{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T22:26:24Z","timestamp":1789770384455,"version":"4.0.1"},"reference-count":39,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,3,14]],"date-time":"2016-03-14T00:00:00Z","timestamp":1457913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"German Research Foundation","doi-asserted-by":"publisher","award":["FOR 793"],"award-info":[{"award-number":["FOR 793"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:label\/><jats:p>Efficient calcium absorption is essential for skeletal health. Patients with impaired gastric acidification display low bone mass and increased fracture risk because calcium absorption is dependent on gastric pH. We investigated fracture healing and post\u2010traumatic bone turnover in mice deficient in <jats:italic>Cckbr<\/jats:italic>, encoding a gastrin receptor that affects acid secretion by parietal cells. <jats:italic>Cckbr<\/jats:italic>\u2212\/\u2212 mice display hypochlorhydria, calcium malabsorption, and osteopenia. <jats:italic>Cckbr<\/jats:italic>\u2212\/\u2212 and wildtype (WT) mice received a femur osteotomy and were fed either a standard or calcium\u2010enriched diet. Healed and intact bones were assessed by biomechanical testing, histomorphometry, micro\u2010computed tomography, and quantitative backscattering. Parathyroid hormone (PTH) serum levels were determined by enzyme\u2010linked immunosorbent assay. Fracture healing was unaffected in <jats:italic>Cckbr<\/jats:italic>\u2212\/\u2212 mice. However, <jats:italic>Cckbr<\/jats:italic>\u2212\/\u2212 mice displayed increased calcium mobilization from the intact skeleton during bone healing, confirmed by significantly elevated PTH levels and osteoclast numbers compared to WT mice. Calcium supplementation significantly reduced secondary hyperparathyroidism and bone resorption in the intact skeleton in both genotypes, but more efficiently in WT mice. Furthermore, calcium administration improved bone healing in WT mice, indicated by significantly increased mechanical properties and bone mineral density of the fracture callus, whereas it had no significant effect in <jats:italic>Cckbr<\/jats:italic>\u2212\/\u2212 mice. Therefore, under conditions of hypochlorhydria\u2010induced calcium malabsorption, calcium, which is essential for callus mineralization, appears to be increasingly mobilized from the intact skeleton in favor of fracture healing. Calcium supplementation during fracture healing prevented systemic calcium mobilization, thereby maintaining bone mass and improving fracture healing in healthy individuals whereas the effect was limited by gastric hypochlorhydria. \u00a9 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. 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