Retention of orally administered 47Ca in man measured in a whole-body counter

A novel dual radio- and stable-isotope method for measuring calcium absorption in humans: comparison with the whole-body radioisotope retention method

BACKGROUND

Dietary calcium absorption can be determined only with the use of isotope techniques. Currently used isotope techniques require exclusive equipment or are not true tracer approaches.

OBJECTIVE

The objective was to compare a dual-isotope method combining radioisotopes and stable isotopes with a whole-body radioisotope retention method for measuring calcium absorption.

DESIGN

Seven healthy adults aged 21-27 y consumed a test meal containing 63 +/- 14 (macro x +/- SD) mg Ca together with a water solution of (47)Ca (0.11 MBq). One hour after ingestion, 18 mg (44)Ca was administered intravenously. All feces and urine were collected for 5 and 6 d, respectively. Calcium absorption was estimated from whole-body retention of the radioisotope 12 times over 3 wk after ingestion and from the excretion of (47)Ca and (44)Ca in a 24-h urine sample collected on day 2. (44)Ca in urine was determined by inductively coupled plasma mass spectrometry.

RESULTS

Mean (+/- SD) calcium absorption was 75 +/- 9% with the dual-isotope method and was 74 +/- 8% with the whole-body radioisotope retention method. There was a high degree of agreement between the methods.

CONCLUSION

The dual-isotope method is a valid approach for measuring calcium absorption from a single meal.

Determination of the retention of 47Ca by whole-body counting

Retention of intravenously or orally administered 47Ca in the human body are described by a two-parameter function. It is then sufficient to make only a few whole-body measurements to determine the retention function, avoiding faeces sampling and stool markers. Seven days after intake the non-absorbed calcium was excreted and the model agreed with the measured relative retention. Absorption of calcium could then, in some cases (e.g. comparative studies), be described by relative retention at the 7th day after intake.

The use of stable tracers to study intestinal calcium absorption. The Italian Society of Osteoporosis

This paper represents the final document released by the Italian Society of Osteoporosis (S.I.OP.), on the occasion of its fifth annual meeting held in Padova, Italy (November 30-December 3, 1993). The S.I.OP. has in fact planned to periodically organize a conference on still-debated, controversial issues. After an exhaustive discussion of the various aspects of the problem by qualified experts in the field, a solution will be proposed by the members of the Society. The problems related to the use of radioactive tracers to study intestinal calcium absorption and the possible ways to over-come them were the issues discussed last year, by four panelists (R. P. Heaney, C. Gennari, G. Mioni, and S. Minisola) coordinated by G. F. Mazzuoli.

Comparative absorption of calcium from carbonate tablets, lactogluconate/carbonate effervescent tablet, and chloride solution

Intestinal absorption of calcium from three different labelled calcium preparations (all containing 500 mg elemental calcium) was determined using the whole body retention and urinary excretion of 47Ca in 14 normal subjects. Chewable calcium carbonate tablets showed a significantly (p less than 0.05) better mean minimum absorption of calcium (25.6% in exp. I, 22.8% in exp. II) than calcium given in the form of a lactogluconate/carbonate effervescent tablet, (17%), but similar to calcium in a chloride solution (24.7%). The minimum calcium absorption varied from 85 to 128 mg. All the preparations were taken with standardized low calcium test meals.

Measurement of 47calcium retention with a whole-body counter

A method for measuring the retention of orally administered 47Ca using a whole-body counter (WBC) is described. One microcurie 47Ca in 90 ml of lowfat milk was given along with 5 microCi 51Cr as a stool marker. The retention of 47Ca was determined at 7 days if less than 2% of the administered 51Cr was present in the body. Correlation between calcium retention by the whole-body-counting and the excreta-recovery methods was highly significant (r = 0.835, P less than 0.0001; N = 17). In 5 subjects, each studied twice while on constant self-selected diets, calcium retention was measured by the WBC method with a precision (standard deviation) of +/- 2.6% of the administered dose or +/- 13.9% of the mean retained fraction. Whole-body measurement of 47Ca retention has the advantages over other techniques that no collections of blood or stool are needed, no residency on a metabolic ward is required, and the radiation exposure (13 mrem) is so low that multiple studies may be performed in the same subject.

Calcium-phosphate metabolism in autosomal recessive idiopathic strio-pallido-dentate calcinosis and Cockayne's syndrome

In three siblings with autosomal recessive idiopathic strio-pallido-dentate calcinosis (SPDC) and in three other siblings with Cockayne's syndrome (CS) studies on plasma values of calcium and phosphate, intestinal calcium absorption, radiograms of the hands and studies on the influence of parathyroid hormone (PTH) on the renal threshold for phosphate revealed no abnormalities. In one of the SPDC patients and one of the CS patients the effect of PTH on the cyclic adenosine monophosphate (cAMP) concentrations in urine and cerebrospinal fluid (CSF) were determined. In both a normal response of urinary cAMP was noted. In the CS patient the response of CSF cAMP was also normal. The SPDC patient, however, had a significantly decreased response of CSF cAMP. It is suggested that a decreased sensitivity of the cerebral adenylate cyclase complex is involved in the etiology of autosomal recessive idiopathic SPDC. Subsequently this disorder could be considered as cerebral pseudohypoparathyroidism. The etiology of CS remains unknown.