Pii: So271-5317(00)00219-o Calcium Homeostasis in Primiparae and Multiparae Pregnant Women with Marginal Calcium Intakes and Response to a 7-day Calcium Supplementation Trial
نویسندگان
چکیده
Among women with adequate calcium intakes, finther increases in dietary or supplemental calcium do not alter the homeostatic response in calcium metabolism during pregnancy. Less is known about women consuming low calcium intakes and the influence of parity on calcium metabolism among women with low intakes. In this study we compared bone and renal indices of calcium homeostasis and response to a 7-day calcium supplementation trial (1000 mg/day) in non-pregnant women (n=3 1) and third-trimester pregnant women (primiparae, t&O, and multiparae, n=30) with habitual calcium intake of 400 mg/day. Markers of bone resorption (urinary hydroxyproline and D-pyridinoline) and of bone formation (activity in plasma of bone alkaline phosphatase) were substantially increased in the pregnant women consistent with increased bone turnover. Urinary hydroxyproline excretion was higher (24%) in primiparous than in multiparous pregnant women. Bone and renal indices responded to the supplementation trial in non-pregnants and pregnants with differences between primiparae and multiparae. Bone alkaline phosphatase activity increased (p<O.OS) with supplementation in all groups; D-pyridinoline did not change in non-pregnants and primiparous pregnants but decreased (p<O.Ol) in pregnant multiparae. Urinary calcium increased (p<O.O5), urinary phosphorous decreased (pcO.01) and hydroxyproline decreased (p<O.Ol) after supplementation in non-pregnants and pregnant primiparae but not in multiparae. Differences in bone and renal indices due to pregnancy were maintained after the supplementation trial in primiparae but not always in multiparae. Our results indicate that parity may accentuate the stress of pregnancy on calcium homeostasis in women with marginal calcium intakes. Follow-up long-term studies are needed to evaluate the effect of calcium supplementation and parity on bone mass in these women during pregnancy. 0 XX@ Elwv~er Science Inc
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