ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2015
Calcium gluconate supplementation is effective to balance calcium homeostasis in patients with gastrectomy.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 39 citations in OpenAlex.
- SECONDARY HYPERPARATHYROIDISM AFTER BARIATRIC SURGERY: TREATMENT IS WITH CALCIUM CARBONATE OR CALCIUM CITRATE?Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2015Trial
- Biopsies from patients with sacral insufficiency fracture are characterized by low bone matrix mineralization and high turnover.JBMR plus · 2024Article
- International Delphi consensus guidelines for follow-up after prophylactic total gastrectomy: the Life after Prophylactic Total Gastrectomy (LAP-TG) study.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2022Article
- Hypercalciuria switches CaGenes & diseases · 2022Article
- Utility of monthly minodronate for osteoporosis after gastrectomy: Prospective multicenter randomized controlled trials.Annals of gastroenterological surgery · 2021Article
- Proton Pump Inhibitors and Fractures in Adults: A Critical Appraisal and Review of the Literature.International journal of endocrinology · 2021Review
- Supplement With Calcium or Alendronate Suppresses Osteopenia Due to Long Term Rabeprazole Treatment in Female Mice: Influence on Bone TRAP and Osteopontin Levels.Frontiers in pharmacology · 2020Article
- Adverse Effects of Proton Pump Inhibitors-Evidence and Plausibility.International journal of molecular sciences · 2019Review
- Mutational analysis uncovers monogenic bone disorders in women with pregnancy-associated osteoporosis: three novel mutations in LRP5, COL1A1, and COL1A2.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018Article
- Bone health in long-term gastric cancer survivors: A prospective study of high-dose vitamin D supplementation using an easy administration scheme.Journal of bone and mineral metabolism · 2018Observational
- [Morphological characteristics of osteopetrosis].Der Pathologe · 2018Review
- A retrospective analysis of bone mineral status in patients requiring spinal surgery.BMC musculoskeletal disorders · 2018Article
- Micronutrient deficiencies in patients with chronic atrophic autoimmune gastritis: A review.World journal of gastroenterology · 2017Review
- Bone biology in the elderly: clinical importance for fracture treatment.Innovative surgical sciences · 2016Review
- Hypochlorhydria-induced calcium malabsorption does not affect fracture healing but increases post-traumatic bone loss in the intact skeleton.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2016Article
- [Calcium and vitamin D in bone metabolism: Clinical importance for fracture treatment].Der Unfallchirurg · 2015Review
- [Vitamin D metabolism of the bone].Der Orthopade · 2015Article
- [Calcium and vitamin D in osteology].Zeitschrift fur Rheumatologie · 2015Article
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
unlabelledWe demonstrate histological evidence for hyperparathyroidism in patients with gastrectomy. This is, at least in part, explained by impaired calcium absorption, resulting in mineralization defects and secondary hyperparathyroidism. Additionally, we demonstrate improved bone mineralization in patients with gastrectomy after gluconate therapy and showed the effectiveness of calcium gluconate over carbonate to balance impaired calcium hemostasis in mice.
introductionGastrectomy and hypochlorhydria due to long-term proton pump inhibitor therapy are associated with increased fracture risk because of intestinal calcium malabsorption. Hence, our objectives were to histologically investigate bone metabolism in patients with gastrectomy and to analyze the impact of calcium gluconate supplementation on skeletal integrity in the setting of impaired gastric acidification.
methodsUndecalcified bone biopsies of 26 gastrectomized individuals were histologically analyzed. In the clinical setting, we retrospectively identified 5 gastrectomized patients with sufficient vitamin D level, who were additionally supplemented with calcium gluconate and had a real bone mineral density (aBMD) follow-up assessments. A mouse model of achlorhydria (ATP4b-/-) was used to compare the effect of calcium gluconate and calcium carbonate supplementation on bone metabolism.
resultsBiopsies from gastrectomized individuals showed significantly increased osteoid, osteoclast, and osteoblast indices and fibroosteoclasia (p < 0.05) as well as impaired calcium distribution in mineralized bone matrix compared to healthy controls. Five gastrectomized patients with sufficient vitamin D level demonstrated a significant increase in aBMD after a treatment with calcium gluconate alone for at least 6 months (p < 0.05). Calcium gluconate was superior to calcium carbonate in maintaining calcium metabolism in a mouse model of achlorhydria.
conclusionGastrectomy is associated with severe osteomalacia, marrow fibrosis, and impaired calcium distribution within the mineralized matrix. We show that calcium gluconate supplementation can increase bone mineral density in gastrectomized individuals and performs superior to calcium carbonate in restoring calcium/skeletal homoeostasis in a mouse model of achlorhydria.
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