Tag Archives: human

GH Improves Bone in GH Deficiency – 4 Year Study

Abstract

Effect of long-term treatment with GH on bone metabolism, bone mineral density and bone elasticity in GH-deficient adults.

Adults with GH deficiency (GHD) commonly have subnormal bone mineral density (BMD), and have been reported to have an increased risk of fractures. It has been suggested that GH replacement therapy may have beneficial effects on bone in such patients. The aim of this study was to investigate the effects of long-term GH replacement therapy on bone metabolism, BMD and bone elasticity in adults with GHD.
At the start of the study, 20 adults with GHD were randomized to receive either GH, 0.25 IU/kg/week (the ‘GH group’) or placebo (the ‘placebo group’). After 6 months, patients in the placebo group were switched to GH therapy, and all patients received GH for a further 42 months.
Of the 20 patients included in the study, 11 were male and nine were female. Mean age at the start of the study was 42.5 +/- 10.1 years. All patients had been GH-deficient for at least 2 years before the start of the study.
Rates of bone resorption and formation were assessed by measuring serum levels of type I collagen carboxyterminal cross-linked telopeptide (ICTP) and carboxyterminal propeptide of type I procollagen (PICP), respectively. BMD was measured at the lumbar spine by dual-photon absorptiometry (DPA) and at the non-dominant forearm by single-photon absorptiometry (SPA). Bone elasticity was assessed by measuring apparent phalangeal ultrasound transmission velocity (APU).
The main results in the GH group were as follows. The rate of bone resorption increased significantly during the first 6 months of treatment and remained significantly elevated above its baseline level thereafter. The rate of bone formation also rose during the first 6 months of treatment and remained elevated thereafter, but was significantly higher than at baseline only after 24 months of treatment. At both sites measured, BMD was subnormal at baseline, decreased during the first 6 months of treatment, and increased progressively for the rest of the study, eventually rising well above its baseline level. Bone elasticity decreased during the first 6 months of treatment, but had returned to its baseline level after 24 months.
Our results support previous findings that BMD is subnormal in adults with GHD, that GH replacement therapy can stimulate bone turnover in such adults and that, in the long term, such stimulation results in a significant increase in BMD. In addition they show, for the first time, that BMD may continue to rise even after GH replacement therapy has been administered for 4 years, and indicate that bone elasticity is not adversely affected by long-term GH therapy.

Kann P, Piepkorn B, Schehler B, Andreas J…
Clin. Endocrinol. (Oxf) May 1998
PMID: 9666867

Low-Dose Creatine Reduces Bone Resorption in Men

Abstract

Low-dose creatine combined with protein during resistance training in older men.

To determine whether low-dose creatine and protein supplementation during resistance training (RT; 3 d x wk(-1); 10 wk) in older men (59-77 yr) is effective for improving strength and muscle mass without producing potentially cytotoxic metabolites (formaldehyde).
Older men were randomized (double-blind) to receive 0.1 g x kg(-1) creatine + 0.3 g x kg(-1) protein (CP; n = 10), creatine (C; n = 13), or placebo (PLA; n = 12) on training days. Measurements before and after RT included lean tissue mass (air-displacement plethysmography), muscle thickness (ultrasound) of elbow, knee, and ankle flexors and extensors, leg and bench press strength, and urinary indicators of cytotoxicity (formaldehyde), myofibrillar protein degradation [3-methylhistidine (3-MH)],and bone resorption [cross-linked N-telopeptides of type I collagen (NTx)].
Subjects in C and CP groups combined experienced greater increases in body mass and total muscle thickness than PLA (P < 0.05). Subjects who received CP increased lean tissue mass (+5.6%) more than C (+2.2%) or PLA (+1.0%; P < 0.05) and increased bench press strength (+25%) to a greater extent than C and PLA combined (+12.5%; P < 0.05). CP and C did not differ from PLA for changes in formaldehyde production (+24% each). Subjects receiving creatine (C and CP) experienced a decrease in 3-MH by 40% compared with an increase of 29% for PLA (P < 0.05) and a reduction in NTx (-27%) versus PLA (+13%; P = 0.05).
Low-dose creatine combined with protein supplementation increases lean tissue mass and results in a greater relative increase in bench press but not leg press strength. Low-dose creatine reduces muscle protein degradation and bone resorption without increasing formaldehyde production.

Candow DG, Little JP, Chilibeck PD, Abeysekara S…
Med Sci Sports Exerc Sep 2008
PMID: 18685526

Creatine Ups Bone Density in Men

Abstract

Creatine monohydrate and resistance training increase bone mineral content and density in older men.

