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Published on: September 8, 2023
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Bone turnover in lactating and nonlactating women
Lena Nerius1, Mandy Vogel1, Uta Ceglarek2
1LIFE Leipzig Research Center for Civilization Diseases, University of Leipzig, 04103, Leipzig, Germany.
Archives of Gynecology and Obstetrics
|September 14, 2023
Summary
Lactation increases bone turnover and loss, with elevated bone markers in both exclusively and non-exclusively breastfeeding women. This bone loss appears largely independent of parathyroid hormone (PTH) levels.
Area of Science:
- Reproductive Endocrinology
- Bone Metabolism
- Maternal Health
Background:
- Lactation mobilizes maternal calcium, leading to bone loss, but underlying mechanisms require further investigation.
- Previous studies on lactational bone metabolism were limited by small sample sizes.
Purpose of the Study:
- To assess bone metabolism during lactation.
- To compare bone metabolism parameters between large cohorts of lactating and nonlactating women.
Main Methods:
- Retrospective cohort study of 779 postpartum women and 742 controls.
- Measured serum levels of parathyroid hormone (PTH), estradiol, calcium, phosphate, and bone turnover markers (ßCTX, P1NP, Osteocalcin).
- Compared parameters between exclusively breastfeeding (exc-bf), non-exclusively breastfeeding (nonexc-bf), and control groups at 3 and 6 months postpartum.
Main Results:
- Bone turnover markers (ßCTX, P1NP, Osteocalcin) were significantly increased in both exc-bf and nonexc-bf women compared to controls.
- ßCTX levels were approximately double in exc-bf women versus controls.
- Estradiol was suppressed in exc-bf women at 3 months postpartum.
Conclusions:
- Both exclusively and non-exclusively breastfeeding states are associated with increased bone formation and resorption markers.
- Lactational bone loss appears to be relatively independent of PTH levels, as indicated by PTH data distribution within the reference range.
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