Effect of Gastric Bypass on Bone Mineral Density, Parathyroid Hormone and Vitamin D: 5 Years Follow-up

Raoof, Mustafa; Näslund, Ingmar; Rask, Eva; Szabó, Éva

doi:10.1007/s11695-016-2114-3

Cited by 46 publications

(43 citation statements)

References 15 publications

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“…Although the subjects had reductions in BMD, they did not show significant changes in serum vitamin D, except they did have correlation with increasing parathyroid hormone, supporting a process of bone remodeling. 98 Although robust studies are lacking, the available literature suggests that it is important to monitor BMD in the population of long-term survivors of pancreatic cancer and that strategies to prevent osteoporosis are important to implement early in this group.…”

Section: Bone Densitymentioning

confidence: 99%

Nutrition Implications for Long‐Term Survivors of Pancreatic Cancer Surgery

Petzel

Hoffman

2017

Nut in Clin Prac

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With slowly increasing survival rates in pancreatic cancer and international consensus guidelines recommending surgical resection of premalignant lesions, survival post-pancreatic resection is increasing. With longer survival time, the significant comorbidities of such major surgery have far-reaching effects on the nutrition status of the survivor of pancreatic cancer. This review describes the many nutrition-related side effects of pancreatic surgery, including the development of pancreatic enzyme insufficiency, micronutrient deficiencies, diabetes, fatty liver, and metabolic bone disease. Beyond causing additional medical problems, each of these can have significant effects on quality of life and functional status. The potential mechanisms, diagnosis criteria, and potential treatments of these conditions are described. Overall, little literature exists to fully describe the effects of these comorbidities, and even less is able to guide effective treatments for this population. Clinicians caring for these patients should begin incorporating goals for promotion of long-term health and reduction of these known and reported comorbidities in patients who have undergone pancreatic surgery. Treatment plans in this population remain understudied, and clinicians may need to consider recommendations for similar disease states when developing interventions for these patients.

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Section: Bone Densitymentioning

confidence: 99%

Nutrition Implications for Long‐Term Survivors of Pancreatic Cancer Surgery

Petzel

Hoffman

2017

Nut in Clin Prac

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“…The systematic literature search resulted in 15 studies including one RCT [69–83]. Most of them have been intervention studies recruiting patients undergoing RYGB surgery (follow-up from 6 months up to 12 months) [69–80, 83] and one observational study [82] (see Table 3).…”

Section: Surgery-induced Weight Loss and Vitamin Dmentioning

confidence: 99%

“…Most of them have been intervention studies recruiting patients undergoing RYGB surgery (follow-up from 6 months up to 12 months) [69–80, 83] and one observational study [82] (see Table 3). Temporarily, after surgery, vitamin D status appears to improve (approximately one month; [73, 74, 76, 77, 79, 82].…”

Section: Surgery-induced Weight Loss and Vitamin Dmentioning

confidence: 99%

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A systematic review of the interrelation between diet- and surgery-induced weight loss and vitamin D status

et al. 2017

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Obesity is a major global health problem and has been associated with vitamin D deficiency. Intentional weight loss may alter vitamin D status and, conversely, vitamin D supplementation has been hypothesized to aid in weight loss. A systematic literature search in PubMed/Medline identified 3,173 articles of which 37 studies (randomized controlled trials (RCT) (n=17), non-RCTs (n=20)) are summarized as effect of: (I) diet-induced weight loss on vitamin D status (n=7), (II) vitamin D supplementation on diet-induced weight loss (n=11), (III) surgery-induced weight loss on vitamin D status (n=15), and (IV) vitamin D supplementation after surgery-induced weight loss on vitamin D status (n=5). While all studies on the effect of diet-induced weight loss on vitamin D status have consistently reported increased vitamin D levels, the targeted percentage of weight loss that is necessary for an increase has varied between 5% and >10%. N=11 RCTs testing the effect of vitamin D supplementation observe that vitamin D supplementation does not result in increased weight loss, but may affect body fat loss. Vitamin D deficiency and subsequent hyperparathyroidism have been detected in post-surgery patients, and there is evidence that vitamin D supplementation improves these post-surgery complications.. We review the current evidence addressing the role of vitamin D status and supplementation in diet- and surgery induced weight loss. Subsequently, we highlight gaps in current research and suggest directions for future research including differences in vitamin D supplementation dosages, indoor vs. outdoor exercise, and the assessment of vitamin D status in different body pools.

