Changes in Bone Mineral Density, Body Composition and Adiponectin Levels in Morbidly Obese Patients after Bariatric Surgery

Carrasco, Fernando; Ruz, Manuel; Rojas, Pamela; Csendes, Attila; Rebolledo, Annabella; Codoceo, Juana; Inostroza, Jorge; Basfi-fer, Karen; Papapietro, Karin; Rojas, Jorge; Pizarro, Fernando; Olivares, Manuel

doi:10.1007/s11695-008-9638-0

Cited by 147 publications

(147 citation statements)

References 36 publications

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“…Carrasco e cols. (29), por meio de estudo longitudinal (seguimento por 12 meses), acompanharam 42 mulheres submetidas ao DGYR e encontraram redução significativa na densidade mineral óssea total, de coluna e quadril. Abbasi e cols.…”

Section: Discussionunclassified

Alterações de parâmetros relacionados ao metabolismo ósseo em mulheres submetidas à derivação gástrica em Y de Roux

Santos

Souza

Fonseca

et al. 2012

Arq Bras Endocrinol Metab

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RESUMOObjetivo: Avaliar o metabolismo ósseo e a densidade mineral óssea (DMO) em mulheres adultas pós-derivação gástrica em Y de Roux (DGYR). Sujeitos e métodos: Estudo transversal com 48 mulheres submetidas a DGYR há três anos e 41 saudáveis. Dados obtidos: índice de massa corporal (IMC), atividade física, consumo alimentar e DMO da coluna lombar, colo e fêmur total. Dosagem de cálcio, fósforo, magnésio, albumina, fosfatase alcalina, telopeptídeo-C (CTX), paratormônio (PTH), 25-hidroxivitamina D (25OHD), osteocalcina e cálcio urinário. Resultados: Maiores alterações no grupo DGYR observadas nos níveis de osteocalcina (p < 0,001), CTX (p < 0,001) e PTH (p < 0,001). Deficiência de 25OHD foi a mais frequente no grupo DGYR (p = 0,010). Deficiência/insuficiência de 25OHD associou-se com hiperparatiroidismo secundário (p = 0,025). Não houve diferença entre os grupos em relação à DMO. A ingestão de energia (p = 0,036) e proteína (p = 0,004) foi maior no grupo controle. Conclusão: Em mulheres pós-DGYR, encontraram-se alta frequência de deficiência de vitamina D, hiperparatireoidismo secundário e elevação nos marcadores de remodelação óssea, sem alteração na DMO quando comparado com o grupo controle não obeso. Arq Bras Endocrinol Metab. 2012;56(6):376-82 Descritores Cirurgia bariátrica; densidade mineral óssea; vitamina D; hiperparatiroidismo secundário; anastomose em-Y de Roux ABSTRACT Objective: To evaluate bone turnover markers and bone mineral density (BMD) in women after Roux-en-Y (RYGB) gastric bypass. Subjects and methods: In a cross-sectional study, 48 women post-RYGB after three years, and 41 healthy women were evaluated. Evaluations: body mass index (BMI); physical activity; food intake; serum levels of calcium, phosphorus, magnesium, alkaline phosphatase, C-terminal telopeptide (CTX), intact parathyroid hormone (PTH), 25-hydroxyvitamin D (25OHD), osteocalcin, urinary calcium and BMD. Results: Significantly higher levels were observed for osteocalcin (p < 0.001), CTX (p < 0.001), and PTH (p < 0.001) in the RYGB group when compared with the control group; 25OHD deficiency/insufficiency was more frequent in the RYGB group (p = 0.010), even after adjusted for nutritional status, and it was associated with secondary hyperparathyroidism (p = 0.025); there was no difference in BMD between the groups. Energy (p = 0.036) and protein intake (p = 0.004) were lower in the RYGB group. Conclusion: Patients submitted to RYGB showed a significantly higher frequency of vitamin D deficiency, secondary hyperparathyroidism, and increase in bone remodeling markers, with no difference in BMD status. Arq Bras Endocrinol Metab. 2012;56(6):376-82

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Section: Discussionunclassified

Alterações de parâmetros relacionados ao metabolismo ósseo em mulheres submetidas à derivação gástrica em Y de Roux