Our purpose was to determine the effects of creatine supplementation combined with resistance training on bone mineral content and density in older men. Twenty-nine older men (age 71 y) were randomized (double blind) to receive creatine (0.3 g/kg creatine for 5 d and 0.07 g/kg thereafter) or placebo while participating in resistance training (12 weeks). Bone mineral content and density were determined by dual energy X-ray absorptiometry before and after training. There was a time main effect for whole-body and leg bone mineral density (p < or = 0.05) with these measures increasing by approximately 0.5%, and 1%, respectively in the combined groups. There was a group by time interaction for arms bone mineral content, with the group receiving creatine increasing by 3.2% (p < 0.01) and the group receiving placebo decreasing by 1.0% (not significant). Changes in lean tissue mass of the arms correlated with changes in bone mineral content of the arms (r = 0.67; p < 0.01). Resistance training of 12 weeks increases bone mineral density in older men and creatine supplementation may provide an additional benefit for increasing regional bone mineral content. The increase in bone mineral content may be due to an enhanced muscle mass with creatine, with potentially greater tension on bone at sites of muscle attachment.

Chilibeck PD, Chrusch MJ, Chad KE, Shawn Davison K…
J Nutr Health Aging
PMID: 16222402

Creatine: No Bone Benefit in Swimmers

Abstract

Effects of creatine supplementation on the performance and body composition of competitive swimmers.

The objective of this study was to determine the effect of creatine supplementation on performance and body composition of swimmers. Eighteen swimmers were evaluated in terms of post-performance lactate accumulation, body composition, creatine and creatinine excretion, and serum creatinine concentrations before and after creatine or placebo supplementation. No significant differences were observed in the marks obtained in swimming tests after supplementation, although lactate concentrations were higher in placebo group during this period. In the creatine-supplemented group, urinary creatine, creatinine, and body mass, lean mass and body water were significantly increased, but no significant difference in muscle or bone mass was observed. These results suggest that creatine supplementation cannot be considered to be an ergogenic supplement ensuring improved performance and muscle mass gain in swimmers.

Mendes RR, Pires I, Oliveira A, Tirapegui J
J. Nutr. Biochem. Aug 2004
PMID: 15302082

FOS+Inulin Like 250mg More Calcium in Adolescents

Abstract

Young adolescents who respond to an inulin-type fructan substantially increase total absorbed calcium and daily calcium accretion to the skeleton.

Calcium absorption and whole-body bone mineral content are greater in young adolescents who receive 8 g/d of Synergy, a mixture of inulin-type fructans (ITF), compared with those who received a maltodextrin control. Not all adolescents responded to this intervention, however. We evaluated 32 responders and 16 nonresponders to the calcium absorptive benefits of ITF. We found no differences in usual dietary calcium intakes. Responders who increased their calcium absorption by at least 3% after 8 wk of Synergy had a greater accretion of calcium to the skeleton over a year based on whole-body dual-energy x-ray absorptiometry data. The absorptive benefit to ITF use in responders is substantial and would be comparable to increasing daily calcium intake by at least 250 mg. Increased intake of ITF may be an important aspect of a multifaceted approach to enhancing peak bone mass.

Abrams SA, Griffin IJ, Hawthorne KM
J. Nutr. Nov 2007
PMID: 17951496 | Free Full Text

Review: FOS and Inulin and Calcium Absorption

Abstract

Current data with inulin-type fructans and calcium, targeting bone health in adults.

In humans, there is increasing evidence that the colon can absorb nutritionally significant amounts of calcium, and this process may be susceptible to dietary manipulation by fermentable substrates, especially inulin-type fructans. Inulin-type fructans can modulate calcium absorption because they are resistant to hydrolysis by mammalian enzymes and are fermented in the large intestine to produce short-chain fatty acids, which in turn reduce luminal pH and modify calcium speciation, and hence solubility, or exert a direct effect on the mucosal transport pathway. Quite a few intervention studies showed an improvement of calcium absorption in adolescents or young adults by inulin-type fructans. In the same way, a positive effect has been reported in older women.

Coxam V
J. Nutr. Nov 2007
PMID: 17951497 | Free Full Text

Fermented Milk Reduces Bone Resorption

Abstract

Short-term effect of bedtime consumption of fermented milk supplemented with calcium, inulin-type fructans and caseinphosphopeptides on bone metabolism in healthy, postmenopausal women.

