Sharon Sprintz, RT, Jane Greensher, R.N., and Marty Feuerman for their expertise and Lynn Maier for preparation of the manuscript.

J.F.A. was the principal investigator for the study, S.A.T. was the co-investigator and was responsible for medical supervision of the study participants; S.P. is the study statistician, performed statistical analyses, analyzed data; J.Y. is laboratory drector and was responsible for biochemical assays in the study.

Funding

This research was funded by National Institute of Aging (RO1 AG15325), NIH.

Conflicts of interest

None

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Authors and Affiliations

  1. Bone Mineral Research Center, Winthrop University Hospital, Mineola, NY, USA

    J. F. Aloia, S. Arunabh-Talwar, S. Pollack & J. K. Yeh

  2. Winthrop University Hospital, 222 Station Plaza North - Suite 510, Mineola, NY, 11501, USA

    J. F. Aloia

Authors
  1. J. F. Aloia
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  2. S. Arunabh-Talwar
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  3. S. Pollack
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  4. J. K. Yeh
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Correspondence to J. F. Aloia.

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Aloia, J.F., Arunabh-Talwar, S., Pollack, S. et al. The remodeling transient and the calcium economy. Osteoporos Int 19, 1001–1009 (2008). https://doi.org/10.1007/s00198-007-0542-6

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  • DOI: https://doi.org/10.1007/s00198-007-0542-6

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