Santos

Souza

Fonseca

et al. 2012

Arq Bras Endocrinol Metab

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“…Interestingly, adiponectin was shown to increase after RNYGB. 19,78,79 Serotonin Serotonin is produced in both the gastrointestinal and central nervous systems. In the duodenum, enterochromaffin cells respond to mechanical stress by producing tryptophan hydroxylase 1, the rate-limiting catalyst of gut-derived serotonin (GDS) production.…”

Section: Impact Of Bariatric Surgery On Bone Metabolismmentioning

confidence: 99%

“…[16][17][18] In addition, the extent of bone loss varies with each study and none have been carried out in a sufficient number of patients to allow a firm conclusion. [19][20][21] Thus, the aim of this review is to summarize the current state of knowledge regarding the relationship between bariatric operations and bone metabolism, to understand the specific mechanisms of action and to suggest further research studies.…”

Section: Introductionmentioning

confidence: 99%

Bariatric surgery and bone disease: from clinical perspective to molecular insights

et al. 2012

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“…In the US, in particular, the prevalence of overweight and obese women stands at 72.6% and 41.8%, respectively (1). Obesity is associated with an increase in overall mortality and a higher risk of developing type 2 diabetes mellitus, dyslipidemia, sleep apnea, gall bladder disease, coronary disease, hypertension, musculoskeletal disorders, cancer and psychosocial disorders (2).…”

Section: Introductionmentioning

confidence: 99%

Bariatric surgery and bone metabolism: a systematic review

Viégas

Vasconcelos

Neves

et al. 2010

Arq Bras Endocrinol Metab

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SUMMARYFew studies have demonstrated the risk of metabolic bone disease and a reduction in bone mineral density (BMD) after bariatric surgery. A systematic review was conducted of case-control and cohort studies with the aim of evaluating the relationship between bariatric surgery and bone metabolism. The search was undertaken in MedLine, covering the period from January 1997 to August 2009, using the keywords: "bariatric surgery" AND "osteoporosis" , "fracture" , "bone diseases" , "metabolic" . Six studies were included, comprising four cohort and two casecontrol studies. Three studies evaluated bone metabolism and BMD, and the other evaluated bone metabolism only. Based on this review, bariatric surgery is associated with alterations in bone metabolism, loss of bone mass and an increased risk of fracture. However, the maximum evaluation period covered by these studies was two years after surgery, hence the need to undertake further studies of longer duration in order to achieve a more thorough understanding of this association. Arq Bras Endocrinol Metab. 2010;54(2):158-63 Keywords Osteoporosis; fracture; bariatric surgery; bone diseases SUMÁRIO Alguns estudos têm demonstrado aumento do risco de doença osteometabólica e redução de densidade mineral óssea (DMO) após a cirurgia bariátrica. Realizou-se uma revisão sistemática de estudos de caso-controle e coorte com o objetivo de avaliar a relação entre cirurgia bariátri-ca e o metabolismo ósseo. A procura foi realizada na MedLine de janeiro 1997 a agosto 2009, utilizando os descritores: "bariatric surgery" e "osteoporosis" , "fracture" , "bone diseases" , "metabolic" . Foram incluídos seis estudos, sendo quatro coortes e dois casos-controle. Três desses estudos avaliaram metabolismo ósseo e DMO e os demais avaliaram apenas o metabolismo ósseo. Com base nesta revisão, a cirurgia bariátrica está associada com alterações no metabolismo ósseo, perda de massa óssea e aumento no risco de fraturas. Entretanto, os estudos tiveram acompanhamento máximo de dois anos após a cirurgia, havendo necessidade de estudos de maior seguimento para melhor conhecimento dessa associação. Arq Bras Endocrinol Metab. 2010;54(2):158-63

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Changes in Bone Mineral Density, Body Composition and Adiponectin Levels in Morbidly Obese Patients after Bariatric Surgery

Abstract: GBP induces a significant BMD loss related with changes in body composition, although some metabolic mediators, such as adiponectin increase, may have an independent action on BMD which deserves further study.

Cited by 147 publications

References 36 publications

Alterações de parâmetros relacionados ao metabolismo ósseo em mulheres submetidas à derivação gástrica em Y de Roux

Alterações de parâmetros relacionados ao metabolismo ósseo em mulheres submetidas à derivação gástrica em Y de Roux

Bariatric surgery and bone disease: from clinical perspective to molecular insights

Bariatric surgery and bone metabolism: a systematic review

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