A Gender Comparison of Bone Metabolic Changes After Gastric Cancer Surgery: A Prospective Observational Study

Abstract

Background/Aim: This study was designed to investigate gender-related differences in changes in bone metabolism after gastric cancer surgery. Patients and Methods: We prospectively recruited 47 patients (38 males and 9 females) who had early gastric cancer. The bone mineral density (BMD), serum levels of 1,25-dihydroxy vitamin D (1,25(OH) 2 VD), 25-hydroxy vitamin D (25(OH)VD), and estradiol (E2) were measured before and after surgery. Results: BMD significantly decreased 12 months after surgery by median degrees of 3.4% and 3.9% in male and female patients, respectively (p<0.001 and p=0.023). There was no significant difference between both genders in the rate of change in BMD after surgery. The serum E2 level in male patients significantly increased by a median value of 22 pg/ml 12 months after gastrectomy (p=0.030). Both the serum 25(OH)VD and 1,25(OH) 2 VD levels remained nearly within the normal range throughout the observation period in both male and female patients. Conclusion: BMD significantly decreased within 12 months after gastrectomy in both male and female patients with gastric cancer, and there was no significant gender-related difference in the rate of change in BMD.

Vitamin D—The Nutritional Status of Post-Gastrectomy Gastric Cancer Patients—Systematic Review

“…However, the findings of several authors suggest that gastric cancer gastrectomy does not affect serum vitamin D concentration levels, or at least some of its metabolites, as stated previously. A study by Atsumi et al in 2021 showed that the concentration levels of 25(OH)D, 1,25(OH) 2 D remained stable 12 months after the surgery [14]. In 2019, the same author reported that despite surgery, 1,25(OH) 2 D levels were consistently in the normal range up to two years of follow-up [17].…”

“…The first report was made by Kobayashi et al in 1994 [31], while the newest data were reported by Atsumi et al in 2021 [14]. The investigated vitamin D metabolites were 25(OH)D (11 studies) [14,[17][18][19]21,[23][24][25][26]28,31], 1,25(OH) 2 D (6 studies) [14,17,24,25,27,31], and 24,25(OH) 2 D (2 studies) [24,31]. Six studies did not report the investigated metabolite [15,16,20,22,29,30], declaring that they analyzed "serum vitamin D".…”

“…The majority of the patients were men. The first report was made by Kobayashi et al in 1994 [31], while the newest data were reported by Atsumi et al in 2021 [14]. The investigated vitamin D metabolites were 25(OH)D (11 studies) [14,[17][18][19]21,[23][24][25][26]28,31], 1,25(OH) 2 D (6 studies) [14,17,24,25,27,31], and 24,25(OH) 2 D (2 studies) [24,31].…”

“…Six studies did not report the investigated metabolite [15,16,20,22,29,30], declaring that they analyzed "serum vitamin D". The other concomitant and most frequently analyzed parameters were bone mineral density (nine studies) [14,16,17,[19][20][21]23,26,30], serum estradiol level (three studies) [14,17,25] and other bone metabolism biomarkers, as part of the studies focused on bone density and risk of osteoporosis after gastric cancer surgery with vitamin D and its metabolites evaluated only as indicators. Five studies reported the type of surgery with the declared techniques Billroth I, Billroth II, and Roux-en-Y [18,24,25,28,31].…”

“…Five studies reported the type of surgery with the declared techniques Billroth I, Billroth II, and Roux-en-Y [18,24,25,28,31]. Seven out of 18 studies analyzed changes or serum vitamin D concentration 12 months after surgery [14,[16][17][18][19]22,23]; the longest reported time from surgery to analysis was 18 years [29].…”