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

Mícheál Ó Breasail*, Kate A. Ward, Simon M. Schoenbuchner, Mustapha Ceesay, Michael Mendy, Landing M Jarjou, Sophie E. Moore, Ann Prentice

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

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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)2D. 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)2D 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. © 2021 crown copyright . Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR). The article published with the permission of the Controller of HMSO and the Queen's Printer of Scotland
Original languageEnglish
Number of pages12
JournalJournal of Bone and Mineral Research
Volume36
Issue number7
Early online date30 Mar 2021
DOIs
Publication statusPublished - 7 May 2021

Keywords

  • ANALYSIS/QUANTIFICATION OF BONE
  • BONE QCT/μCT
  • EPIDEMIOLOGY
  • GENERAL POPULATION STUDIES
  • AGING
  • BONE MODELING AND REMODELING
  • BIOCHEMICAL MARKERS OF BONE TURNOVER

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