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“…Several studies have shown a reduction in bone mineral density after bariatric surgery and retrospective studies indicate that bariatric surgery is associated with increased fracture risk . However, a small randomized trial found no increased fracture risk for patients receiving bariatric surgery and a recent meta‐analysis on fracture risk after bariatric surgery called for additional high‐quality, prospective studies that investigate fracture risk after bariatric surgery .…”

Section: Introductionmentioning

confidence: 99%

Fracture risk after three bariatric surgery procedures in Swedish obese subjects: up to 26 years follow‐up of a controlled intervention study

et al. 2020

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Ahlin S, Peltonen M, Sj€ oholm K, Anveden A, Jacobson P, Andersson-Assarsson JC, Taube M, Larsson I, Lohmander LS, N€ aslund I, Svensson P-A, Carlsson LMS ). Fracture risk after three bariatric surgery procedures in Swedish obese subjects: up to 26 years follow-up of a controlled intervention study. J Intern Med 2020; 287: 546-557.Background. Previous studies have reported an increased fracture risk after bariatric surgery.Objective. To investigate the association between different bariatric surgery procedures and fracture risk.Methods. Incidence rates and hazard ratios for fracture events were analysed in the Swedish Obese Subjects study; an ongoing, nonrandomized, prospective, controlled intervention study. Hazard ratios were adjusted for risk factors for osteoporosis and year of inclusion. Information on fracture events were captured from the Swedish National Patient Register. The current analysis includes 2007 patients treated with bariatric surgery (13.3% gastric bypass, 18.7% gastric banding, and 68.0% vertical banded gastroplasty) and 2040 control patients with obesity matched on group level based on 18 variables. Median follow-up was between 15.1 and 17.9 years for the different treatment groups.Results. Duringfollow-up,the highestincidence ratefor first-time fracture was observed in the gastric bypass group (22.9 per 1000 person-years). The corresponding incidence rates were 10.4, 10.7 and 9.3 per 1000 person-years for the vertical banded gastroplasty, gastric banding and control groups, respectively. The risk of fracture was increased in the gastric bypass group compared with the control group (adjusted hazard ratio [adjHR] 2.58; 95% confidence interval [CI] 2.02-3.31; P < 0.001), the gastric banding group (adjHR 1.99; 95%CI 1.41-2.82; P < 0.001), and the vertical banded gastroplasty group (adjHR 2.15; 95% CI 1.66-2.79; P < 0.001).Conclusions. The risk of fracture is increased after gastric bypass surgery. Our findings highlight the need for long-term follow-up of bone health for patients undergoing this treatment.Fracture and bariatric surgery / S. Ahlin et al.

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Effect of Gastric Bypass on Bone Mineral Density, Parathyroid Hormone and Vitamin D: 5 Years Follow-up

Abstract: LRYGB is an efficient method for sustained long-term body weight loss. There is, however, a concomitant decrease in BMD and S-calcium, and an increase in fP-PTH.

Cited by 46 publications

References 15 publications

Nutrition Implications for Long‐Term Survivors of Pancreatic Cancer Surgery

Nutrition Implications for Long‐Term Survivors of Pancreatic Cancer Surgery

A systematic review of the interrelation between diet- and surgery-induced weight loss and vitamin D status

Fracture risk after three bariatric surgery procedures in Swedish obese subjects: up to 26 years follow‐up of a controlled intervention study

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