title: Effect of Ramadan fasting in Saudi Arabia on serum bone profile and immunoglobulins.
abstract: BACKGROUND
  Each year Muslims fast from dawn to sunset for 1 month (Ramadan). In Saudi Arabia, the sleep-wake cycle during Ramadan is severely disturbed and is associated with abolition of the circadian cortisol rhythm, exposing Saudis to continuously increased cortisol levels, which may influence the immune response. In addition to cortisol, sleep and fasting affect the secretion of parathyroid hormone (PTH) and hence bone metabolism.
  
  
  METHODS
  Our objective was to investigate the effect of Ramadan type fasting on secretory patterns of PTH, markers of bone metabolism, and serum immunoglobulins. Blood samples from healthy young volunteers were collected at 9 a.m. and 9 p.m. (± 1 hour) before (Shaban) and 2 weeks into Ramadan. Calcium, phosphorus, magnesium, albumin, alkaline phosphatase, 25-OH vitamin D, intact PTH (iPTH), and immunoglobulin (Ig) A, M and G were measured.
  
  
  RESULTS
  During Ramadan, evening-adjusted calcium was higher (p = 0.036) and phosphate lower (p < 0.001) than the corresponding morning value. Moreover, the Ramadan mean morning phosphate was higher and the evening level lower was than Shabaan values (p = 0.010 and p <0.001, respectively), while mean iPTH level was decreased compared with the morning value (p = 0.001), and the evening mean during Shabaan (p = 0.029). Mean IgG concentration was significantly lower during Ramadan (p = 0.003 and p = 0.021 for morning and evening, respectively).
  
  
  CONCLUSIONS
  Changes in dietary practices during Ramadan modulated PTH secretion to a pattern which might be beneficial to bone health. Combined effects of fasting and disturbed sleep led to a noted decrease in IgG level. Therefore, a possible beneficial effect of fasting on bone turnover is combined with decreased immune response.
authors.affiliation: Department of Clinical Biochemistry, Faculty of Medicine, Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, PO Box 4873, Jeddah 21412, Saudi Arabia.
authors.forename: Suhard M
authors.initials: SM
authors.lastname: Bahijri
authors.affiliation: Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Ghada M
authors.initials: GM
authors.lastname: Ajabnoor
authors.affiliation: Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Anwar
authors.initials: A
authors.lastname: Borai
authors.affiliation: Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Jumana Y
authors.initials: JY
authors.lastname: Al-Aama
authors.affiliation: Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: George P
authors.initials: GP
authors.lastname: Chrousos
keywords: PTH; Ramadan fasting; bone metabolism; cortisol; immune response; immunoglobulins; sleep–wake cycle