Bone Disease After Jejuno-Ileal Bypass for Obesity

Compston, J.E.; Laker, M. F.; Woodhead, J. S.; Gazet, J C; Horton, L. W. L.; Ayers, A. B.; Bull, Harold J.; Pilkington, T. R. E.

doi:10.1016/s0140-6736(78)91318-1

Cited by 121 publications

(33 citation statements)

References 27 publications

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“…This finding supports the earlier observations of Compston et al (33) and Kruse et al (28). After three months on diet B supplemented with 0.04mg of vitamin D3/100g of diet, Ca content in femur was similar to that seen after one month on this regimen, and higher in comparison to resected rats given diet A.…”

Section: Discussionsupporting

confidence: 93%

Nutritive utilization of calcium in rats: Effects of dietary fat components and vitamin D3 on intestinal resected rats.

Campos

López-Áliaga

Barrionuevo

et al. 1989

Journal of Nutritional Science and Vitaminology, J Nutr Sci Vit

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SummaryThe nutritive utilization of calcium was studied in adult rats in which 50% of the distal small intestine (DSI) had been resected and in sham-operated controls one month and three months after the operation. Resection of half the DSI reduced the digestive utilization of Ca as reflected by mineral content in bone. Three months after resection, nutritive utilization of Ca had still not recovered. Feeding the resected rats with a diet in which fat content consisted of equal parts of medium-chain triglycerides (MCT), sunflower seed oil, and olive oil failed to improve nutritive utilization of Ca after one or three months in comparison with a diet containing olive oil as the only source of lipids. Supplementation with vitamin D3 (0.04mg/100g diet) enhanced nutritive utilization of Ca in resected rats after one month, the beneficial effect becoming much more patent after three months. At the dose used, vitamin D3 favored calcium deposition in bone tissue. Serum levels of Ca remained unchanged under all experimental conditions, both one month and three months after 50% DSI resection.

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Section: Discussionsupporting

confidence: 93%

Nutritive utilization of calcium in rats: Effects of dietary fat components and vitamin D3 on intestinal resected rats.

Campos

López-Áliaga

Barrionuevo

et al. 1989

Journal of Nutritional Science and Vitaminology, J Nutr Sci Vit

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“…Our results confirm previous reports of calcium malabsorption in patients with small intestinal resection [5,16] or bypass [6,11,21] and demonstrate that oral administration of 2 pg daily of l,25(OH)2D3 or 1-alpha-(OH)D3 increase calcium absorption in these patients. Although oral l,25(OH)2D3 and 1-alpha-(OH)D3 have both been shown to stimulate intestinal calcium absorption in normal subjects [3] and in a variety of disease states [2,3,15], little is known about their effect in patients with malabsorption.…”

Section: Discussionsupporting

confidence: 92%

“…3 weeks treatment with 1-alpha-hydroxyvitamin D, 1 pg b.d., or 1,25-dihydroxyvitamin D, 1 pg b.d., was associated with significant increases in absorption whereas 3 weeks treatment with 24,25-dihydroxyvitamin D had no effect. This study demonstrates that oral 1.25-dihydroxyvitamin D or 1-alpha-hydroxyvitamin D are effective in increasing calcium absorption.Calcium malabsorption has been reported after small intestinal resection [5,16] or by pass surgery [6,11,21] and may contribute to the osteomalacia that occurs in some of these patients. …”

mentioning

confidence: 99%

Intestinal Calcium Absorption in Patients after Jejuno-Ileal Bypass or Small Intestinal Resection and the Effect of Vitamin D

1986

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A forearm counter and double-isotope technique were used to measure intestinal calcium absorption in 21 patients after jejuno-ileal bypass for obesity or small intestinal resection. In all but 2 patients calcium absorption was below the normal range for 10 male controls. 3 weeks treatment with 1-alpha-hydroxyvitamin D, 1 μg b.d., or 1,25-dihydroxyvitamin D, 1 μg b.d., was associated with significant increases in absorption whereas 3 weeks treatment with 24,25-dihydroxyvitamin D had no effect. This study demonstrates that oral 1,25-dihydroxyvitamin D or 1-alpha-hydroxyvitamin D are effective in increasing calcium absorption.

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“…This is supported by the fact that the fall in serum calcium is not always due to a disturbance of vitamin D metabolism. 10,11 Roux-en-Y gastric bypass is essentially restrictive, but also causes moderate and selective malabsorption. 12 Several studies have shown a high incidence of vitamin B 12 (70%), folate (38%) and iron (49%) deficiencies, and anemia (12%) after this procedure.…”

Section: Introductionmentioning

confidence: 99%

Bone metabolism and risk of secondary hyperparathyroidism 12 months after gastric banding in obese pre-menopausal women

et al. 2003

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OBJECTIVE:To evaluate, during the first postoperative year in obese pre-menopausal women, the effects of laparoscopic gastric banding on calcium and vitamin D metabolism, the potential modifications of bone mineral content and bone mineral density, and the risk of development of secondary hyperparathyroidism. SUBJECTS: Thirty-one obese pre-menopausal women aged between 25 and 52 y with a mean body mass index (BMI) of 43.6 kg=m 2 , scheduled for gastric banding were included. Patients with renal, hepatic, metabolic and bone disease were excluded. METHODS: Body composition and bone mineral density (BMD) were measured at baseline, 6 and 12 months after gastric banding using dual-energy X-ray absorptiometry. Serum calcium, phosphate, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, g-glutamyltransferase, bilirubin, urea, creatinine, uric acid, proteins, parathormone, vitamin D 3 , IGF-1, IGF-BP3 and telopeptide, as well as urinary telopeptide, were measured at baseline and 1, 3, 6, 9 and 12 months after surgery. RESULTS: After 1 y vitamin D3 remained stable and PTH decreased by 12%, but the difference was not significant. Serum telopeptide C increased significantly by 100% (P < 0.001). There was an initial drop of the IGF-BP3 during the first 6 months (P < 0.05), but the reduction was no longer significant after 1 y. The BMD of cortical bone (femoral neck) decreased significantly and showed a trend of a positive correlation with the increase of telopeptides (P < 0.06). The BMD of trabecular bone, at the lumbar spine, increased proportionally to the reduction of hip circumference and of body fat. CONCLUSION: There is no evidence of secondary hyperparathyroidism 1 y after gastric banding. Nevertheless biochemical bone markers show a negative remodelling balance, characterized by an increase of bone resorption. The serum telopeptide seems to be a reliable parameter, not affected by weight loss, to follow up bone turnover after gastroplasty.

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Bone Disease After Jejuno-Ileal Bypass for Obesity

Cited by 121 publications

References 27 publications

Nutritive utilization of calcium in rats: Effects of dietary fat components and vitamin D3 on intestinal resected rats.

Nutritive utilization of calcium in rats: Effects of dietary fat components and vitamin D3 on intestinal resected rats.

Intestinal Calcium Absorption in Patients after Jejuno-Ileal Bypass or Small Intestinal Resection and the Effect of Vitamin D

Bone metabolism and risk of secondary hyperparathyroidism 12 months after gastric banding in obese pre-menopausal women

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