Effect of Roux-en Y Gastric Bypass on Bone Metabolism in Patients with Morbid Obesity: Mansoura Experiences

Mahdy, Tarek; Atia, Samir M; Farid, Mohamed; Adulatif, Atef

doi:10.1007/s11695-008-9653-1

Cited by 83 publications

(79 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the present study, median serum 25(OH)D in BS group was low and not different from Cont before surgery, which agrees well with other reports (9,12). Whereas hypovitaminosis D in class II and III obese patients more often occurs because of the sequestration of vitamin D in adipose tissue (16), the reasons in BS patients include not only pre-operative low levels of 25(OH)D (15), but also low compliance with oral supplements (17).…”

Section: Discussionsupporting

confidence: 93%

“…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%

“…However, the procedure entails long-term complications such as nutritional deficiencies, nephrolithiasis (5), as well as other disturbances in bone and mineral metabolism, including low bone mass and increased risk of fractures after a substantial weight loss (6)(7)(8)(9). Bone loss may be attributed to a reduction of lean body mass during the weight reduction process, previous obesity-induced hypovitaminosis D, which persists even after surgery, and malabsorption of calcium and vitamin D following the procedure (10,11).…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies that evaluated skeletal changes after bariatric surgery through dual-energy x-ray absorptiometry (DXA), quantitative computed tomography (QCT) and high-resolution peripheral computed tomography (HR-pQCT) demonstrated a decreased BMD and also increased bone turnover markers (7,9,(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Bone turnover after bariatric surgery

Melo

Froeder

Baia

et al. 2017

Arch. Endocrinol. Metab.

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Bone turnover after bariatric surgery

Melo

Froeder

Baia

et al. 2017

Arch. Endocrinol. Metab.

View full text Add to dashboard Cite

show abstract

“…acompanharam 70 pacientes obesos, submetidos à cirurgia bariátrica, por um ano, recebendo suplementação de 1.000 mg de cálcio e 800 UI de vitamina D e verificaram que não houve modificação nos níveis de 25OHD e na frequência de hiperparatiroidismo secundário, após a suplementação. Vale ressaltar que a adesão à suplementação de cálcio e vitamina D, em longo prazo, frequentemente não é satisfatória, favorecendo, em pacientes submetidos à cirurgia bariátrica, a instalação de doença metabólica óssea (21).…”

Section: Discussionunclassified

Alterações de parâmetros relacionados ao metabolismo ósseo em mulheres submetidas à derivação gástrica em Y de Roux

Santos

Souza

Fonseca

et al. 2012

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

RESUMOObjetivo: Avaliar o metabolismo ósseo e a densidade mineral óssea (DMO) em mulheres adultas pós-derivação gástrica em Y de Roux (DGYR). Sujeitos e métodos: Estudo transversal com 48 mulheres submetidas a DGYR há três anos e 41 saudáveis. Dados obtidos: índice de massa corporal (IMC), atividade física, consumo alimentar e DMO da coluna lombar, colo e fêmur total. Dosagem de cálcio, fósforo, magnésio, albumina, fosfatase alcalina, telopeptídeo-C (CTX), paratormônio (PTH), 25-hidroxivitamina D (25OHD), osteocalcina e cálcio urinário. Resultados: Maiores alterações no grupo DGYR observadas nos níveis de osteocalcina (p < 0,001), CTX (p < 0,001) e PTH (p < 0,001). Deficiência de 25OHD foi a mais frequente no grupo DGYR (p = 0,010). Deficiência/insuficiência de 25OHD associou-se com hiperparatiroidismo secundário (p = 0,025). Não houve diferença entre os grupos em relação à DMO. A ingestão de energia (p = 0,036) e proteína (p = 0,004) foi maior no grupo controle. Conclusão: Em mulheres pós-DGYR, encontraram-se alta frequência de deficiência de vitamina D, hiperparatireoidismo secundário e elevação nos marcadores de remodelação óssea, sem alteração na DMO quando comparado com o grupo controle não obeso. Arq Bras Endocrinol Metab. 2012;56(6):376-82 Descritores Cirurgia bariátrica; densidade mineral óssea; vitamina D; hiperparatiroidismo secundário; anastomose em-Y de Roux ABSTRACT Objective: To evaluate bone turnover markers and bone mineral density (BMD) in women after Roux-en-Y (RYGB) gastric bypass. Subjects and methods: In a cross-sectional study, 48 women post-RYGB after three years, and 41 healthy women were evaluated. Evaluations: body mass index (BMI); physical activity; food intake; serum levels of calcium, phosphorus, magnesium, alkaline phosphatase, C-terminal telopeptide (CTX), intact parathyroid hormone (PTH), 25-hydroxyvitamin D (25OHD), osteocalcin, urinary calcium and BMD. Results: Significantly higher levels were observed for osteocalcin (p < 0.001), CTX (p < 0.001), and PTH (p < 0.001) in the RYGB group when compared with the control group; 25OHD deficiency/insufficiency was more frequent in the RYGB group (p = 0.010), even after adjusted for nutritional status, and it was associated with secondary hyperparathyroidism (p = 0.025); there was no difference in BMD between the groups. Energy (p = 0.036) and protein intake (p = 0.004) were lower in the RYGB group. Conclusion: Patients submitted to RYGB showed a significantly higher frequency of vitamin D deficiency, secondary hyperparathyroidism, and increase in bone remodeling markers, with no difference in BMD status. Arq Bras Endocrinol Metab. 2012;56(6):376-82

