The effects of adolescent laparoscopic adjustable gastric band and sleeve gastrectomy on markers of bone health and bone turnover

Weiner, Alyson; Cowell, Amanda; McMahon, Donald J.; Tao, Rachel; Zitsman, Jeffrey L.; Oberfield, Sharon E.; Fennoy, Ilene

doi:10.1111/cob.12411

Cited by 12 publications

(10 citation statements)

References 37 publications

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“…However, adolescents in previous studies undergoing SG report lower PTH and higher 25-hydroxy vitamin D levels than observed in our study ( 24 , 25 ). For instance, Weiner et al reported baseline PTH levels of 42.95 ± 29.37 pg/ml among adolescents with significant decline at 6 (−3.2%) and 12 months (−6.8%) post SG ( 24 ) compared to baseline PTH of 65.9 ± 19.4 pg/ml observed in our study cohort which remained unchanged at 12 months.…”

Section: Discussioncontrasting

confidence: 88%

“…For instance, Weiner et al reported baseline PTH levels of 42.95 ± 29.37 pg/ml among adolescents with significant decline at 6 (−3.2%) and 12 months (−6.8%) post SG (24) compared to baseline PTH of 65.9 ± 19.4 pg/ml observed in our study cohort which remained unchanged at 12 months. Weiner et al also reported a higher baseline 25-hydroxy vitamin D (19.86 ± 8.24 ng/ml) compared to our study (13.6 ± 6.3 ng/ml), although the levels remained unchanged at 12 months in both studies (25). These results are possibly confounded by the fact that patients received vitamin D3 and calcium supplementations, as is typical after bariatric surgery, to counter the detrimental impact on bone health.…”

Section: Discussioncontrasting

confidence: 71%

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Metabolic and hormonal changes after laparoscopic sleeve gastrectomy in pediatric population: An observational study

et al. 2022

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IntroductionDespite the growing popularity of laparoscopic sleeve gastrectomy (SG) for managing severe obesity in children, adolescents, and adults, there is a paucity of studies reporting the effects of SG on metabolic and hormonal outcomes in pediatric populations.MethodologyIn this single-centre, retrospective study, we assessed nutritional biomarkers (hemoglobin, ferritin, iron profile, Vitamin B12, Vitamin D, and calcium), glucose homeostasis indicators (C-peptide, HbA1C, and random blood glucose), blood lipids (triglycerides and cholesterol components), hormones involved in the hypothalamic-pituitary-adrenal axis (cortisol and adrenocorticotropic hormone), and thyroid hormones (T3, T4, thyroid-stimulating hormone, and parathyroid hormone) preoperatively and 12-month after SG in children aged 5–15 years.ResultsThis study included 64 adolescents (mean age = 11.2 ± 2.3 years) who underwent laparoscopic SG. Significant reduction in circulatory C-peptide (−62.1%; p = 0.005), HbA1C (−10.9%; p = 0.001), random blood glucose (−15.4%; p = 0.036), and triglycerides (−39.4%; p = 0.003) were observed postoperatively at 12 months compared to baseline. Although we did not observe any changes in cortisol levels, adrenocorticotropic hormone levels declined significantly by −40.9% postoperatively (p = 0.033). However, cholesterol components, thyroid hormones, and nutritional biomarkers remained unchanged from baseline.ConclusionsConsistent with prior literature, our study demonstrates improvement or resolution of diabetes and hypertriglyceridemia in the year following SG. However, given that blood cholesterol components, nutritional biomarkers, and thyroid profiles remained unchanged warrants long-term monitoring of nutritional, metabolic, and endocrine factors in adolescents undergoing laparoscopic SG. To the best of our knowledge, this is the first study reporting the effects of SG on thyroid and hypothalamic-pituitary-adrenal axis hormones in pediatric populations.

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Section: Discussioncontrasting

confidence: 88%

Section: Discussioncontrasting

confidence: 71%

Metabolic and hormonal changes after laparoscopic sleeve gastrectomy in pediatric population: An observational study

et al. 2022

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“…Interestingly, the magnitude of variation in bone turnover markers is reportedly similar between diabetic and non-diabetic cohorts undergoing bariatric surgery, yet patients T2DM patients carry per se a higher risk of osteoporosis ( 122 , 123 ). Because alterations in CTX and P1NP levels have also been reported in adolescents after RYGB ( 124 ) and SG ( 125 ), uncertainties remain on the final effect of bariatric surgery on bone mass peak and subsequent adult risk of osteoporosis.…”

