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Is there a potential therapeutic value of copper and zinc for osteoporosis?

Published online by Cambridge University Press:  27 March 2009

Nicola M Lowe*
Department of Biological Sciences, University of Central Lancashire, Preston PR1 2HE, UK
William D Fraser
Department of Clinical Chemistry
Malcolm J Jackson
Department of Medicine, University of Liverpool, Liverpool L61 3GA, UK
*Dr Nicola Lowe, fax +44 1772 892929, email
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Osteoporosis is almost universal in very old age, and is a major cause of morbidity and mortality in the elderly of both sexes. Bone is lost at a rate of 0·2–0·5 %/year in both men and women after the age of 40–45 years. The causes of age-related changes in bone mass are multifactorial and include genetic predisposition, nutritional factors, endocrine changes, habitual exercise levels and body weight. Bone loss is accelerated to 2–5 % year immediately before and for up to 10 years post-menopause (Heaney, 1986). In women hormone-replacement therapy is effective in reducing the rate of bone loss caused by this peri-menopausal decrease in hormone levels (Smith & Studd, 1993); however, in men and older women (>10 years post-menopause) nutrition plays a key role in the rate of bone loss. One factor contributing to bone loss in the elderly may be a subclinical Zn and/or Cu deficiency, due to a reduced dietary intake of micronutrients and reduced absorption (Thomson & Keelan, 1986). Zn and Cu are essential cofactors for enzymes involved in the synthesis of various bone matrix constituents. Paradoxically, Ca supplementation may accentuate the problem of reduced Zn and Cu levels by impairing the absorption of simultaneously-ingested Zn and the retention of Cu (Snedeker et al. 1982; Grekas et al. 1988). The present paper will review the current literature on the potential benefits of Cu and Zn supplementation in reducing bone loss, and present new information on the effect of Ca supplementation on Zn and Cu status in post-menopausal women with osteoporosis.

Symposium on ‘Micronutrient supplementation: is there a case?’
Copyright © The Nutrition Society 2002


Ali, SA, Lowe, NM, Jack, CIA, Carmichael, DN, Beattie, JH, Reid, MD, King, JC & Jackson, MJ (1998 a) The effect of Zinc kinetics in young and elderly subjects. In Metal Ions in Biology and Medicine, vol. 5, pp. 218222. [Collery, P, Bratter, P, de Bratter, V Negretti, Khassanove, L and Etienne, J-C, editors]. London: Libby.Google Scholar
Ali, SA, Lowe, NM, Jack, CIA, Reid, DM, Beattie, JH, King, JC & Jackson, MJ (1998 b), Zinc absorption in the healthy elderly. Proceedings of the Nutrition Society 57, 69A.Google Scholar
Argiratos, V & Samman, S (1993) The effect of calcium carbonate and calcium citrate in the absorption of zinc in healthy female subjects European Journal of Clinical Nutrition 48, 198204.Google Scholar
Atik, OS (1983) Zinc in senile osteoporosis. Journal of the American Geriatrics Society 31 790791.CrossRefGoogle ScholarPubMed
Conlan, D, Korula, R & Tallentire, D, (1990) Serum copper levels in elderly patients with femoral-neck fractures Age and Ageing 19, 212214.CrossRefGoogle ScholarPubMed
Couzy, F, Kantenmayer, P, Mansourian, R, Guinchard, S, Munoz-Box, R & Dirren, H, (1993) Zinc absorption in healthy elderly humans and the effect of diet American Journal of Clinical Nutrition 58, 690694.CrossRefGoogle Scholar
