Los resultados de un metanálisis sobre el uso de suplementos de calcio en mujeres, “sugieren fuertemente un riesgo relativamente modesto de infarto del miocardio y de accidentes vasculares cerebrales. Aunque los autores reconocen las limitaciones inherentes a este tipo de estudios, recomiendan “una reevaluación del rol de los suplementos de calcio en el manejo de la osteoporosis”. Como posibles mecanismos subyacentes se plantea un proceso de calcificación vascular regulado en forma similar a la osteogénesis y la posibilidad de que un exceso de calcio contribuya al riesgo de formación de trombos arteriales. El presente ensayo no pretende recomendar cambios en el uso clínico de los suplementos de calcio ni profundizar o ampliar en cuanto a los mecanismos mencionados y otros, sino tomar el problema como un ejemplo por analizar de acuerdo con los principios de la medicina darwiniana. Se debe tener en cuenta que el enfoque evolucionario trata de explicar la vulnerabilidad a la enfermedad del <span name="style_italic">homo sapiens</span> como especie. Aunque es indudable que existen susceptibilidades individuales a prácticamente todas las enfermedades, las expectativas del Proyecto del Genoma Humano -en cuanto a ejemplos y peso de genes predisponentes- con muy escasas excepciones, han estado lejos de cumplirse. Es razonable suponer que el interés por esta dimensión olvidada en la biomedicina -del todo ignorada en el artículo de marras- podría ayudar a entender mejor el origen de problemas médicos como este, e inclusive a orientar la investigación y aplicación de esa “medicina personalizada”. como especie. Aunque es indudable que existen susceptibilidades individuales a prácticamente todas las enfermedades, las expectativas del Proyecto del Genoma Humano -en cuanto a ejemplos y peso de genes predisponentes- con muy escasas excepciones, han estado lejos de cumplirse. Es razonable suponer que el interés por esta dimensión olvidada en la biomedicina -del todo ignorada en el artículo de marras- podría ayudar a entender mejor el origen de problemas médicos como este, e inclusive a orientar la investigación y aplicación de esa “medicina personalizada”.

The results of a meta-analysis on the use of calcium supplements by women, “strongly suggest a relatively modest risk of myocardial infarction and stroke”. Although the authors acknowledge the inherent limitations in such studies, they recommend “a reassessment of the role of calcium supplements in the management of osteoporosis.” As possible underlying mechanisms, they suggest that a regulated vascular calcification process similar to osteogenesis occurs, and the possibility that excess calcium contributes to the risk of arterial thrombus formation. This essay is not intended to recommend changes in the clinical use of calcium supplements or to suggest a deeper analysis of the mentioned and other mechanisms. It seeks to analyze the problem according to the principles of Darwinian medicine. It is important to bear in mind that the evolutionary approach tries to explain the vulnerability to disease of <span name="style_italic">Homo sapiens</span> as a species. Although there is no doubt that individual susceptibilities to virtually all diseases may be present, with very few exceptions, the expectations of the Human Genome Project, in terms of examples and of the relevance of predisposing genes, have been far from fulfilled. It is reasonable to assume that the interest in this forgotten dimension of biomedicine -entirely ignored in the aforementioned article- could help to better understand the origin of medical problems such as the one related to the use of calcium supplements by women, and even to guide research and application of “personalized medicine”. as a species. Although there is no doubt that individual susceptibilities to virtually all diseases may be present, with very few exceptions, the expectations of the Human Genome Project, in terms of examples and of the relevance of predisposing genes, have been far from fulfilled. It is reasonable to assume that the interest in this forgotten dimension of biomedicine -entirely ignored in the aforementioned article- could help to better understand the origin of medical problems such as the one related to the use of calcium supplements by women, and even to guide research and application of “personalized medicine”.

The results of a meta-analysis on the use of calcium supplements by women, &#8220;strongly suggest a relatively modest risk of myocardial infarction and stroke&#8221;. Although the authors acknowledge the inherent limitations in such studies, they recommend &#8220;a reassessment of the role of calcium supplements in the management of osteoporosis.&#8221; As possible underlying mechanisms, they suggest that a regulated vascular calcification process similar to osteogenesis occurs, and the possibility that excess calcium contributes to the risk of arterial thrombus formation. This essay is not intended to recommend changes in the clinical use of calcium supplements or to suggest a deeper analysis of the mentioned and other mechanisms. It seeks to analyze the problem according to the principles of Darwinian medicine. It is important to bear in mind that the evolutionary approach tries to explain the vulnerability to disease of <i>Homo sapiens</i> as a species. Although there is no doubt that individual susceptibilities to virtually all diseases may be present, with very few exceptions, the expectations of the Human Genome Project, in terms of examples and of the relevance of predisposing genes, have been far from fulfilled. It is reasonable to assume that the interest in this forgotten dimension of biomedicine -entirely ignored in the aforementioned article- could help to better understand the origin of medical problems such as the one related to the use of calcium supplements by women, and even to guide research and application of &#8220;personalized medicine&#8221;.

^*Correspondencia a: * cdecespedesm@gmail.com

Fecha recibido: 28 de agosto de 2012 Fecha aceptado: 13 de setiembre de 2012