title: Acute effect of a supplemented milk drink on bone metabolism in healthy postmenopausal women is influenced by the metabolic syndrome.
abstract: BACKGROUND
  Dietary factors acutely influence the rate of bone resorption, as demonstrated by changes in serum bone resorption markers. Dietary calcium exerts its effect by reducing parathyroid hormone levels while other components induce gut incretin hormones both of which reduce bone resorption markers. The impact of dietary calcium on bone turnover when energy metabolism is modulated such as in metabolic syndrome has not been explored. This study was designed investigate whether metabolic syndrome or a greater amount of visceral fat influences the impact of dietary calcium on bone turnover.
  
  
  METHODS
  The influence of the metabolic syndrome on effects of dietary calcium on bone turnover in community dwelling postmenopausal women was studied. Twenty five volunteers consumed 200 mL of low fat milk with additional 560 mg calcium (one serve of Milo®) in the evening on one occasion. Fasting morning serum biochemistry before and after the milk drink with lumber spine bone density, bone mineral content, fat and lean mass using dual energy X-ray absorptiometry (DXA) and waist circumference were measured. The women were divided into 2 groups using the waist measurement of 88 cm, as a criterion of metabolic syndrome. Student's t tests were used to determine significant differences between the 2 groups.
  
  
  RESULTS
  The lumbar spine mineral content was higher in women with metabolic syndrome. After consuming the milk drink, serum bone resorption marker C terminal telopeptide (CTX) was suppressed to a significant extent in women with metabolic syndrome compared to those without.
  
  
  CONCLUSIONS
  The results suggests that dietary calcium may exert a greater suppression of bone resorption in post-menopausal women with metabolic syndrome than healthy women. Despite substantial evidence for close links between energy metabolism and bone metabolism this is the first report suggesting visceral fat or metabolic syndrome may influence the effects of dietary calcium on bone metabolism.
authors.affiliation: Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia. Devika.thomas@health.sa.gov.au.|Endocrine and Metabolic Unit, Royal Adelaide Hospital, Level 7, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, 5000, Australia. Devika.thomas@health.sa.gov.au.
authors.forename: Sunethra D C
authors.initials: SD
authors.lastname: Thomas
authors.affiliation: School of Pharmacy and Health Sciences, University of South Australia, Adelaide, South Australia, Australia. howard.morris@health.sa.gov.au.|Chemical Pathology, SA Pathology, Adelaide, South Australia, Australia. howard.morris@health.sa.gov.au.
authors.forename: Howard A
authors.initials: HA
authors.lastname: Morris
authors.affiliation: Endocrine and Metabolic Unit, Royal Adelaide Hospital, Level 7, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, 5000, Australia.
authors.forename: B E C
authors.initials: BE
authors.lastname: Nordin
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000818:Animals; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D015519:Bone Density; D016723:Bone Remodeling / Q000502:physiology*; D002118:Calcium / Q000652:urine; D002136:Calcium, Dietary / Q000008:administration & dosage; D003404:Creatinine / Q000652:urine; D005215:Fasting; D005260:Female; D005527:Food, Fortified; D006801:Humans; D050152:Intra-Abdominal Fat / Q000378:metabolism; D016014:Linear Models; D008159:Lumbar Vertebrae / Q000187:drug effects / Q000378:metabolism; D024821:Metabolic Syndrome / Q000097:blood / Q000503:physiopathology*; D008875:Middle Aged; D008892:Milk / Q000737:chemistry*; D017698:Postmenopause; D011795:Surveys and Questionnaires; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; D002136:Calcium, Dietary; D003404:Creatinine; D002118:Calcium