Evaluation of Markers of Bone Turnover During Lactation in African-Americans: A Comparison With Caucasian Lactation (original) (raw)

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1The University of Fortaleza School of Medicine (R.M.C.), Fortaleza, Ceará, Brazil

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2The Division of Endocrinology and Metabolism (L.P., M.B.T., A.F.S., M.J.H.), The University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213

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2The Division of Endocrinology and Metabolism (L.P., M.B.T., A.F.S., M.J.H.), The University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213

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3The University of Pittsburgh School of Nursing and Graduate School of Public Health (S.M.S.), Pittsburgh, Pennsylvania 15261

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4The Department of Orthopedics (C.M.G.), Yale University of Medicine, New Haven, Connecticut 06520

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2The Division of Endocrinology and Metabolism (L.P., M.B.T., A.F.S., M.J.H.), The University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213

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2The Division of Endocrinology and Metabolism (L.P., M.B.T., A.F.S., M.J.H.), The University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213

*Address all correspondence and requests for reprints to: Mara J. Horwitz, MD, Division of Endocrinology, University of Pittsburgh School of Medicine, NW 810, University of Pittsburgh Medical Center Montefiore, 3459 Fifth Avenue, Pittsburgh, Pennsylvania 15213.

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Accepted:

12 November 2012

Published:

01 February 2013

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Raquel M. Carneiro, Linda Prebehalla, Mary Beth Tedesco, Susan M. Sereika, Caren M. Gundberg, Andrew F. Stewart, Mara J. Horwitz, Evaluation of Markers of Bone Turnover During Lactation in African-Americans: A Comparison With Caucasian Lactation, The Journal of Clinical Endocrinology & Metabolism, Volume 98, Issue 2, 1 February 2013, Pages 523–532, https://doi.org/10.1210/jc.2012-2118
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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)2D] 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.

Copyright © 2013 by The Endocrine Society

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