Serum concentrations of vitamin D metabolites (chromatography) and bone mineral status (125I absorptiometry) were examined in a group of Aleutian Islanders age 40-75 from St Paul Island, Alaska. Based on 25-(OH)D (16.6 ng/ml) vitamin D status appeared adequate. However, high concentrations of 1,25-(OH)2D (44.3 pg/ml) and very low concentrations of 24,25-(OH)2D3 (0.6 ng/ml) were found. Among females, low bone mineral levels were associated with high concentrations of 1,25-(OH)2D. A low calcium intake in these Aleutians may be responsible for high concentrations of 1,25-(OH)2D and resorption of calcium from bone.
From: Fortuine, Robert et al. 1993. The Health of the Inuit of North America: A Bibliography from the Earliest Times through 1990. University of Alaska Anchorage. Citation number 973.
In 575 55-year-old residents of Malmö, Sweden, the authors studied the interrelationships between back pain and bone mineral content, degree of kyphosis and lordosis, height, and weight, and in women also the age of menarche and menopause, and number of childbirths. Men with back pain tended to be heavier than those without back pain. Back pain was not related to body height nor to degree of kyphosis or lordosis. In women, a positive correlation was found between the degree of kyphosis and lordosis and body weight. Body height in women also was correlated to degree of kyphosis, but not to the degree of lordosis. In men, the authors found no such relationships. Bone mineral content was not related to the occurrence of back pain but to body height and weight in men and in women. Back pain in women was not related to the age at menarche or menopause, nor to the number of children to whom they had given birth.
Patterns of bone loss in the axial skeleton have been studied in a sample of Swedish women participating in a longitudinal population study which was started in 1968. In 1976, the mineral content of the lumbar spine (predominantly trabecular bone) was measured in vivo in 130 women by dual photon absorptiometry. Premenopausal or recently postmenopausal women were compared with women of identical age who had been postmenopausal for a long time. The first group was found to have significantly higher values of bone mineral content. Five years later, in 1981, the same women were re-examined with identical techniques. A slight decrease in bone mineral content with age was found in postmenopausal women. The findings were mostly in agreement with those of the first cross-sectional study, with bigger differences in bone mineral content between women of different menstrual status than between women of different age. In addition, the lower values in women with early menopause compared to those with late menopause remained in spite of increasing age.
The water chemistry of 20 municipal water treatment plants in southern Sweden, representing various bedrock situations, and water qualities, were investigated. Four water samples, raw and treated, were collected from each plant and analyzed by predominantly ICP-OES and ICP-MS at four occasions from June to December, 2001. The concentrations of Ca, Mg, K, Na, HCO(3) and a number of micronutrients, varied considerably in treated waters from the studied plants (ranges; Ca: 9.1-53.7 mg L(-1), Mg: 1.4-10.9 mg L(-1), K: 1.1-4.8 mg L(-1), Na; 5.4-75.6 mg L(-1), HCO(3): 27-217 mg L(-1)). The elimination of Fe and Mn from raw water was efficient in all treatments investigated, giving concentrations in treated waters below the detection limits at some plants. Softening filters gave waters with Ca-concentrations comparable to the softest waters in this study. Adjustment of pH by use of chemicals like lye, soda or lime, modified the consumer water composition significantly, besides raising the pH. It was estimated that drinking water contributed to approximately 2.2-13% of the daily Ca uptake, if the gastrointestinal uptake efficiency from food and water was estimated to be around 50%. The corresponding figures for Mg was 1.0-7% and for F 0-59%. None of the studied elements showed any significant time trends in raw or treated waters during the follow-up period. The concentrations of potentially toxic metals such as Al, Pb and U were low and did not indicate risks for adverse health effects (ranges; Al: 0.5-2.3 microg L(-1), Pb: 0-0.3 microg L(-1), U: 0.2.5 microg L(-1)).
Patients treated with conventional hemodialysis (HD) develop disorders of mineral metabolism that are associated with increased morbidity and mortality. More frequent and longer HD has been associated with improvement in hyperphosphatemia that may improve outcomes.
Systematic review and meta-analysis to inform the clinical practice guideline on intensive dialysis for the Canadian Society of Nephrology.
Adult patients receiving outpatient long (=5.5 hours/session; 3-4 times per week) or long-frequent (=5.5 hours/session, =5 sessions per week) HD.
We included clinical trials, cohort studies, case series, case reports, and systematic reviews.
Fragility fracture, peripheral arterial and coronary artery disease, calcific uremic arteriolopathy, mortality, intradialytic hypotension, parathyroidectomy, extraosseous calcification, markers of mineral metabolism, diet liberalization, phosphate-binder use, and muscle mass.
21 studies were identified: 2 randomized controlled trials, 2 reanalyses of data from the randomized controlled trials, and 17 observational studies. Dialysate calcium concentration =1.5 mmol/L for patients treated with long and long-frequent HD prevents an increase in parathyroid hormone levels and a decline in bone mineral density without causing harm. Both long and long-frequent HD were associated with a reduction in serum phosphate level of 0.42-0.45 mmol/L and a reduction in phosphate-binder use. There was no direct evidence to support the use of a dialysate phosphate additive.
Almost all the available information is related to changes in laboratory values and surrogate outcomes.
Dialysate calcium concentration =1.5 mmol/L for most patients treated with long and long-frequent dialysis prevents an increase in parathyroid hormone levels and decline in bone mineral density without increased risk of calcification. It seems prudent to add phosphate to the dialysate for patients with a low predialysis phosphate level or very low postdialysis phosphate level until more evidence becomes available.
Comment In: Am J Kidney Dis. 2013 Nov;62(5):1018-924157274
Comment In: Am J Kidney Dis. 2013 Nov;62(5):1019-2024157276
A protracted consumption of little-mineralized water, as well as deficiency of calcium salts in the food result in a change of a number of indicators on the level of the water and salt and mineral metabolism in the organism of polar explorers, this manifesting itself in a reduced content of calcium salts in the blood and urine, in a change of the bleeding and blood coagulation time, of diuresis and water intake, acid-base equilibrium and of specific weight of the urine. All these changes occur also against the background of an insufficient supply of a complex set of vitamins into the organism, this being due to the fact that the foodstuffs are delivered to the station but once a year, stored for a long time and then subjected to sulinary treatment. An additional active vitaminzation with increased doses of vitamins and mineralization of the food right from the first days of sojourn at the station made it possible to eliminate all the undesirable consequences and to narrow the range of the acclimatization shifts in the body of polar explorers exposed to extremely unfavourable conditions prevailing in the Antarctic.