The change of bone mineral density and bone metabolism after gastrectomy for gastric cancer: a meta-analysis

Oh, Hyukjun; Yoon, Byung‐Ho; Ha, Yong Chan; Suh, Dongchul; Lee, S.-M.; Koo, Kyung Hoi; Lee, Y.-K.

doi:10.1007/s00198-019-05220-2

Cited by 20 publications

(20 citation statements)

References 40 publications

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“…Factors leading to decreased bone mineral density in this population were calcium malabsorption, secondary hyperparathyroidism, and dominant bone resorption with a pooled incidence of decreased BMD estimated at 36%. It was also found that calcium and 25(OH)vitamin D levels were significantly decreased, while PTH and 1,25(OH)D levels increased significantly in the gastrectomy group compared to the control group [49]. Their findings remain consistent with those obtained in this review: in all studies investigating BMD after gastrectomy in gastric cancer survivors, it was decreased [14,16,17,[19][20][21]23,26,30].…”

Section: Discussionsupporting

confidence: 86%

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

et al. 2022

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Gastric cancer is a malignant neoplasm of the gastrointestinal tract, with one of the standard treatment methods remaining gastrectomy. The authors conducted a systemic review of the Medline and Embase databases concerning the serum vitamin D level in post-gastrectomy gastric cancer patients, regarding all articles published until 22 May 2022 according to the PRISMA guidelines. 18 studies with a total number of 908 gastric cancer survivors were included in the analysis. The initial rate of vitamin D deficiency in gastric cancer patients undergoing gastrectomy appears to be similar to the global population deficiency. In post-gastrectomy survivors, the level of 25(OH)D may remain stable or decrease, while the level of 1, 25(OH)2D remains normal. Supplementation with vitamin D results in an improvement in its serum concentration and positively affects bone mineral density, which is gradually reduced in post-gastrectomy survivors. Combining vitamin D supplementation with calcium and bisphosphonates enables us to obtain better results than vitamin D and calcium only. The type of surgery influences the level of serum vitamin D and its metabolites, with total or partial gastrectomy and maintenance of the duodenal food passage remaining the most important factors. There is a strong need for randomized, controlled trials that would investigate this matter in the future.

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Section: Discussionsupporting

confidence: 86%

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

et al. 2022

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“…Metabolic bone disorders after gastrectomy and after gastric bypass with Roux-en-Y reconstruction have been well described in the literature. 10,[14][15][16][17] Loss of bone mineral density after gastric resection has been attributed to decreased dietary intake, vitamin D deficiency, loss of load-bearing weight due to weight loss, decreased calcium absorption secondary to bypass of the duodenum, and rapid transit leading to increased bone resorption. 10,[14][15][16][17] Weakened bone mass can lead to osteopenia or osteoporosis, which increases the risk of fractures and can reduce overall quality of life.…”

Section: Why Emerging Adults Should Be Worried About the Ptg Diet And...mentioning

confidence: 99%

“…10,[14][15][16][17] Loss of bone mineral density after gastric resection has been attributed to decreased dietary intake, vitamin D deficiency, loss of load-bearing weight due to weight loss, decreased calcium absorption secondary to bypass of the duodenum, and rapid transit leading to increased bone resorption. 10,[14][15][16][17] