Immobilization-related bone loss in the rat is increased by calcium deficiency

The object of this study was to investigate whether a calcium-deficient diet increases the bone loss produced by mechanical hypofunction (disuse) in the rat. Male Sprague-Dawley rats of approximately 150 g were placed on either a normal diet or a calcium-deficient diet. After 7 days, all rats underwent unilateral hind-limb immobilization by sciatic neurectomy and were sacrificed 30 hours, 72 hours, or 10 days postsurgery. Femora were ashed and the total mineral content (ash weight) was determined. Tibiae were embedded, sectioned, and stained. The metaphyseal secondary spongiosa and the diaphyseal cortical bone were subjected to histomorphometric analysis. Femoral length and serum calcium were not affected by calcium intake or immobilization. Serum parathyroid hormone levels were elevated in rats on the calcium-deficient diet compared to those on the normal diet. Calcium deficiency caused a significant reduction in femoral ash weight (20-35%), tibial cortical thickness (16-20%), and trabecular bone volume (TBV) (33-39%) at 72 hours and 10 days postsurgery. Additional loss of bone mass occurred in the immobilized limb compared to the contralateral intact limb of both dietary groups. This loss occurred earlier (30 hours postsurgery versus 72 hours) in the animals on a calcium-deficient diet and was larger compared to animals on a normal diet (10.6% versus 4.8% at 72 hours and 17.9% versus 12.45% at 10 days). The total bone loss induced by the combination of a calcium-deficient diet and immobilization in this experiment was estimated to equal 46% of femoral ash weight and 79% of tibial TBV. Calcium deficiency increased the number of osteoclasts/mm bone surface in the secondary spongiosa by 25-45%. Immobilization caused a further increase of 50-60% by 72 hours postsurgery. Endosteal mineral apposition rate was significantly decreased (27-44%) by immobilization but was not altered by the low-calcium diet. These data suggest that dietary calcium deficiency augments immobilization-related osteopenia by increasing bone resorption.