show abstract

Association of Bariatric Surgery With Risk of Fracture in Patients With Severe Obesity

et al. 2020

View full text Add to dashboard Cite

IMPORTANCE Given the complex relationship between body mass index, body composition, and bone density and the correlative nature of the studies that have established the prevailing notion that higher body mass indices may be protective against osteopenia and osteoporosis and, therefore, fracture, the absolute risk of fracture in patients with severe obesity who undergo either Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) compared with those who do not undergo bariatric surgery is unknown. OBJECTIVE To assess the rates of fractures associated with obesity and compare rates between those who do not undergo bariatric surgery, those who undergo RYGB, and those who undergo SG. DESIGN, SETTING, AND PARTICIPANTS In this retrospective multicenter cohort study of Medicare Standard Analytic Files derived from Medicare parts A and B records from January 2004 to December 2014, patients classified as eligible for bariatric surgery using the US Centers of Medicare & Medicaid criteria who either did not undergo bariatric surgery or underwent RYGB or SG were exactly matched in a 1:1 fashion based on their age, sex, Elixhauser Comorbidity Index, hypertension, smoking status, nonalcoholic fatty liver disease, hyperlipidemia, type 2 diabetes, osteoporosis, osteoarthritis, and obstructive sleep apnea status. Data were analyzed from November to December 2019. EXPOSURES RYGB or SG. MAIN OUTCOMES AND MEASURES The primary outcome measured in this study was the odds of fracture overall based on exposure to bariatric surgery. Secondary outcomes included the odds of type of fracture (humerus, radius or ulna, pelvis, hip, vertebrae, and total fractures) based on exposure to bariatric surgery. RESULTS A total of 49 113 patients were included and were equally made up of 16 371 bariatric surgery-eligible patients who did not undergo weight loss surgery, 16 371 patients who had undergone RYGB, and 16 371 patients who had undergone SG. Each group consisted of an equal number of 4109 men (25.1%) and 12 262 women (74.9%) and had an equal distribution of ages, with 11 780 patients (72.0%) 64 years or younger, 4230 (25.8%) aged 65 to 69 years, 346 (2.1%) aged 70 to 74 years, and 15 (0.1%) aged 75 to 79 years. Patients undergoing RYGB were found to have no significant difference in odds of fractures compared with bariatric surgery-eligible patients who did not undergo surgery. Patients undergoing undergone SG were found to have decreased odds of fractures of the humerus (odds ratio [OR], 0.57; 95% CI, 0.45-0.73), radius or ulna (OR, 0.38; 95% CI, 0.25-0.58), hip (OR, 0.49; 95% CI, 0.33-0.74), pelvis (OR, 0.34; 95% CI, 0.18-0.64), vertebrae (OR, 0.60; 95% CI, 0.48-0.74), or fractures in general (OR, 0.53; 95% CI, 0.46-0.62). Compared with patients undergoing SG, patients undergoing RYGB had a significantly greater risk of total fractures (OR, 1.79; 95% CI, 1.55-2.06) and humeral fractures (OR, 1.60; 95% CI, 1.24-2.07).

show abstract

Effect of Roux-en Y Gastric Bypass on Bone Metabolism in Patients with Morbid Obesity: Mansoura Experiences

Cited by 83 publications

References 40 publications

Bone turnover after bariatric surgery

Bone turnover after bariatric surgery

Alterações de parâmetros relacionados ao metabolismo ósseo em mulheres submetidas à derivação gástrica em Y de Roux

Association of Bariatric Surgery With Risk of Fracture in Patients With Severe Obesity

Contact Info

Product

Resources

About