Bone Turnover Markers After Standard and Distal Roux-en-Y Gastric Bypass: Results from a Randomized Controlled Trial

Svanevik, Marius; Risstad, Hilde; Hofsø, Dag; Blom-Høgestøl, Ingvild Kristine; Kristinsson, Jon; Sandbu, Rune; Småstuen, Milada Cvancarova; Thorsby, Per Medbøe; Mala, Tom; Hjelmesæth, Jøran

doi:10.1007/s11695-019-03909-1

Cited by 15 publications

(19 citation statements)

References 32 publications

(40 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Levels of the bone turnover marker CTX-1 and parathyroid hormone increased more after distal than standard RYGB. The prevalence of secondary hyperparathyroidism was also higher after distal compared with standard RYGB, corresponding to findings after 2 years 34 . Higher levels of bone turnover markers are associated with faster bone loss and predict fractures, even after adjustment for aBMD 35–37 .…”

Section: Discussionmentioning

confidence: 53%

Standard versus distal Roux-en-Y gastric bypass in patients with BMI 50–60 kg/m2: 5-year outcomes of a double-blind, randomized clinical trial

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background The optimal surgical weight loss procedure for patients with a BMI of 50 kg/m 2 or more is uncertain. This study compared distal Roux-en-Y gastric bypass (RYGB) with standard RYGB. Methods In this double-blind RCT, patients aged 18–60 years with a BMI of 50–60 kg/m 2 were allocated randomly to receive standard (150 cm alimentary, 50 cm biliopancreatic limb) or distal (150 cm common channel, 50 cm biliopancreatic limb) RYGB. The primary outcome (change in BMI at 2 years) has been reported previously. Secondary outcomes 5 years after surgery, such as weight loss, health-related quality of life, and nutritional outcomes are reported. Results Between May 2011 and April 2013, 123 patients were randomized, 113 received an intervention, and 92 attended 5-year follow-up. Mean age was 40 (95 per cent c.i. 38 to 41) years and 73 patients (65 per cent) were women; 57 underwent standard RYGB and 56 distal RYGB. BMI was reduced by 15.1 (95 per cent c.i. 13.9 to 16.2) kg/m 2 after standard and 15.7 (14.5 to 16.9) kg/m 2 after distal RYGB; the between-group difference was −0.64 (−2.3 to 1.0) kg/m 2 ( P = 0.447). Total cholesterol, low-density lipoprotein cholesterol, and haemoglobin A1c levels declined more after distal than after standard RYGB. High-density lipoprotein cholesterol levels increased more after standard RYGB. Vitamin A and vitamin D levels were lower after distal RYGB. Changes in bone mineral density, resting metabolic rate, and total energy intake were comparable. Conclusion Distal RYGB did not enable greater weight loss than standard RYGB. Differences in other outcomes favouring distal RYGB may not justify routine use of this procedure in patients with a BMI of 50–60 kg/m 2 . Registration number: NCT00821197 ( http://www.clinicaltrials.gov ). Presented in part as abstract to the IFSO (International Federation for the Surgery of Obesity and Metabolic disorders) conference, Madrid, Spain, August 2019.

show abstract

Section: Discussionmentioning

confidence: 53%

Standard versus distal Roux-en-Y gastric bypass in patients with BMI 50–60 kg/m2: 5-year outcomes of a double-blind, randomized clinical trial

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Individuals with T2DM treated by gastric bypass, compared to individuals with T2DM of similar age and body composition not treated by gastric bypass, have been reported to have lower BMD, lower bone strength, and increased levels of several bone turnover markers [45]. Another recent study has also reported that levels of bone turnover markers increased significantly after gastric bypass surgery [46]. Systematic vitamin D and calcium supplementation seems advisable although its beneficial effect on BMD in the post-surgical population remains to be seen.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Status After Gastric Bypass or Sleeve Gastrectomy over 4 Years of Follow-up

