1 Biosensing Technology Research Unit, National Center for Genetic Engineering and Biotechnology (BIOTEC) , National Science and Technology Development Agency (NSTDA), Pathum Thani, Thailand .
2 Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok, Thailand .
Breastfeed Med. 2017 Jul/Aug;12(6):331-337. doi: 10.1089/bfm.2016.0204. Epub 2017 May 15.
Lactation often affects calcium metabolism and induces bone loss. Calcium supplementation and a high calcium diet are recommended to prevent bone loss, especially during inadequate calcium intake. Our study aimed at determining bone loss in breastfeeding mothers, and if it occurred, whether it was site specific and there were correlations between serum bone turnover markers.
Since the 6-month exclusive breastfeeding is usually recommended in several countries, our study examined bone mineral density (BMD) in early (1-2 month), mid (3-4 month)-, and late (5-6 month) lactation compared with nonpregnant, nonlactating control women. Site-specific bone loss was monitored in lumbar vertebrae and femora. Bone turnover markers, that is, C-terminal telopeptide of type 1 collagen and N-terminal propeptide of type 1 collagen (P1NP), were determined by electrochemiluminescence immunoassays.
The onset of bone loss in exclusive breastfeeding mothers was site specific, for example, in the lumbar bone at mid-lactation and in the femoral bone in late lactation. Serum ionized calcium levels in late lactation were lower than the normal levels. In addition, a correlation was found between bone turnover marker, P1NP, and femoral BMD.
The onset of bone loss in exclusive breastfeeding mothers was site specific, and the lumbar bone was a vulnerable and perhaps better representative site for bone loss detection. It was suggested that the optimal starting time for calcium supplementation should be before the mid-lactation when the bone loss was observed. In addition, the biochemical marker that best predicted the onset of bone loss in lactating women was P1NP.
哺乳期常影响钙代谢并导致骨质流失。推荐补充钙和高钙饮食以预防骨质流失，尤其是在钙摄入不足时。本研究旨在确定哺乳期母亲的骨质流失情况，以及是否存在部位特异性，以及血清骨转换标志物之间是否存在相关性。
由于在几个国家通常推荐 6 个月的纯母乳喂养，因此我们的研究比较了早期（1-2 个月）、中期（3-4 个月）和晚期（5-6 个月）哺乳期与未怀孕、未哺乳的对照组女性的骨密度（BMD）。监测腰椎和股骨的部位特异性骨质流失。通过电化学发光免疫测定法测定骨转换标志物，即 1 型胶原 C 端肽和 1 型前胶原 N 端肽（P1NP）。
纯母乳喂养母亲的骨质流失起始具有部位特异性，例如在中期哺乳期的腰椎和晚期哺乳期的股骨。晚期哺乳期血清离子钙水平低于正常水平。此外，还发现骨转换标志物 P1NP 与股骨 BMD 之间存在相关性。
纯母乳喂养母亲的骨质流失起始具有部位特异性，腰椎是骨质流失检测的敏感部位，或许是更具代表性的部位。建议在观察到骨质流失的中期哺乳期之前开始最佳的补钙时间。此外，预测哺乳期妇女骨质流失起始的最佳生化标志物是 P1NP。
