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Skeleton and Calcium Homeostasis

Skeleton and Calcium Homeostasis

Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.

Bone Disorders

Bone Disorders

Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...

Hormones and Bone Tissue

Hormones and Bone Tissue

The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...

Role of Vitamins in Maintaining Bone Health

Role of Vitamins in Maintaining Bone Health

The growth and maintenance of bone are regulated by a combination of nutritional factors, including vitamins, such as vitamin A, B12, C, D, and K.
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Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
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Bone Remodeling

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Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.

Osteoclasts in Bone Remodeling

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Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...

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Related Experiment Video

Updated: Dec 24, 2025

Development of a Human Preclinical Model of Osteoclastogenesis from Peripheral Blood Monocytes Co-cultured with Breast Cancer Cell Lines

Development of a Human Preclinical Model of Osteoclastogenesis from Peripheral Blood Monocytes Co-cultured with Breast Cancer Cell Lines

Published on: September 13, 2017

Risk Factors for Development of Hypocalcemia in Patients With Cancer Treated With Bone-Modifying Agents.

Paul S White¹, Michael Dennis², Eric A Jones³

¹Section of Hematology and Oncology, Department of Medicine, and.

Journal of the National Comprehensive Cancer Network : JNCCN

|April 8, 2020

Summary

Cancer patients receiving bone-modifying agents (BMAs) have a 25% risk of developing hypocalcemia. Hematologic malignancy, bone metastases, inpatient status, and low vitamin D increase risk, while prior hypercalcemia is protective.

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Last Updated: Dec 24, 2025

Development of a Human Preclinical Model of Osteoclastogenesis from Peripheral Blood Monocytes Co-cultured with Breast Cancer Cell Lines

Development of a Human Preclinical Model of Osteoclastogenesis from Peripheral Blood Monocytes Co-cultured with Breast Cancer Cell Lines

Published on: September 13, 2017

Models of Bone Metastasis

Models of Bone Metastasis

Published on: September 4, 2012

Murine Hind Limb Long Bone Dissection and Bone Marrow Isolation

Murine Hind Limb Long Bone Dissection and Bone Marrow Isolation

Published on: April 14, 2016

Area of Science:

Oncology
Pharmacology
Endocrinology

Background:

Bone-modifying agents (BMAs) are crucial for supportive care in cancer patients.
Hypocalcemia is a potential adverse effect of BMA treatment.
Understanding risk factors for hypocalcemia is essential for patient safety.

Purpose of the Study:

To determine the prevalence of hypocalcemia in cancer patients treated with BMAs.
To identify clinical and laboratory risk factors associated with hypocalcemia development.
To inform monitoring and management strategies for patients receiving BMAs.

Main Methods:

Retrospective analysis of 835 cancer patients receiving BMAs (pamidronate, zoledronic acid, denosumab) from 2005-2015.
Review of medical records for clinical parameters, laboratory values, and patient outcomes.
Multivariate analysis to identify predictors of hypocalcemia.

Main Results:

25% of patients developed hypocalcemia (grade ≥1) within 8 weeks of BMA initiation.
Risk factors included hematologic malignancy (OR 1.96), bone metastases (OR 2.44), inpatient status (OR 2.59), and low baseline vitamin D (OR 2.55).
Pre-existing hypercalcemia was protective (OR 0.47).

Conclusions:

Patients with hematologic malignancies and/or bone metastases require closer calcium monitoring during BMA therapy.
Low pretreatment vitamin D levels are significantly associated with hypocalcemia.
Adequate vitamin D repletion prior to BMA initiation is recommended to mitigate hypocalcemia risk.