Fioruci BF, Marino DC

Idioma: Ingles.
Referencias bibliográficas: 53
Paginas: 201-209
Archivo PDF: 98.77 Kb.

RESUMEN

En este trabajo se hace una revisión de las adaptaciones fisiológicas del metabolismo del calcio y hueso durante el embarazo y lactancia en mujeres adultas y adolescentes, con énfasis en la absorción intestinal, la excreción urinaria, el recambio óseo y la regulación hormonal. En mujeres adultas los ajustes para mantener la homeostasis del calcio durante el embarazo y la lactancia parecen no tener ningún efecto nocivo a largo plazo en la salud ósea materna, dentro de un amplio intervalo de ingestión de calcio. En el caso de los adolescentes se sabe mucho menos sobre la capacidad de adaptación a las altas demandas de calcio durante el embarazo y la lactancia para preservar la masa ósea materna. Los requerimientos de calcio pueden duplicarse si el embarazo y la lactancia se asocian con la adolescencia y los mecanismos homeostáticos pueden no ser suficientes para asegurar un adecuado incremento de la masa ósea de la madre joven, junto con un adecuado crecimiento fetal y la producción de leche. La evidencia disponible indica que el embarazo y la lactancia son condiciones fisiológicas que pueden afectar la adquisición de masa ósea de mujeres adolescentes cuando la ingestión de calcio es baja. Se necesitan estudios a largo plazo para evaluar el impacto del embarazo y la lactancia durante la adolescencia en la masa ósea materna en la edad adulta. Los estudios acerca de la masa ósea durante el embarazo y la lactancia, deben considerarse el análisis del calcio, de otros micronutrientes, el polimorfismo genético, así como considerar el estudio de otros grupos vulnerables, como el materno.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Prentice A. Micronutrients and the bone mineral content of the mother, fetus and newborn. J Nutr 2003; 133: 1693S-9S.

2. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for calcium, phospho- More studies are needed to evaluate the effect of the maternal pubertal stage on calcium and bone metabolism during pregnancy and lactation, and on lactational performance of adolescent mothers. There are other special groups of women, besides adolescent mothers, for whom the process of bone loss during pregnancy and lactation and recovery after weaning may be compromised. These include women who breastfed multiple infants, women with closely spaced pregnancies and women with advanced maternal age, although information regarding these groups are limited.3,52,53 ACKNOWLEDGEMENTS This work was supported in part by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and by Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ), Brazil. CMD is a Research Fellow of CNPq, Brazil. rus, magnesium, vitamin D and fluoride. Washington: DC; National Academic Press, 1997.

3. Kalkwarf HJ. Lactation and maternal bone health. Adv Exp Med Biol 2004; 554:101-14.

4. Bailey DA, Martin AD, McKay HA, Whiting S, Mirwald R. Calcium accretion in girls and boys during puberty: a longitudinal analysis. J Bone Min Res 2000; 15: 2245-50.

5. Martin AD, Bailey DA, McKay HA, Whiting S. Bone mineral and calcium accretion during puberty. Am J Clin Nutr 1997; 66: 611-5.

6. Cross NA, Hillman LS, Allen SH, Krause GF, Vieira NE. Calcium homeostasis and bone metabolism during pregnancy, lactation, and postweaning: a longitudinal study. Am J Clin Nutr 1995; 61: 514 - 23.

7. Ritchie LD, Fung EB, Halloran BP et al. A longitudinal study of calcium homeostasis during human pregnancy and lactation and after resumption of menses. Am J Clin Nutr 1998; 67: 693-701.

8. Vargas-Zapata CL, Donangelo CM, Woodhouse LR, Abrams SE, Martin ES, King JC. Calcium homeostasis during pregnancy and lactation in Brazilian women with low calcium intakes: a longitudinal study. Am J Clin Nutr 2004; 80: 417-22.

9. Fairweather-Tait S, Prentice A, Heumann KG, Jarjou LMA, Stirling DM, Wharf SG, et al. Effect of calcium supplements and stage of lactation on the calcium absorption efficiency of lactating women accustomed to low calcium intakes. Am J Clin Nutr 1995; 62: 1188-92.

10. O’Brien KO, Nathanson MS, Manzini J, Witter FR. Calcium absorption is significantly higher in adolescents during pregnancy than in the early postpartum period. Am J Clin Nutr 2003; 78: 1188-93.

11. Naylor KE, Iqbal P, Fledelius C, Fraser RB, Eastell R. The effect of pregnancy on bone density and bone turnover. J Bone Min Res 2000; 15: 129-37.

