Vitamin D and calcium supplementation for three years in postmenopausal osteoporosis significantly alters bone mineral and organic matrix quality

• Published in: Bone (New York, N.Y.) Vol. 95; pp. 41 - 46
• Main Authors: Paschalis, E.P, Gamsjaeger, S, Hassler, N, Fahrleitner-Pammer, A, Dobnig, H, Stepan, J.J, Pavo, I, Eriksen, E.F, Klaushofer, K
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2017
• Subjects: Aged; Aged, 80 and over; Amino Acids - metabolism; Analysis of Variance; Bone Matrix - drug effects; Bone Matrix - metabolism; Bone quality; Calcification, Physiologic - drug effects; Calcium; Calcium - pharmacology; Calcium - therapeutic use; Dietary Supplements; Female; Glycosaminoglycans - metabolism; Humans; Nanoparticles - chemistry; Orthopedics; Osteoporosis, Postmenopausal - drug therapy; Osteoporosis, Postmenopausal - physiopathology; Porosity; Postmenopausal osteoporosis; Raman spectroscopy; Spectrum Analysis, Raman; Vitamin D; Vitamin D - pharmacology; Vitamin D - therapeutic use; C alcium; P ostmenopausal osteoporosis; Raman spectroscopy; V itamin D; B one quality; Bone quality; Vitamin D; Calcium; Postmenopausal osteoporosis
• ISSN: 8756-3282; 1873-2763
• DOI: 10.1016/j.bone.2016.11.002

Abstract Prospective, controlled clinical trials in postmenopausal osteoporosis typically compare effects of an active drug with placebo in addition to vitamin D and calcium supplementation in both treatment arms. While clinical benefits are documented, the effect of this supplementation in the placebo arm and in clinical practice on bone material composition properties is unknown. The purpose of the present study was to evaluate these bone quality indices (specifically mineral/matrix, nanoporosity, glycosaminoglycan content, mineral maturity/crystallinity, and pyridinoline content) in patients that either received long-term vitamin D (400 – 1200 IU) and calcium (1.0 – 1.5 g) supplementation, or did not. We have analyzed by Raman microspectroscopy the bone forming trabecular surfaces of iliac crest in pre-treatment samples of a teriparatide study and the endpoint biopsies of the control arm obtained from the HORIZON trial. In general, the mineral/matrix ratio and the glycosaminoglycan (GAG) content was higher while nanoporosity, (a surrogate for tissue water content), the mineral maturity/crystallinity (MMC) and the pyridinoline (Pyd) content was lower in patients without long-term supplementation. Moreover, all indices were significantly dependent on tissue age. In conclusion, vitamin D and calcium supplementation is associated with altered mineral and organic matrix properties.