Evaluation of Markers of Bone Turnover During Lactation in African-Americans: a Comparison with Caucasian Lactation

Overview

Journal J Clin Endocrinol Metab

Publisher Oxford University Press

Specialty Endocrinology

Date 2013 Jan 1

PMID 23275526

Citations 5

Authors

Raquel M Carneiro

Linda Prebehalla

Mary Beth Tedesco

Susan M Sereika

Caren M Gundberg

Andrew F Stewart

Mara J Horwitz

Affiliations

Soon will be listed here.

Abstract

Context: The African-American skeleton is resistant to PTH; whether it is also resistant to PTHrP and the hormonal milieu of lactation is unknown.

Objectives: The objective of the study was to assess bone turnover markers in African-Americans during lactation vs Caucasians.

Design And Participants: A prospective cohort study with repeated measures of markers of bone turnover in 60 African-American women (3 groups of 20: lactating, bottle feeding, and healthy controls), compared with historic Caucasian women.

Setting: The study was conducted at a university medical center.

Outcome Measures: Biochemical markers of bone turnover and calcium metabolism were measured.

Results: 25-Hydroxyvitamin D (25-OHD) and PTH were similar among all 3 African-American groups, but 25-OHD was 30%-50% lower and PTH 2-fold higher compared with Caucasians (P < .001, P < .002), with similar 1,25 dihydroxyvitamin D [1,25(OH)(2)D] values. Formation markers [amino-terminal telopeptide of procollagen-1 (P1NP) and bone-specific alkaline phosphatase (BSAP)] increased significantly (2- to 3-fold) in lactating and bottle-feeding African-American women (P1NP, P < .001; BSAP, P < .001), as did resorption [carboxy-terminal telopeptide of collagen-1 (CTX) and serum amino-terminal telopeptide of collagen 1 (NTX), both P < .001]. P1NP and BSAP were comparable in African-American and Caucasian controls, but CTX and NTX were lower in African-American vs Caucasian controls. African-American lactating mothers displayed quantitatively similar increases in markers of bone formation but slightly lower increases in markers of resorption vs Caucasians (P = .036).

Conclusions: Despite reported resistance to PTH, lactating African-American women have a significant increase in markers of bone resorption and formation in response the hormonal milieu of lactation. This response is similar to that reported in Caucasian women despite racial differences in 25-OHD and PTH. Whether this is associated with similar bone loss in African-Americans as in Caucasians during lactation is unknown and requires further study.

Citing Articles

Bone Mineral Density During and After Lactation: A Comparison of African American and Caucasian Women.

Augustine M, Boudreau R, Cauley J, Majchel D, Nagaraj N, Roe L Calcif Tissue Int. 2023; 113(4):426-436.

PMID: 37640959 PMC: 10516787. DOI: 10.1007/s00223-023-01125-9.

Hypoparathyroidism in Pregnancy and Lactation: Current Approach to Diagnosis and Management.

Ali D, Dandurand K, Khan A J Clin Med. 2021; 10(7).

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Standards of care for hypoparathyroidism in adults: a Canadian and International Consensus.

Khan A, Koch C, Van Uum S, Baillargeon J, Bollerslev J, Brandi M Eur J Endocrinol. 2018; 180(3):P1-P22.

PMID: 30540559 PMC: 6365672. DOI: 10.1530/EJE-18-0609.

Use of CTX-I and PINP as bone turnover markers: National Bone Health Alliance recommendations to standardize sample handling and patient preparation to reduce pre-analytical variability.

Szulc P, Naylor K, Hoyle N, Eastell R, Leary E Osteoporos Int. 2017; 28(9):2541-2556.

PMID: 28631236 DOI: 10.1007/s00198-017-4082-4.

OPG Treatment Prevents Bone Loss During Lactation But Does Not Affect Milk Production or Maternal Calcium Metabolism.

Ardeshirpour L, Dumitru C, Dann P, Sterpka J, VanHouten J, Kim W Endocrinology. 2015; 156(8):2762-73.

PMID: 25961842 PMC: 4511126. DOI: 10.1210/en.2015-1232.

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