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Dietary calcium intake and serum vitamin D are major determinants of bone mass variations in women. A longitudinal study

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Abstract

Background and aims: Bone mineral density (BMD) is one of the main determinants in the pathogenesis of fractures. However, data on factors predicting longitudinal variations in BMD are still limited and incomplete. Such data would be of great importance in order to better focus prevention strategies in both the clinical setting and at the population level. The aim of the study was to investigate the predictive value of both serological and questionnaire variables for bone mass variations in healthy women participating in a population-based longitudinal study carried out in Napoli, Italy. Methods: High completion rate (85.2%) and adequate sample size were obtained: 139 women (45 to 79 years of age) were examined at study entry and then again after two years (24±2 months) following the same protocol. They underwent medical examination, questionnaire, anthropometric measurements, blood sampling and urine collection. BMD was measured by dual energy X-ray absorptiometry (DEXA) at the lumbar spine (L1-L4) and femoral neck. Data analysis included calculation of the percent variation in BMD in the 2-year period. Longitudinal data underwent stepwise analysis for a global evaluation of mutual interactions between independent variables. Results and conclusions: Our findings indicate that dietary and serum calcium, and serum 25(OH)vitamin D are the only independent determinants of BMD variations at the lumbar and femoral level, respectively. While the pharmacological significance of calcium and vitamin D in the therapy of established osteoporosis is still controversial, the present longitudinal data evidence their role as essential nutrients in determining the natural history of BMD variations.

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References

  1. Kanis JA, and the WHO Study Group World Health Organization Study Document. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. Osteoporos Int 1994; 4: 368–81.

    Article  PubMed  CAS  Google Scholar 

  2. Raisz LG. Osteoporosis: current approaches and future prospects in diagnosis, pathogenesis. and management. J Bone Miner Metab 1999; 17: 79–89.

    Article  CAS  Google Scholar 

  3. Kanis JA. McCloskey EV. Risk factors in osteoporosis. Maturitas 1998; 30: 229–33.

    CAS  Google Scholar 

  4. Auquier P, Manuel C, Molines C. Risk factors for post-menopausal osteoporosis. Review of the literature 1990–95. Rev Epidemiol Santé Publique 1997; 45: 328–42.

    CAS  Google Scholar 

  5. Reid IR, Ames RW, Evans MC, Sharpe SJ, Gamble GD. Determinants of the rate of bone loss in normal postmenopausal women. J Clin Endocrinol Metab 1994; 79: 950–4.

    Article  PubMed  CAS  Google Scholar 

  6. Reginster JY, Deroisy R, Collette J, Albert A, Zegels B. Prediction of bone loss rate in healthy postmenopausal women. Calcif Tissue Int 1997; 60: 261–4.

    Article  PubMed  CAS  Google Scholar 

  7. Christiansen C, Riis BJ, Rodbro P. Prediction of rapid bone loss in postmenopausal women. Lancet 1987; 1: 1105–8.

    Article  PubMed  CAS  Google Scholar 

  8. Luckey MM, Wallenstein S, Lapinski R, Meier DE. A prospective study of bone loss in African American and white women; a clinical research center study. J Clin Endocrinol Metab 1996; 81: 2948–56.

    Article  PubMed  CAS  Google Scholar 

  9. Burger H, de Laet CEDH, van Daele PLA, et al. Risk factors for increased bone loss in an elderly population. The Rotterdam Study. Am J Epidemiol 1998; 147: 871–9.

    Article  CAS  Google Scholar 

  10. Jones G, Nguyen T, Sambrook P, Kelly PJ, Eisman JA. Progressive loss of bone in the femoral neck in elderly people: longitudinal findings from the Dubbo osteoporosis epidemiology study. BMJ 1994; 309: 691–5.

    Article  PubMed  CAS  Google Scholar 

  11. Dennison E, Eastell R, Fall CHD, Kellingray S, Wood PJ, Cooper C. Determinants of bone loss in elderly men and women: A prospective population-based study. Osteoporos Int 1999; 10: 384–91.

    Article  PubMed  CAS  Google Scholar 

  12. Kanis JA. The use of calcium in the management of osteoporosis. Bone 1999; 24: 279–90.

    Article  PubMed  CAS  Google Scholar 

  13. Dawson-Hughes B. Osteoporosis treatment and the calcium requirement. (Editorial). Am J Clin Nutr 1998; 67: 5–6.

    PubMed  CAS  Google Scholar 

  14. del Puente A, Heyse SP, Mandes MG, et al. Epidemiology of osteoporosis in women in Southern Italy. Aging Clin Exp Res 1998; 10: 53–8.

