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.

No abstract

Background: Decreased appetite is a symptom often found in chronic kidney disease. Poor appetite may negatively affect food intake, what in long-term may contribute to the development of protein–energy malnutrition. Methods: An Appetite and Food Satisfaction Questionnaire (AFSQ) was developed consisting of a question that assesses the level of appetite through a facial hedonic scale and five other questions adapted from the Buckner and Dwyer tool that assess some aspects related to food satisfaction. Each question received an arbitrary score of 0 to 3. The sum of the scores ranged from 0, the best, to 18, the worst condition. Nutritional status was assessed through seven-point SGA, bioelectrical impedance, anthropometry, and handgrip strength (HGS). Results: Eighty-four patients on peritoneal dialysis (PD; 58.3% women, mean age 54.7 ± 14.2 years, and body mass index (BMI) of 26.0 ± 4.8 kg/m2) were evaluated. Median AFSQ score was 4.0 (1.0–6.8; median and IQ). Patients were divided into tertiles according to the AFSQ score. Comparing the third tertile (score ≥ 6) with the first tertile (score < 2), the prevalence of malnutrition was greater (32.1% vs. 6.7%, respectively, p = 0.005), HGS adequacy was lower (74.6% vs. 87.3%, p = 0.001), and body cell mass index (5.7% vs. 7.4%, p = 0.001) and lean BMI were lower (11% vs. 13.4%, p = 0.001) in the third tertile. Conclusion: Poor appetite and food satisfaction determined by the questionnaire was related to worse nutritional markers, indicating AFSQ as a valid easy-to-use tool to be applied as an initial screening to identify PD patients with potential risk of malnutrition.

Background Low areal bone mineral density (BMD), increased fracture risk, and altered bone remodelling have been described among stone formers (SF), but the magnitude of these findings differs by age, sex, menopausal status, and urinary calcium (uCa). This study aimed to investigate volumetric (v) BMD, bone microarchitecture and biomechanical properties by high-resolution peripheral quantitative computed tomography (HR-pQCT) and finite element analysis (FEA) in young SF, irrespective of calciuria, further distinguishing trabecular from cortical compartments. Methods HR-pQCT/FEA was performed at distal tibia (DT) and radius (DR) in 106 SF (57 males/49 premenopausal females; median age, 37 years) and compared with 106 non-SF (NSF) retrieved from an existing database, matched for age, sex, and body mass index (BMI). Biochemical/hormonal serum and urinary parameters were obtained from SF. Results SF exhibited significantly lower trabecular number (Tb.N), higher trabecular separation (Tb.Sp) than NSF at both anatomical sites and lower cortical porosity in DR. In a subgroup analysis separated by sex, female SF presented significantly lower Tb.vBMD, relative bone volume fraction (BV/TV) and Tb.N, and higher Tb.Sp than NSF at both sites, while male SF showed significantly lower stiffness and failure load. A multivariate analysis showed Tb.N to be independently associated with sex and BMI at both sites and with uCa at DR. Conclusions The present findings suggest that bone disease represents an early event among SF, associated at least in part with calcium excretion, and mainly characterized by trabecular bone microarchitecture impairment, especially among women, but with reduced bone strength parameters in men.