Acute Suppression of Bone Turnover With Calcium Infusion in Persons With Spinal Cord Injury

J Spinal Cord Med, 2009 · DOI: · Published: August 1, 2009

Spinal Cord Injury Nutrition & Dietetics Musculoskeletal Medicine

Simple Explanation

People with spinal cord injury (SCI) often experience bone loss, potentially increasing fracture risk. This study investigates whether a calcium infusion could reduce bone turnover in individuals with chronic SCI who have low vitamin D levels or elevated parathyroid hormone (PTH). The study involved administering a calcium gluconate infusion to eight men with chronic SCI. Blood samples were taken to measure calcium, creatinine, N-telopeptide (NTx), and PTH levels. NTx is a marker of osteoclastic activity, indicating bone breakdown. The results showed that calcium infusion led to a decrease in serum NTx concentrations, suggesting reduced bone turnover. This indicates that maintaining adequate calcium levels might help preserve bone integrity in individuals with SCI.

Study Duration

Not specified

Participants

Eight men with chronic SCI

Evidence Level

Case series

Key Findings

1
Baseline serum 25-hydroxyvitamin D level was 14.5 ± 3.5 ng/mL, indicating relatively low vitamin D levels in the participants.
2
PTH concentration was suppressed after calcium infusion, indicating a reduction in secondary hyperparathyroidism.
3
Serum NTx concentration was reduced by 38 ± 16% at 4 hours and 38 ± 22% at 6 hours after the calcium infusion, suggesting a decrease in bone collagen catabolism.

Research Summary

This study examined the effect of acute calcium infusion on bone turnover in men with chronic SCI, some of whom had low vitamin D and/or elevated PTH levels. The researchers hypothesized that calcium infusion would suppress bone turnover. The results demonstrated that calcium infusion significantly suppressed PTH and NTx levels, suggesting reduced bone turnover. The study indicates that maintaining adequate calcium and vitamin D levels might be a potential strategy to mitigate bone loss in individuals with SCI. The authors conclude that evaluating and addressing treatable causes of heightened bone turnover, such as vitamin D deficiency, is crucial for people with SCI to minimize the risk of fractures over their lifetime.

Practical Implications

Clinical Monitoring

Regularly assess vitamin D and PTH levels in individuals with SCI to identify and address deficiencies.

Dietary Supplementation

Consider calcium and vitamin D supplementation as a cost-effective therapeutic approach to reduce fracture risk in paralyzed individuals.

Further Research

Investigate the long-term effects of oral calcium and vitamin D supplementation on bone turnover and bone mineral density in individuals with SCI.

Study Limitations

1
Dietary intakes of vitamin D and calcium were not obtained.
2
The study did not evaluate the degree of NTx suppression with more physiologic calcium infusion or oral supplementation.
3
The long-term effects of increased serum calcium concentration on bone turnover and density were not addressed.

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