The bone remodeling transient: interpreting interventions involving bone-related nutrients

Area of Science:

• Bone biology and endocrinology
• Skeletal physiology
• Calcium metabolism

Background:

• Bone remodeling involves a dynamic balance between bone formation and resorption.
• Interventions affecting bone remodeling can induce temporary changes, known as remodeling transients.
• Parathyroid hormone (PTH) regulates remodeling activity and is influenced by calcium intake.

Purpose of the Study:

• To explain the concept of the bone remodeling transient.
• To highlight the necessity of accounting for remodeling transients when evaluating interventions.
• To demonstrate potential errors in bone mass measurement by ignoring these transients.

Main Methods:

• Analysis of the bone remodeling transient concept.
• Review and worked examples from three published calcium intervention studies.
• Description of errors arising from ignoring the transient in bone mass assessments.

Main Results:

• Altering calcium intake invariably induces a bone remodeling transient due to PTH regulation.
• Ignoring the transient can lead to inaccurate conclusions about the steady-state effects of interventions.
• Worked examples illustrate significant errors in interpreting bone mass changes without considering the transient.

Conclusions:

• The bone remodeling transient is a critical factor in bone intervention studies.
• Accurate assessment of long-term intervention effects requires factoring out the transient response.
• Future studies must account for remodeling transients for reliable bone mass change interpretations.