Danks, DM (1987) Copper deficiency in infants with particular reference to Menkes' disease. In Copper in Animals and Man, vol. 2 pp. 2951 [Howell, J McD and Gawthorne, JM, editors]. Boca Raton, FL: CRC Press.Google Scholar
Davies, NT & Nightingale, R, (1975) The effects of phytate on intestinal absorption and secretion of Zn and whole-body retention of Zn, Cu, Fe and Mn in rats. British Journal of Nutrition 24, 243258.CrossRefGoogle Scholar
Delmi, M, Rapin, C-H, Bengoa, J-M, Delmas, PD, Vasey, H & Bonjour, J-P, (1990) Dietary supplementation in elderly patients with fractured neck of femur. Lancet 335, 10131016.CrossRefGoogle Scholar
Eberle, J, Schindmayer, S, Erben, RG, Stangassinger, M & Roth, HP, (1999) Skeletal effects of zinc deficiency in growing rats. Journal of Trace Elements in Medicine and Biology 13, 2126.CrossRefGoogle ScholarPubMed
Garrow, JS, James, WPT & Ralph, A (editors) (2000) Human Nutrition and Dietetics 10th ed. London: Churchill Livingstone.Google Scholar
Grekas, D, Alivanis, P, Balaskas, E, Dombros, N & Tourkantonis, A, (1988) Effect of aluminium hydroxide and calcium on zinc tolerance test in uremic patients. Trace Elements in Medicine 5, 172175.Google Scholar
Guigliano, & Milward, DJ, (1984) Growth and zinc homeostasis in the severely zinc deficient rat. British Journal of Nutrition 52, 545560.CrossRefGoogle Scholar
Heaney, RP, (1986) Calcium bone health and osteoporosis. In Bone and Mineral Research vol. 4, pp. 255301 [Peck, WA, editor]. New York: Elsevier.Google Scholar
Helliwell, TR, Kelly, SA, Walsh, HPJ, Klenerman, L, Haines, J, Clark, R & Roberts, NB, (1996) Elemental analysis of femoral bone from patients with fractured neck of femur or osteoarthritis Bone 18, 151157.CrossRefGoogle ScholarPubMed
King, JC, Shames, DM, Lowe, NM, Woodhouse, LR, Sutherland, BS, Abrams, SA, Turnlund, JR & Jackson, MJ, (2001) Effect of acute zinc depletion on zinc homeostasis and plasma zinc kinetics in men American Journal of Clinical Nutrition 74, 116124.CrossRefGoogle ScholarPubMed
Kishi, S & Yamaguchi, M, (1994) Inhibitory effect of zinc compounds on osteoclast-like cell formation in mouse marrow cultures. Biochemical Pharmacology 48, 12251230.CrossRefGoogle ScholarPubMed
Lowe, NM, Bremner, I & Jackson, MJ, (1991) Plasma65Zn kinetics in the rat. British Journal of Nutrition 65, 445455.CrossRefGoogle ScholarPubMed
Lowe, NM, Woodhouse, LR, Matel, JS & King, JC, (2000) Estimation of zinc absorption in humans using four stable isotope tracer methods and compartmental analysis. American Journal of Clinical Nutrition 71, 523529.CrossRefGoogle Scholar
Lyon, TDB, Fell, GS, Gaffney, D, McGaw, BA, Russell, RI, Park, RHR, Beattie, AD, Curry, G, Crofton, RJ, Gunn, I, Sturniolo, GS, D'Inca, R & Patriarca, M, (1995) Use of stable copper isotope (65Cu) in the differential diagnosis of Wilson's disease. Clinical Science 88, 727732.CrossRefGoogle ScholarPubMed
Ma, J & Betts, NM, (2000) Zinc and copper intakes and their major food sources for older adults in the 1994–96 Continuing Survey of Food Intakes by individuals (CSFII) Journal of Nutrition 130, 28382843.CrossRefGoogle Scholar
Moynahan, EJ, (1974) Acrodermatitis enteropathica: A lethal inherited human zinc deficiency disorder. Lancet ii, 399400.CrossRefGoogle Scholar
Oberleas, D, Muhrer, ME & O'Dell, BL, (1966) Dietary metalcomplexing agents and zinc availability in the rat. Journal of Nutrition 90, 5662.CrossRefGoogle ScholarPubMed
Opsahl, W, Zeronian, H, Ellison, M, Lewis, D, Rucker, RB & Riggins, RS, (1982) Role of copper in collagen cross-linking and its influence on selected mechanical properties of chick bone and tendon. Journal of Nutrition 112, 708716.CrossRefGoogle Scholar
