Osteoporosis & bone health

Calcium isotope ratio (δ44/42Ca) reflects kidney function and calcium excretion but not bone mineral density or bone turnover: a cross-sectional study

Osteoporos IntPublished Cross-sectional study

Authors' conclusion

While δ44/42Ca reflects aspects of calcium metabolism, such as nutritional calcium supply, in this real-world setting, it failed to predict fractures or distinguish osteoporosis from healthy controls or osteopenia and vice versa, indicating limited clinical use.

Study context

Population
Patients with osteoporosis and osteopenia, with controls43 controls
Participants
301 patients
Outcome
Serum and urine δ44/42Ca as a biomarker of bone metabolism, vs bone (incl. bone density) and treatment parameters
Methodological detailsreal-world setting
  • Real-world setting

Main finding

As reported in the abstract

Correlation of δ44/42Ca with urinary calcium excretion
Serum δ44/42Ca vs urinary calcium excretion, r²
0.55
Urine δ44/42Ca vs urinary calcium excretion, r²
0.20
P for correlation
p<0.0001

Observational data: associations, not effects.

Further findings

Factors affecting δ44/42Ca

Higher β-CTX associated with low δ44/42Ca
P < 0.05
Age, kidney function and calcium intake significantly affected δ44/42Ca

Treatment effects on δ44/42Ca

Osteoanabolic therapy increased δ44/42Ca
P < 0.05
Antiresorptive treatment had no effect

δ44/42Ca by fracture, BMD and age-adjusted stratification

Above age-adjusted δ44/42Ca threshold: higher urinary calcium and PTH (both)
P < 0.0001
No differences in δ44/42Ca by fracture or BMD stratification
  • Pattern consistent with neutral or positive bone mineral balance

Original publication

Calcium isotope ratio (δ44/42Ca) reflects kidney function and calcium excretion but not bone mineral density or bone turnover: a cross-sectional study. Osteoporos Int. Published 11 April 2026. doi:10.1007/s00198-026-07935-5

Composed by AI from the published abstract and checked against it. How Briefs are made →

Get them every week

New studies on this topic in My Week and in your Monday e-mail.

We e-mail you a sign-in link and a code. No password, no spam.