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Obesity Surgery
Published in: Obesity Surgery 8/2012

01-08-2012 | Allied Care

Changes in Bone Mineral Density in Women Following 1-Year Gastric Bypass Surgery

Authors: Daniela Schaan Casagrande, Giuseppe Repetto, Claudio Corá Mottin, Jatin Shah, Ricardo Pietrobon, Mathias Worni, Beatriz D. Schaan

Published in: Obesity Surgery | Issue 8/2012

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Abstract

Background

Roux-en-Y gastric bypass (RYGB) surgery is the gold standard surgical treatment for obesity. However, unintended nutritional deficiencies following this surgery are common, including changes in bone metabolism. We assessed changes in bone mineral density (BMD), nutritional compounds, and bone resorption markers before and 1 year following RYGB surgery.

Methods

Our study included 22 female patients with class II/III obesity. A clinical questionnaire, a 24-h recall, blood and urine samples, and dual-energy X-ray absorptiometry were provided.

Results

Mean age was 37.2 ± 9.6 years; 86 % were Caucasian and 77.2 % were premenopausal. Mean preoperative body mass index was 44.4 ± 5.0 and 27.5 ± 4.5 kg/m2 at 1-year follow-up (p < 0.001). 25-OH-vitamin D-levels were similar in both periods [11.7 (9.7–18.0) vs. 15.7 (10.2–2.7) pg/dL, p = 0.327]. Serum N-telopeptide (16.3 ± 3.4 vs. 38.2 ± 7.0 nM BCE, p < 0.001) and parathyroid hormone (45.4 ± 16.7 vs. 62.7 ± 28.9 pg/mL, p = 0.026) increased after RYGB surgery, reflecting bone resorption. BMD decreased after RYGB surgery in the lumbar spine (1.13 ± 0.11 vs. 1.04 ± 0.09 g/cm2, p = 0.001), femoral neck (1.03 ± 0.15 vs. 0.94 ± 0.16 g/cm2, p = 0.001), and total femur (1.07 ± 0.11 vs. 0.97 ± 0.15 g/cm2, p = 0.003).

Conclusions

Decreased BMD in the lumbar spine, femoral neck, and total femur is detectable in women 1 year after RYGB surgery. Calcium malabsorption, caused by vitamin D deficiency and increased bone resorption, is partially responsible for these outcomes and should be targeted in future clinical trials.
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Metadata
Title
Changes in Bone Mineral Density in Women Following 1-Year Gastric Bypass Surgery
Authors
Daniela Schaan Casagrande
Giuseppe Repetto
Claudio Corá Mottin
Jatin Shah
Ricardo Pietrobon
Mathias Worni
Beatriz D. Schaan
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 8/2012
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-012-0687-z

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