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Pregnancy-related change in pQCT and bone biochemistry in a population with a habitually low calcium intake

Pregnancy-related change in pQCT and bone biochemistry in a population with a habitually low calcium intake
Pregnancy-related change in pQCT and bone biochemistry in a population with a habitually low calcium intake
In pregnancy, changes in maternal calcium (Ca) economy occur to satisfy fetal Ca demand. It is unclear whether maternal mineral reserves facilitate these requirements and no data exist from sub-Saharan Africa. The aim was to determine skeletal changes with peripheral quantitative computed tomography (pQCT) and bone biochemistry between early second and third trimesters. Pregnant rural Gambians aged 18 to 45 years (n = 467) participating in a trial of antenatal nutritional supplements (ISRCTN49285450) had pQCT scans and blood collections at mean (SD) 14 (3) and 31 (1) weeks' gestation. Outcomes were pQCT: radius/tibia 4% total volumetric bone mineral density (vBMD), trabecular vBMD, total cross-sectional area (CSA), 33%/38% radius/tibia cortical vBMD, bone mineral content (BMC), total CSA; biochemistry: collagen type 1 cross-linked β-C-telopeptide (β-CTX), type 1 procollagen N-terminal (P1NP), parathyroid hormone (PTH), and 1,25(OH)2 D. Independent t tests tested whether pooled or within-group changes differed from 0. Multiple regression was performed adjusting for age. Data for change are expressed as mean (confidence interval [CI] 2.5, 97.5%). Radius trabecular vBMD, cortical vBMD, and BMC increased by 1.15 (0.55, 1.75)%, 0.41 (0.24, 0.58)%, and 0.47 (0.25, 0.69)%. Tibia total and trabecular vBMD increased by 0.34 (0.15, 0.54)% and 0.46 (0.17, 0.74)%, while tibia cortical vBMD, BMC, and cortical CSA increased by 0.35 (0.26, 0.44)%, 0.55 (0.41, 0.68)% and 0.20 (0.09, 0.31)%, respectively. CTX, PTH, and 1,25(OH)2 D increased by 23.0 (15.09, 29.29)%, 13.2 (8.44, 19.34)%, and 21.0 (17.67, 24.29)%, while P1NP decreased by 32.4 (-37.19, -28.17)%. No evidence of mobilization was observed in the peripheral skeleton. Resorption, although higher in late versus early gestation, was lower throughout pregnancy compared with non-pregnant non-lactating (NPNL) in the same community. Formation was lower in late pregnancy than in early, and below NPNL levels. This suggests a shift in the ratio of resorption to formation. Despite some evidence of change in bone metabolism, in this population, with habitually low Ca intakes, the peripheral skeleton was not mobilized as a Ca source for the fetus.
0884-0431
1269-1280
Breasail, Micheal O.
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Ward, Kate
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Schoenbuchner, Simon M.
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Ceesay, Mustapha
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Mendy, Michael B.
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Jarjou, Landing M.
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Moore, Sophie E.
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Prentice, Ann
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Breasail, Micheal O.
91913ba1-a694-4365-80f0-dc253cc025c2
Ward, Kate
39bd4db1-c948-4e32-930e-7bec8deb54c7
Schoenbuchner, Simon M.
b85a6074-51c4-4448-a72b-c0bbef04fe66
Ceesay, Mustapha
0754d731-b8d2-4938-97f2-ca1dd7791ec0
Mendy, Michael B.
b29a7fee-add2-4411-a33a-d551858bf823
Jarjou, Landing M.
ca2935b3-3c0d-4541-bff7-afd191cf502b
Moore, Sophie E.
bea65f65-3f11-45cd-96d2-c088a18ccc55
Prentice, Ann
675810ad-8022-453c-b3a3-8afff0e1a920

Breasail, Micheal O., Ward, Kate, Schoenbuchner, Simon M., Ceesay, Mustapha, Mendy, Michael B., Jarjou, Landing M., Moore, Sophie E. and Prentice, Ann (2021) Pregnancy-related change in pQCT and bone biochemistry in a population with a habitually low calcium intake. Journal of Bone and Mineral Research, 1269-1280. (doi:10.1002/jbmr.4295).

Record type: Article

Abstract

In pregnancy, changes in maternal calcium (Ca) economy occur to satisfy fetal Ca demand. It is unclear whether maternal mineral reserves facilitate these requirements and no data exist from sub-Saharan Africa. The aim was to determine skeletal changes with peripheral quantitative computed tomography (pQCT) and bone biochemistry between early second and third trimesters. Pregnant rural Gambians aged 18 to 45 years (n = 467) participating in a trial of antenatal nutritional supplements (ISRCTN49285450) had pQCT scans and blood collections at mean (SD) 14 (3) and 31 (1) weeks' gestation. Outcomes were pQCT: radius/tibia 4% total volumetric bone mineral density (vBMD), trabecular vBMD, total cross-sectional area (CSA), 33%/38% radius/tibia cortical vBMD, bone mineral content (BMC), total CSA; biochemistry: collagen type 1 cross-linked β-C-telopeptide (β-CTX), type 1 procollagen N-terminal (P1NP), parathyroid hormone (PTH), and 1,25(OH)2 D. Independent t tests tested whether pooled or within-group changes differed from 0. Multiple regression was performed adjusting for age. Data for change are expressed as mean (confidence interval [CI] 2.5, 97.5%). Radius trabecular vBMD, cortical vBMD, and BMC increased by 1.15 (0.55, 1.75)%, 0.41 (0.24, 0.58)%, and 0.47 (0.25, 0.69)%. Tibia total and trabecular vBMD increased by 0.34 (0.15, 0.54)% and 0.46 (0.17, 0.74)%, while tibia cortical vBMD, BMC, and cortical CSA increased by 0.35 (0.26, 0.44)%, 0.55 (0.41, 0.68)% and 0.20 (0.09, 0.31)%, respectively. CTX, PTH, and 1,25(OH)2 D increased by 23.0 (15.09, 29.29)%, 13.2 (8.44, 19.34)%, and 21.0 (17.67, 24.29)%, while P1NP decreased by 32.4 (-37.19, -28.17)%. No evidence of mobilization was observed in the peripheral skeleton. Resorption, although higher in late versus early gestation, was lower throughout pregnancy compared with non-pregnant non-lactating (NPNL) in the same community. Formation was lower in late pregnancy than in early, and below NPNL levels. This suggests a shift in the ratio of resorption to formation. Despite some evidence of change in bone metabolism, in this population, with habitually low Ca intakes, the peripheral skeleton was not mobilized as a Ca source for the fetus.

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Pregnancy-related change in pQCT and bone biochemistry 2021.03.13 - Accepted Manuscript
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Accepted/In Press date: 16 March 2021
e-pub ahead of print date: 30 March 2021
Published date: 19 July 2021

Identifiers

Local EPrints ID: 447960
URI: http://eprints.soton.ac.uk/id/eprint/447960
ISSN: 0884-0431
PURE UUID: a827f5e7-ea38-44c5-84c0-953cf5b63cbb
ORCID for Kate Ward: ORCID iD orcid.org/0000-0001-7034-6750

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Date deposited: 29 Mar 2021 16:30
Last modified: 17 Mar 2024 03:40

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Contributors

Author: Micheal O. Breasail
Author: Kate Ward ORCID iD
Author: Simon M. Schoenbuchner
Author: Mustapha Ceesay
Author: Michael B. Mendy
Author: Landing M. Jarjou
Author: Sophie E. Moore
Author: Ann Prentice

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