Pecoud, A, Donzel, P & Schelling, JL, (1975) Effect of foodstuffs on the absorption of zinc sulphates. Clinical Pharmacology and Therapeutics 17, 469474.CrossRefGoogle Scholar
Relea, P, Revilla, M, Ripoll, E, Arribas, I, Villa, LF & Rico, H, (1995) Zinc, biochemical markers of nutrition and type 1 osteoporosis. Age and Ageing 24, 303307.CrossRefGoogle Scholar
Rico, H, (1991) Minerals and osteoporosis Osteoporosis International 2, 2025.CrossRefGoogle ScholarPubMed
Rucker, RB, Kosonen, T, Clegg, MS, Mitchell, A, Rucker, BR, Uriu-Hare, JY & Keen, C, (1998) Copper, lysyl oxidase and extracellular matrix protein cross-linking. American Journal of Clinical Nutrition 67, 996S1002S.CrossRefGoogle ScholarPubMed
Saltman, PD & Strause, LG, (1993) The role of trace minerals in osteoporosis. Journal of the American College of Nutrition 12, 384389.CrossRefGoogle ScholarPubMed
Sandstead, HH, Henriksen, LK, Greger, JL, Prasad, AS & Good, RA, (1982) Zinc nutriture in the elderly in relation to taste acuity, immune response and wound healing American Journal of Clinical Nutrition 36, 10461059.CrossRefGoogle ScholarPubMed
Smith, RNJ & Studd, JWW, (1993) Recent advances in hormone replacement therapy. British Journal of Hospital Medicine 49, 799808.Google ScholarPubMed
Snedeker, SM, Smith, SA & Greger, JL, (1982) Effect of dietary calcium and phosphorus levels on the utilization of iron, copper and zinc by adult males Journal of Nutrition 112, 135143.CrossRefGoogle ScholarPubMed
Strain, JJ, (1988) A reassessment of diet and osteoporosis: possible role of copper. Medical Hypotheses 27, 333338.CrossRefGoogle ScholarPubMed
Thomson, ABR & Keelan, M, (1986) The aging gut. Canadian Journal of Physiology and Pharmacology 64, 3038.CrossRefGoogle ScholarPubMed
Turnlund, JR, Durkin, N, Costa, F & Margen, S, (1986) Stable isotope studies of zinc absorption and retention in young and elderly men. Journal of Nutrition 116, 12391247.CrossRefGoogle Scholar
Vir, SC & Love, AHG, (1979) Zinc and copper status of the elderly. American Journal of Clinical Nutrition 32, 14721476.CrossRefGoogle ScholarPubMed
Walravens, PA, Hambidge, KM & Koepfer, DM, (1989) Zinc supplementation in infants with a nutritional pattern of failure to thrive: a double-blind, controlled study. Pediatrics 83, 532538.Google ScholarPubMed
Wapnir, RA, (1998) Copper absorption and bioavailability. American Journal of Clinical Nutrition 67, 1054S1060S.CrossRefGoogle ScholarPubMed
Weismann, K & Høyer, H, (1985) Serum alkaline phosphatase and serum zinc levels in the diagnosis and exclusion of zinc deficiency in man. American Journal of Clinical Nutrition 41, 12141219.CrossRefGoogle ScholarPubMed
Wood, R (1990) Zinc. In Nutrition in the Elderly, Boston Nutritional Status Survey, pp. 177182 [Hartz, SC Russell, RM and Rosenberg, IH, editors]. London: Smith-Gordon.Google Scholar
World Health Organization (1994) Assessment of Fracture Risk and its Application to Screening for Postmenopausal Osteoporosis; Report of a WHO Study Group. WHO Technical Report Series, no. 843. Geneva: WHO.Google Scholar
Yamaguchi, M, (1995) β-Alanyl-L-histidinato zinc and bone resorption. General Pharmacology 26, 11791183.CrossRefGoogle ScholarPubMed
Yamaguchi, M, (1998) Role of zinc in bone formation and bone resorption. Journal of Trace Elements in Experimental Medicine 11, 119135.3.0.CO;2-3>CrossRefGoogle Scholar
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