Skip to main content
Log in

Malabsorption of calcium in corticosteroid-induced osteoporosis

  • Clinical Investigations
  • Published:
Calcified Tissue International Aims and scope Submit manuscript

Summary

We have examined the relation between radiocalcium absorption and serum 1,25-dihydroxy-vitamin D [1,25(OH)2D3] levels in a set of 60 postmenopausal women on corticosteroid therapy (29 with and 31 without vertebral compression fractures) and compared these results with those from 31 normal postmenopausal women age-matched with the “normal” corticosteroid-treated women. Radiocalcium absorption was a function of serum 1,25(OH)2D3 in both corticosteroid-treated groups and in the set as a whole, but the impaired calcium absorption in the corticosteroid-treated patients with osteoporosis was not accounted for by their slightly reduced serum 1,25(OH)2D3 levels. This apparent resistance to the intestinal action of 1,25(OH)2D3 was quantified by a Z score which expresses, in standard deviation units, the difference between the measured calcium absorption and that predicted from the 1,25(OH)2D3 level. The Z score was significantly reduced in the osteoporotic group. Vertebral mineral density (VMD) was measured by quantitative computed tomography in 43 of the corticosteroid-treated cases and in all the normal postmenopausal women; analysis by VMD yielded similar conclusions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Kimberg DV (1969) Effects of vitamin D and steroid hormones on the active transport of calcium by the intestine. N Engl J Med 280:1396–1405

    Article  PubMed  CAS  Google Scholar 

  2. Krawitt EL (1972) The role of intestinal transport proteins in cortisone-mediated suppression of calcium transport. Biochim Biophys Acta 274:179–188

    Article  PubMed  CAS  Google Scholar 

  3. Crilly RG, Horsman A, Marshall DH, Nordin BEC (1978) Post-menopausal and corticosteroid-induced osteoporosis. Front Horm Res 5:53–75

    CAS  Google Scholar 

  4. Need AG, Philcox JC, Hartley TF, Nordin BEC (1986) Calcium metabolism and osteoporosis in corticosteroid-treated postmenopausal women. Aust NZ J Med 16:341–346

    CAS  Google Scholar 

  5. Nordin BEC, Crilly RG, Smith DA (1984) Osteoporosis. In: Nordin BEC (ed) Metabolic bone and stone disease. Churchill Livingstone, Edinburgh, pp 1–70

    Google Scholar 

  6. Crilly RG, Peacock M, Taylor GA, Nordin BEC (1982) Effect of corticosteroid therapy on plasma 1,25-dihydroxy-vitamin D levels. Clin Sci 60(Abstract):26

    Google Scholar 

  7. Nordin BEC, Wishart JM, Horowitz M, Need AG, Bridges A, Bellon M (1988) The relation between forearm and vertebral mineral density and fractures in postmenopausal women. Bone Miner 5:21–33

    Article  PubMed  CAS  Google Scholar 

  8. Taylor GA, Peacock M, Pelc B, Brown W, Holmes A (1980) Purification of plasma vitamin D metabolites for radioimmunoassay. Clin Chim Acta 108:239–246

    Article  PubMed  CAS  Google Scholar 

  9. Nordin BEC, Need AG, Hartley TF, Philcox JC, Wilcox M, Thomas DW (1989) Improved method for calculating calcium fractions in plasma: reference values and effect of menopause. Clin Chem 35:14–17

    PubMed  CAS  Google Scholar 

  10. Francis RM, Peacock M, Barkworth SA, Marshall DH (1986) A comparison of the effects of sorbitol and glucose on calcium absorption in postmenopausal women. Am J Clin Nutr 43:72–76

    PubMed  CAS  Google Scholar 

  11. Marshall DH, Nordin BEC (1981) A comparison of radioactive calcium absorption tests with net calcium absorption. Clin Sci 61:477–481

    PubMed  CAS  Google Scholar 

  12. Nordin BEC, Robertson A, Seamark RF, Bridges A, Philcox JC, Need AG, Horowitz M, Morris HA, Deam S (1985) The relation between calcium absorption, serum dehydroepiandrosterone, and vertebral mineral density in postmenopausal women. J Clin Endocrinol Metab 60:651–657

    Article  PubMed  CAS  Google Scholar 

  13. Need AG, Horowitz M, Philcox JC, Nordin BEC (1987) Biochemical effects of a calcium supplement in osteoporotic postmenopausal women with normal absorption and malabsorption of calcium. Mineral Electrolyte Metab 13:112–116

    CAS  Google Scholar 

  14. Need AG, Horowitz M, Philcox JC, Nordin BEC (1985) 1,25-dihydroxycalciferol and calcium therapy in osteoporosis with calcium malabsorption. Miner Electrolyte Metab 11:35–40

    PubMed  CAS  Google Scholar 

  15. Riggs BL, Melton JL (1986) Involutional osteoporosis. N Engl J Med 314:1676–1686

    Article  PubMed  CAS  Google Scholar 

  16. Laake H (1960) The action of corticosteroids on the renal reabsorption of calcium. Acta Endocrinol 34:60–64

    PubMed  CAS  Google Scholar 

  17. Nemere I, Norman AW (1987) The rapid, hormonally stimulated transport of calcium (transcaltachyia). J Bone Min Res 2:167–169

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Morris, H.A., Need, A.G., O'Loughlin, P.D. et al. Malabsorption of calcium in corticosteroid-induced osteoporosis. Calcif Tissue Int 46, 305–308 (1990). https://doi.org/10.1007/BF02563820

Download citation

  • Received:

  • Revised:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02563820

Key words

Navigation