    Google Scholar 

  15. Maggi S, Sorenson AW, Steel K. The need for a strict methodology in dietary surveys: The experience of the WHO Osteoporosis Project. Aging Clin Exp Res 1993; 5: 23–8.

    CAS  Google Scholar 

  16. del Puente A, Postiglione A, Esposito-del Puente A, Carpinelli A, Romano M, Oriente P. Peripheral body fat has a protective role on bone mineral density in elderly women. Eur J Clin Nutr 1998; 52: 690–3.

    Article  PubMed  Google Scholar 

  17. Optimal Calcium Intake. NIH Consensus Development Panel on Optimal Calcium Intake. JAMA 1994; 272: 1942–8.

    Article  Google Scholar 

  18. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Institute of Medicine. Dietary reference intakes: calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington, DC: National Academy Press, 1997.

  19. Utiger RD. The need for more vitamin D. (Editorial). N Engl J Med 1998; 12: 828–9.

    Article  Google Scholar 

  20. Thomas MK, Lloyd-Jones DM, Thadhani RI, et al. Hypovita-minosis D in medical inpatients. N Engl J Med 1998; 338: 777–83.

    Article  PubMed  CAS  Google Scholar 

  21. Gloth FM, Gundberg CM, Hollis BW, Haddad JG Jr, Tobin JD. Vitamin D deficiency in homebound elderly persons. JAMA 1995; 274: 1683–6.

    Article  PubMed  Google Scholar 

  22. Glüer C-C, Faulkner KG, Estilo MJ, Engelke K, Rosin J, Genant HK. Quality assurance for bone densitometry research studies: concept and impact. Osteoporos Int 1993; 3: 227–35.

    Article  PubMed  Google Scholar 

  23. SAS Institute Inc. The STEPDISC Procedure. In: SAS User’s Guide: Statistics. Version 5. Cary. NC: SAS Institute Inc. 1985: 749–62.

    Google Scholar 

  24. Holick MF. McCollum Award Lecture. 1994: Vitamin D — new horizons for the 21st century. Am J Clin Nutr 1994; 60: 619–30.

    CAS  Google Scholar 

  25. Lau EM, Cooper C. The epidemiology of osteoporosis. The oriental perspective in a world context. Clin Orthop 1996; 323: 65–74.

    Google Scholar 

  26. Looker AC, Loria CM, Carroll MD, McDowell MA, Johnson CL. Calcium intakes of Mexican Americans, Cubans, Puerto Ricans, non-Hispanic whites and non-Hispanic blacks in the United States. J Am Diet Assoc 1993; 93: 1274–9.

    Article  PubMed  CAS  Google Scholar 

  27. van der Wielen RPJ, Lowik MRH, van den Berg H, et al. Serum vitamin D concentrations among elderly people in Europe. Lancet 1995; 346: 207–10.

    Article  PubMed  Google Scholar 

  28. Ripoll E, Revilla M, Hernandez ER, Arribas I, Villa LF, Rico H. New evidence that serum beta-2 microglobulin behaves as a biological marker of bone remodelling in women. Eur J Clin Invest 1996; 26: 681–5.

    Article  PubMed  CAS  Google Scholar 

  29. Riggs BL, Melton LJ. Involutional osteoporosis. N Engl J Med 1986; 314: 1676–86.

    Article  PubMed  CAS  Google Scholar 

  30. Silverberg SJ, Shane E, de la Cruz L, Segre GV, Clemens TL, Bilezikian JP. Abnormalities in parathyroid secretion and 1.25-dihydroxyvitamin D3 formation in women with osteoporosis. N Engl J Med 1989; 320: 277–81.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Rheumatology Unit, University “Federico II”, Napoli

    Antonio del Puente M.D., Assunta Carpinelli & Pasquale Oriente

  2. Hospital S. Maria della Pietà, Casoria (Napoli)

    Antonella Esposito

  3. Department of Endocrinology and Molecular and Clinical Oncology, University “Federico II”, Napoli

    Silvia Savastano

  4. Department of Biology and Cellular and Molecular Pathology “Califano”, University “Federico II”, Napoli, Italy

    Loredana Postiglione

Authors
  1. Antonio del Puente M.D.
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  2. Antonella Esposito
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  3. Silvia Savastano
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  4. Assunta Carpinelli
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  5. Loredana Postiglione
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  6. Pasquale Oriente
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Correspondence to Antonio del Puente M.D..

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del Puente, A., Esposito, A., Savastano, S. et al. Dietary calcium intake and serum vitamin D are major determinants of bone mass variations in women. A longitudinal study. Aging Clin Exp Res 14, 382–388 (2002). https://doi.org/10.1007/BF03324466

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  • DOI: https://doi.org/10.1007/BF03324466

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