Weight-Reducing Gastroplasty with Roux-en-Y Gastric Bypass: Impact on Vitamin D Status and Bone Remodeling Markers

Biagioni, M.; Mendes, Adriana Lúcia; Nogueira, Célia Regina; Paiva, Sérgio Alberto Rupp de; Leite, Celso Vieira de Souza; Mazeto, Gláucia Maria Ferreira da Silva

doi:10.1089/met.2013.0026

Cited by 17 publications

(9 citation statements)

References 26 publications

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“…(15) and with other investigators, who employed different biochemical markers of bone formation (8,12). Moreover, urinary DPYD was also higher in BS patients than in Cont, indicating an increased bone resorption, as detected by other investigators (20,21), even when using different bone resorption markers as well (8,20,22,23). Therefore, an increased bone turnover has been clearly evidenced by the present findings, which corroborates with numerous reports (8,12,13,15,24), although not with all of them (9,21).…”

Section: Discussionsupporting

confidence: 92%

Bone turnover after bariatric surgery

Melo

Froeder

Baia

et al. 2017

Arch. Endocrinol. Metab.

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Objective: The aim of the present study was to evaluate parameters of bone and mineral metabolism after bariatric surgery. Subjects and methods: This sectional study included data from medical records from 61 bariatric surgery (BS) patients (minimum period of 6 months after the procedure) and from 30 class II and III obese patients as a control group (Cont), consisting of daily dietary intake of macronutrients, calcium and sodium, serum 25(OH)D and parathyroid hormone (PTH) and other biochemical serum and urinary parameters. Bone alkaline phosphatase (BAP), leptin, fibroblast growth factor-23 (FGF-23) and deoxypyridinoline (DPYD) were determined from available banked serum and urinary samples. Results: Mean body mass index (BMI), median energy, carbohydrate, protein and sodium chloride consumption were significantly lower in the BS versus Cont, but calcium and lipids were not. No significant differences were found in ionized calcium, 25(OH)D, PTH and fibroblast growth factor 23 (FGF-23) between groups. Mean serum BAP was significantly higher for BS versus Cont and had a positive correlation with time after the surgical procedure. Mean serum leptin was significantly lower and median urinary DPYD higher in BS versus Cont. Conclusion: The present study showed an increase in bone markers of both bone formation and resorption among bariatric patients up to more than 7 years after the surgical procedure, suggesting that an increased bone turnover persists even at a very long-term follow-up in such patients. Arch Endocrinol Metab.2017;61(3):332-6.

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Section: Discussionsupporting

confidence: 92%

Bone turnover after bariatric surgery

Melo

Froeder

Baia

et al. 2017

Arch. Endocrinol. Metab.

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“…(29) Case reports have identified bone pain, height loss, and hypocalcemia, (30) as well as histologically confirmed osteomalacia (31) and osteitis fibrosa cystica (32) after RYGB. Numerous studies document elevated urinary and serum bone turnover markers, (17,19,20,(23)(24)(25)(26)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43) beginning as early as 3 months after surgery (19,34,35,42,43) that remain elevated throughout the second postoperative year (19,36,44) (Table 2). The typical increase in bone resorption markers far exceeds the increase in bone formation, consistent with net bone loss.…”

Section: Roux-en-y Gastric Bypass (Rygb)mentioning

confidence: 99%

Bone Metabolism After Bariatric Surgery

2014

Journal of Bone and Mineral Research

183

138

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Bariatric surgery is a popular and effective treatment for severe obesity, but may have negative effects on the skeleton. This review summarizes changes in bone density and bone metabolism from animal and clinical studies of bariatric surgery, with specific attention to Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB), and sleeve gastrectomy (SG). Skeletal imaging artifacts from obesity and weight loss are also considered. Despite challenges in bone density imaging, the preponderance of evidence suggests that bariatric surgery procedures have negative skeletal effects that persist beyond the first year of surgery, and that these effects vary by surgical type. The long-term clinical implications and current clinical recommendations are presented. Further study is required to determine mechanisms of bone loss after bariatric surgery. Although early studies focused on calcium/vitamin D metabolism and mechanical unloading of the skeleton, it seems likely that surgically-induced changes in the hormonal and metabolic profile may be responsible for the skeletal phenotypes observed after bariatric surgery.

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“…These findings suggest that bone formation occurs after bone resorption. Indeed, another study did not find changes in this marker shortly after RYGB [39].…”

Section: Discussionmentioning

confidence: 92%