Milk products are good sources of calcium and their consumption may reduce bone resorption and thus contribute to prevent bone loss.
We tested the hypothesis that bedtime consumption of fermented milk supplemented with calcium inhibits the nocturnally enhanced bone resorption more markedly than fermented milk alone, and postulated that this effect was most pronounced when calcium absorption enhancers were added.
In a controlled, parallel, double-blind intervention study over 2 weeks we investigated the short-term effects of two fermented milks supplemented with calcium from milk minerals (f-milk + Ca, n = 28) or calcium from milk minerals, inulin-type fructans and caseinphosphopeptides (f-milk + Ca + ITF + CPP; n = 29) on calcium and bone metabolism in healthy, postmenopausal women, and compared them with the effect of a fermented control milk without supplements (f-milk, n = 28). At bedtime 175 ml/d of either test milk was consumed. Fasting blood samples and 48 h-urine were collected at baseline and at the end of the intervention. Urine was divided into a pooled daytime and nighttime fraction. Multifactorial ANOVA was performed.
Fermented milk independent of a supplement (n = 85) reduced the nocturnal excretion of deoxypyridinoline, a marker of bone resorption, from 11.73 +/- 0.54 before to 9.57 +/- 0.54 micromol/mol creatinine at the end of the intervention (P = 0.005). No effect was seen in the daytime fraction. Differences between the three milks (n = 28 resp. 29) were not significant. Fermented milk reduced bone alkaline phosphatase, a marker of bone formation, from 25.03 +/- 2.08 to 18.96 +/- 2.08 U/l, with no difference between these groups either. Fermented milk increased the nocturnal but not daytime urinary excretion of calcium and phosphorus. The effects on calcium and phosphorus excretion were mainly due to the group supplemented with Ca + ITF + CPP.
Bedtime consumption of fermented milk reduced the nocturnal bone resorption by decelerating its turnover. Supplemented calcium from milk mineral had no additional effect unless the absorption enhancers ITF + CPP were added. A stimulated intestinal calcium absorption may be assumed, since urinary calcium excretion increased at a constant bone resorption.

Adolphi B, Scholz-Ahrens KE, de Vrese M, Açil Y…
Eur J Nutr Feb 2009
PMID: 19030908

FOS-Inulin Mix Increases Osteocalcin in Women

Abstract

Effects of oligofructose-enriched inulin on intestinal absorption of calcium and magnesium and bone turnover markers in postmenopausal women.

Deficiency of oestrogen at menopause decreases intestinal Ca absorption, contributing to a negative Ca balance and bone loss. Mg deficiency has also been associated with bone loss. The purpose of the present investigation was to test the hypothesis that treatment with a spray-dried mixture of chicory oligofructose and long-chain inulin (Synergy1; SYN1) would increase the absorption of both Ca and Mg and alter markers of bone turnover. Fifteen postmenopausal women (72.2 (SD 6.4) years) were treated with SYN1 or placebo for 6 weeks using a double-blind, placebo-controlled, cross-over design. Fractional Ca and Mg absorption were measured using dual-tracer stable isotopes before and after treatment. Bone turnover markers were measured at baseline, 3 and 6 weeks. Fractional absorption of Ca and Mg increased following SYN1 compared with placebo (P < 0.05). Bone resorption (by urinary deoxypyridinoline cross-links) was greater than baseline at 6 weeks of active treatment (P < 0.05). Bone formation (by serum osteocalcin) showed an upward trend at 3 weeks and an increase following 6 weeks of SYN1 (P < 0.05). Closer examination revealed a variation in response, with two-thirds of the subjects showing increased absorption with SYN1. Post hoc analyses demonstrated that positive responders had significantly lower lumbar spine bone mineral density than non-responders (dual X-ray absorptiometry 0.887 +/- 0.102 v. 1.104 +/- 0.121 g/cm2; P < 0.01), and changes in bone turnover markers occurred only in responders. These results suggest that 6 weeks of SYN1 can improve mineral absorption and impact markers of bone turnover in postmenopausal women. Further research is needed to determine why a greater response was found in women with lower initial spine bone mineral density.

Holloway L, Moynihan S, Abrams SA, Kent K…
Br. J. Nutr. Feb 2007
PMID: 17298707

Review: FOS Preventive Effects on Bone [Japanese]

Abstract

Prevention of osteoporosis by foods and dietary supplements. The effect of fructooligosaccharides (FOS) on the calcium absorption and bone.

Fructooligosaccharides (FOS) are well known as prebiotics which improve intestinal microflaura. FOS also have increasing effect on the intestinal absorption of calcium (Ca), magnesium (Mg) and iron. These effects were inspected by many animal experiments and then by human studies. Especially, FOS clearly prevent the decrease of bone mineral density by gastrectomy in rats. In this report, we mainly explain the preventive effect of FOS on the bone of gastrectomized rats and introduce relationship between another food ingredient or exercise.

Ohta A
Clin Calcium Oct 2006
PMID: 17012821

Review: Prebiotics in Adolescents

Abstract

A prebiotic substance persistently enhances intestinal calcium absorption and increases bone mineralization in young adolescents.

A number of short-term (9 days to 5 weeks) studies have reported that non-digestible. oligosaccharides enhance intestinal calcium absorption. Recent interesting data from an intervention trial in adolescents (9-13 years of age) suggest that a non-digestible oligosaccharide can persistently stimulate calcium absorption over 12 months and can also enhance bone mineralization during pubertal growth.

Cashman KD
Nutr. Rev. Apr 2006
PMID: 16673754