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Naturally Occurring Stable Calcium Isotope Ratios in Body Compartments Provide a Novel Biomarker of Bone Mineral Balance in Children and Young Adults

Early effects of androgen deprivation on bone and mineral homeostasis in adult men

Calcium isotope ratios in blood and urine: A new biomarker for the diagnosis of osteoporosis

Biological fractionation of stable Ca isotopes in Göttingen minipigs as a physiological model for Ca homeostasis in humans

A pilot study on the use of natural calcium isotope (44Ca/40Ca) fractionation in urine as a proxy for the human body calcium balance

Calcium isotope markers (CIM) are the key to new possibilities in osteoporosis therapy

The Osteolabs laboratory test measures calcium turnover. This method was developed in a 17-week study by NASA (J. Skulan et al 2007). Based on this, the clinical studies OSTEOGEO (100 postmenopausal women) and "Peak Bone" (30 healthy premenopausal women) were carried out in cooperation with the Schleswig-Holstein University Hospital in Kiel, the GEOMAR - Helmholtz Centre, Prof. Dr. rer. nat. Eisenhauer and Osteolabs GmbH in Kiel and the company CRC Kiel.

With a sensitivity of 100 %, all previously detected cases of osteoporosis were identified as expected by means of calcium isotope markers (CIM). Furthermore, thanks to the procedure, additional diseased women (specificity 55 %) could be identified. This can be explained by the detection of calcium loss at an earlier stage and the detection of the entire skeleton. The result of this research is a world first, as it is possible to diagnose osteoporosis at an early stage, e.g. at the onset of postmenopause, a time advantage for sufferers of up to 25 years!

Calcium (Ca++) occurs in food in isotopes of different weights, e.g. 42Ca or 44Ca. Isotopes react chemically in the same way, but are of different weights. Calcium isotopes are stable and not radioactive. Light Ca isotopes undergo chemical reactions faster than heavy ones and accumulate at the end of the process (in bones in humans). Because light Ca isotopes react more quickly, light Ca isotopes (42Ca) are predominantly incorporated during bone formation.

If more light Ca isotopes are incorporated in the bone, more heavy Ca isotopes (44Ca) remain in the blood/urine. This can be measured with our new method. When bone substance is broken down (e.g. osteoporosis), the reverse happens. More light Ca isotopes are released from the bone into the blood/urine. This can also be measured. The following graph shows the differences in the calcium isotope marker (CIM) in different materials in healthy people and people with osteoporosis.

Ca isotope values in blood and serum are plotted with their corresponding mean values for diet, faeces and calculated mean value for bone. There is no statistical difference in Ca isotope levels between the two groups with respect to diet (p = 0.3) or faeces (p = 0.6). However, women suffering from DXA-diagnosed osteoporosis showed significantly lower δ44/42Ca (serum) (p = 0.001) and δ44/42Ca (urine) (p = 0.004) values than women without osteoporosis.

The 42Ca/44Ca (δ44/42Ca) ratio can be used to conclude whether bone is built up or broken down. The measurement reflects calcium build-up/loss, which can be converted into grams/day. We will add the algorithm here shortly.

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