12. Kovacs CS, Kronenberg HM. Maternal-Fetal calcium and bone metabolism during pregnancy, puerperium, and lactation. Endocrine Rev 1997; 18: 832-72.

13. Bezerra FF, Laboissière F, King J, DonangeloCM. Pregnancy and lactation affect markers of calcium and bone metabolism differently in adolescent and adult women with low calcium intakes. J Nutr 2002; 132: 2183-7.

14. Gertner JM, Coustan DR, Kliger AS, Mallette LE, Ravin N, Broadus AE. Pregnancy as state of physiologic absorptive hypercalciuria. Am J Med 1986; 81: 451-6.

15. Kent GN, Price RI, Gutteridge DH, et al. Effect of pregnancy and lactation on maternal bone mass and calcium metabolism. Osteoporos Int 1993; 3: 44S-7S.

16. Prentice A, Jarjou LMA, Cole TJ, Stirling DM, Dibba B, Fairweather-Tait S. Calcium requirements of lactating Gambian mothers: effects of a calcium supplement on breast-milk calcium concentration, maternal bone mineral content, and urinary calcium excretion. Am J Clin Nutr 1995; 62: 58-67.

17. Krebs NF, Reidinger CJ, Robertson AD, and Brenner M. Bone mineral density changes during lactation: maternal, dietary, and biochemical correlates. Am J Clin Nutr 1997; 65:1738-46.

18. Kalkwarf HD. Hormonal and dietary regulation of changes in bone density during lactation and after wearning in women. J Mammary Gland Biol Neoplasia 1999; 4: 319-29.

19. 19.Wastney ME, NG J, Smith D, Martin BR, Peacock M, Weaver CM. Differences in calcium kinetics between adolescent girls and young women. Am J Physiol 1996; 271:208-16.

20. Matkovic V, Ilich JZ, Andon MB, Hsieh LC, Tzagournis MA, Lagger BJ, et al. Urinary calcium, sodium, and bone mass of young females. Am J Clin Nutr 1995; 62: 417-25.

21. Prentice A . Calcium in pregnancy and lactation. Annu Rev Nutr 2000; 20: 249-72.

22. Sowers M, Hollis BW, Shapiro B. Elevated parathyroid hormone-related peptide associated with lactation and bone density loss. JAMA 1996; 276: 549-54.

23. Prentice A, Jarjou LMA, Stirling DM, Buffenstein R, Fairweather-Tait S. Biochemical markers of calcium and bone metabolismduring 18 months of lactation in Gambian women accustomed to a low calcium intake and in those consuming a calcium supplement. J Clin Endocrinol Metab 1998; 83: 1059-66.

24. Cattani AO, Zubarew TG, Maddaleno H, Mosso LG, López MM. Recambio óseo en nodrizas adolescentes: evaluación al término de la gestación, lactancia y postdestete. Rev Med Chile 2000; 128: 145-53.

25. Casanueva E, Flores-Quijano ME, Frike E, Samano R, De Santiago S. Bone mineral density and bone turnover in adolescent mothers after lactation. In: Pickering LK, Morrow AL, Ruiz-Palacios GM and Schanler RJ (eds.) Protecting infants through human milk. Advancing the Scientific Evidence. Kluwer Academic/ Plenum Publishers. 2004, 341-3.

26. Sowers MF, Scholl T, Harris L and Jannausch M. Bone loss in adolescent and adult pregnant women. Obstetr Gynecol 2000; 96: 189-93.

27. Holmberg-Marttila D, Sievanen H, Tuimala R. Changes in bone mineral density during pregnancy and postpartum: prospective data on five women. Osteoporos Int 1999; 10: 41-6.

28. Kalkwarf HJ, Specker BL, Bianchi DC, Ranz J, Ho M. The effect of calcium supplementation on bone density during lactation and after weaning. N Engl J Med 1997; 337: 523-8.

29. Affinito P, Tommaselli GA, di Carlo C, GuidaF, Nappi C. Changes in bone mineral density and calcium metabolism in breastfeeding women: a one year follow-up study. J Clin Endocrinol Metab 1996; 81: 2314 - 8.

30. Laskey MA, Prentice A, Hanratty LA, Jarjou LMA, Dibba B, Beavan SR, et al. Bone changes after 3 mo of lactation: influence of calcium intake, breast-milk output, and vitamin D-receptor genotype. Am. J Clin Nutr 1998; 67: 685-92.

31. Sowers MF, Zhang D, Hollis BW, Shapiro B, Janney CA, Cruthfield M, et al. Role of calciotrophic hormones in calcium mobilization of lactation. Am J Clin Nutr. 1998; 67:284-91.