et al. 2019

View full text Add to dashboard Cite

Background Bariatric surgery for severe obesity can lead to micronutrient/vitamin deficiencies. Aims To study baseline and post-surgical prevalence of vitamin D deficiency in patients undergoing bariatric surgery. Participants and Setting Patients undergoing bariatric surgery in a university teaching hospital in North West England. Methods We performed an observational cohort analysis of longitudinal data on vitamin D and related parameters in patients who underwent bariatric surgery. Patients were routinely recommended daily combined calcium and vitamin D supplementation post-surgery. Results We studied 460 patients who had completed at least 12 months post-operatively; mean (standard deviation) age was 48.0 (10.5) years, weight 144.7 (27.3) kg and body mass index 50.0 (7.6) kg/m 2 ; 292 (63.5%) underwent gastric bypass and 168 (36.5%) sleeve gastrectomy. Vitamin D level was 33.1 (23.9) nmol/L at baseline, rising to 57.1 (23.1) nmol/L at 12 months postsurgery. Whereas 43.2% had vitamin D deficiency and 34.7% insufficiency preoperatively, 8.9% and 26.7% had deficiency and insufficiency, respectively, at 12 months with similar trends up to 4 years of follow-up. There were no significant differences between procedures or sexes in vitamin D levels or sufficiency rates. Conclusion Vitamin D deficiency and insufficiency were prevalent pre-surgery and reduced significantly with routine supplementation post-surgery.

show abstract

“…Relationships of calcium and vitamin D with PTH should be explored further, as PTH may impact bone turnover and bone mineral density (BMD) postoperatively [14][15][16][17][18][19][20][21][22][23][24]. More focus on these are needed during follow-up.…”

Section: Introductionmentioning

confidence: 99%

Relationships Between Vitamin D Status and PTH over 5 Years After Roux-en-Y Gastric Bypass: a Longitudinal Cohort Study

et al. 2020

Self Cite

View full text Add to dashboard Cite

Purpose Secondary hyperparathyroidism (SHPT) after obesity surgery may affect bone health. Optimal vitamin D levels have not been established to prevent SHPT postoperatively. We investigated whether SHPT differed across threshold levels of serum 25-hydroxyvitamin D (S-25(OH)D) from 6 months up to 5 years after Roux-en-Y gastric bypass (RYGB). Materials and Methods We included 554 patients at follow-up 5 years postoperatively. Blood samples were analysed for S-25(OH)D, ionized calcium (iCa) and parathyroid hormone (PTH) during follow-up. Results PTH and prevalence of SHPT increased from 6 months to 5 years postoperatively, while S-25(OH)D and iCa decreased (all P < 0.001). PTH and SHPT development are related with S-25(OH)D, and PTH differed between all subgroups of S-25(OH)D. SHPT occurred less frequently across all subgroups of S-25(OH)D ≥ 50 nmol/l during follow-up: odds ratio (OR) 0.44 (95% CI 0.36-0.54) in patients with S-25(OH)D ≥ 50 nmol/l, OR 0.38 (0.30-0.49) with S-25(OH)D ≥ 75 nmol/l and OR 0.19 (0.12-0.31) with S-25(OH) D ≥ 100 nmol/l, all compared with S-25(OH)D < 50 nmol/l. At 5 years, 208/554 patients (38%) had SHPT; SHPT was found in 94/188 patients (50%) with S-25(OH)D < 50 nmol/l, in 69/222 (31%) with S-25(OH)D 50-74 nmol/l, in 40/117 (34%) with S-25(OH)D 75-99 nmol/l and in 5/27 (19%) with S-25(OH)D ≥ 100 nmol/l. An interaction existed between S-25(OH)D and iCa. Bone alkaline phosphatase remained increased with SHPT. Conclusions A significant relationship existed between S-25(OH)D and development of PTH and SHPT. The prevalence of SHPT was lower with threshold levels 25(OH)D ≥ 50 nmol/l and ≥ 75 nmol/l over the 5 years, and lowest with S-25(OH)D ≥ 100 nmol/l.

show abstract

Bone Turnover Markers After Standard and Distal Roux-en-Y Gastric Bypass: Results from a Randomized Controlled Trial

Cited by 15 publications

References 32 publications

Standard versus distal Roux-en-Y gastric bypass in patients with BMI 50–60 kg/m2: 5-year outcomes of a double-blind, randomized clinical trial

Standard versus distal Roux-en-Y gastric bypass in patients with BMI 50–60 kg/m2: 5-year outcomes of a double-blind, randomized clinical trial

Vitamin D Status After Gastric Bypass or Sleeve Gastrectomy over 4 Years of Follow-up

Relationships Between Vitamin D Status and PTH over 5 Years After Roux-en-Y Gastric Bypass: a Longitudinal Cohort Study

Contact Info

Product

Resources

About