Section: Bone Turnover Markers After Bariatric Surgerymentioning

confidence: 99%

Bone Response to Weight Loss Following Bariatric Surgery

et al. 2022

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Obesity is a global health challenge that warrants effective treatments to avoid its multiple comorbidities. Bariatric surgery, a cornerstone treatment to control bodyweight excess and relieve the health-related burdens of obesity, can promote accelerated bone loss and affect skeletal strength, particularly after malabsorptive and mixed surgical procedures, and probably after restrictive surgeries. The increase in bone resorption markers occurs early and persist for up to 12 months or longer after bariatric surgery, while bone formation markers increase but to a lesser extent, suggesting a potential uncoupling process between resorption and formation. The skeletal response to bariatric surgery, as investigated by dual-energy X-ray absorptiometry (DXA), has shown significant loss in bone mineral density (BMD) at the hip with less consistent results for the lumbar spine. Supporting DXA studies, analyses by high-resolution peripheral quantitative computed tomography (HR-pQCT) showed lower cortical density and thickness, higher cortical porosity, and lower trabecular density and number for up to 5 years after bariatric surgery. These alterations translate into an increased risk of fall injury, which contributes to increase the fracture risk in patients who have been subjected to bariatric surgery procedures. As bone deterioration continues for years following bariatric surgery, the fracture risk does not seem to be dependent on acute weight loss but, rather, is a chronic condition with an increasing impact over time. Among the post-bariatric surgery mechanisms that have been claimed to act globally on bone health, there is evidence that micro- and macro-nutrient malabsorptive factors, mechanical unloading and changes in molecules partaking in the crosstalk between adipose tissue, bone and muscle may play a determining role. Given these circumstances, it is conceivable that bone health should be adequately investigated in candidates to bariatric surgery through bone-specific work-up and dedicated postsurgical follow-up. Specific protocols of nutrients supplementation, motor activity, structured rehabilitative programs and, when needed, targeted therapeutic strategies should be deemed as an integral part of post-bariatric surgery clinical support.

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“…The bone resorption marker β-CTX was used for the assessment of bone remodelling in the case presented, mainly for its widespread availability. β-CTX has a wide range of potential applications in paediatric settings regarding either primary or secondary bone metabolism disorders [ 14 , 15 , 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Bone Turnover Marker for the Evaluation of Skeletal Remodelling in Autosomal Recessive Osteopetrosis after Haematopoietic Stem Cell Transplantation: A Case Report

Horváth

Kassa

et al. 2023

Children

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Background: Autosomal recessive osteopetrosis (ARO) is a rare genetic disorder of bone metabolism, primarily affecting the remodelling function of osteoclasts. Haematopoietic stem cell transplantation (HSCT) is the first-line treatment for ARO. Traditional tools for the assessment of therapeutic response, such as measuring donor chimerism, do not provide information on bone remodelling. The use of bone turnover markers (BTMs) might be ideal. Here, we report a case of a paediatric ARO patient undergoing successful HSCT. Methods: For the evaluation of donor-derived osteoclast activity and skeletal remodelling throughout the transplantation, the bone resorption marker β-CTX (β-C-terminal telopeptide) was used. Results: The low baseline level of β-CTX markedly increased after transplantation and remained in the elevated range even after 3 months. Donor-derived osteoclast activity reached its new baseline level around the 50th percentile range after 5 months and proved to be stable during the 15-month follow-up time. The apparent increase of the baseline osteoclast activity after HSCT was in consonance with the radiographic improvement of the disease phenotype and the correction of bone metabolic parameters. Despite the successful donor-derived osteoclast recovery, craniosynostosis developed, and reconstructive surgery had to be performed. Conclusions: The use of β-CTX may be of aid in assessing osteoclast activity throughout the transplantation. Further studies could help to establish the extended BTM profile of ARO patients using the available osteoclast- and osteoblast-specific markers.

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The effects of adolescent laparoscopic adjustable gastric band and sleeve gastrectomy on markers of bone health and bone turnover

Cited by 12 publications

References 37 publications

Metabolic and hormonal changes after laparoscopic sleeve gastrectomy in pediatric population: An observational study

Metabolic and hormonal changes after laparoscopic sleeve gastrectomy in pediatric population: An observational study

Bone Response to Weight Loss Following Bariatric Surgery

Bone Turnover Marker for the Evaluation of Skeletal Remodelling in Autosomal Recessive Osteopetrosis after Haematopoietic Stem Cell Transplantation: A Case Report

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