32. Kovacs CS. Calcium and bone metabolism in pregnancy and lactation. J Clin Endocrinol Metab. 2001; 86: 2344-8.

33. Chan GM, Slater P, Ronald N, Roberts CC, Thomas MR, Folland D, et al. Bone mineral status of lactating mothers of different ages. J Clin Endocrinol Metab 1982; 144: 438-41.

34. Bezerra FF, Mendonça LCM, Lobato EC, O’Brien KO, Donangelo CM. Bone mass is recovered from lactation to postweaning in adolescent mothers with low calcium intakes. Am J Clin Nutr 2004; 80: 1322-6.

35. Chan GM, McMurry M, Westover K, Engelbert-Fenton K, Thomas MR. Effects of increased dietary calcium intake upon the calcium and bone mineral status of lactating adolescent and adult women. Am J Clin Nutr 1987; 46: 319-23.

36. Chan GM, McElligott K, McNaught T, Gill G. Effects of dietary calcium intervention on adolescent mothers and newborns. Obstet Gynecol 2006; 108: 565-71.

37. Prentice A, Jarjou LMA, Cole TJ, Stirling DM, Dibba B, Fairweather-Tait S. Calcium requirements of lactating Gambian mothers: effects of a calcium supplement on breastmilk calcium concentration, maternal bone mineral content, and urinary calcium excretion. Am J Clin Nutr 1995; 62: 58-67.

38. Chantry CJ, Auinger P, Byrd RS. Lactation among adolescent mothers and subsequent bone mineral density. Arch Pediatr Adolesc Med 2004; 158: 650-6.

39. Roughead ZK & Kunkel, ME. Effect of diet on matrix constituents. J Am Coll Nutr 1991; 10: 242-6.

40. Shearer MJ, Bach A, Kohlmeier M. Chemistry, nutritional sources, tissue distribution and metabolism of vitamin K with special reference to bone health. J Nutr 1996; 126: 1181S- 6S.

41. New SA, Robins SP, Campbell MK, MartinJC, Garton MJ, Bolton-Smith C, et al. Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health? Am J Clin Nutr 2000; 71: 142-51.

42. Allen LH. Multiple micronutrients in pregnancy and lactation: an overview. Am J Clin Nutr 2005; 81: 1206S-12S.

43. Azeredo VB, Bezerra FF, Figueiredo R, Donangelo CM and Trugo NMF. Micronutrient status of Brazilian lactating adolescents. Adv Exp Med Biol. 2004; 554: 333-6.

44. Ralston SH. Genetic Control of Susceptibility to Osteoporosis. J Clin Endocrinol Metab 2002; 87: 2460–6.

45. Prentice A. The relative contribution of diet and genotype to bone development. Proc Nutr Soc. 2001; 60: 45-52.

46. Holmberg-Marttila D, Sievanen H, Jarvinen TL, Jarvinen TA. Vitamin D and estrogen receptor polymorphisms and bone mineral changes in postpartum women. Calcif Tissue Int 2000; 66: 184-9.

47. Bezerra FF, Wall CS, Cabello GK, Donangelo CM. Influence of allelic variants of the vitamin d receptor (VDR) gene on bone and calcium metabolism of lactating adolescents. FASEB J 2005; 19: A436 (Abstract).

48. Wood RJ and Fleet JC. The genetics of osteoporosis: Vitamin D receptor polymorphisms. Annu Rev Nutr 1998; 18: 233-58.

49. Kitagawa I, Kitagawa Y, Kawase Y, Nagaya T and Tokudome S. Advanced onset of menarche and higher bone mineral density depending on vitamin D receptor gene polymorphism. Eur J Endocrinol 1998; 139: 522-7.

50. Laaksonen MML, Karkkainen MUM, Outila TA, Rita HJ, Lamberg-Allardt CJE. Vitamin D receptor start codon polymorphism (FokI) is associated with forearm bone mineral density and calcaneal ultrasound in Finnish adolescent boys but not in girls. J Bone Min Metab 2004; 22: 479-85.

51. Saggese G, Baroncelli GI, Bertelloni S. Puberty and bone development. Best Pract Res Clin Endocrinol Metab 2002; 16: 53-64.

52. Abrams SA. Editorial: Bone turnover during lactation – Can calcium supplementation make a difference? J Clin Endocrinol Metab 1998; 83: 1056-8.

53. Hopkinson JM, Butte NF, Ellis K, Smith EO. Lactation delays postpartum bone mineral accretion and temporarily alters its regional distribution in women. J Nutr 2000; 130: 777-83.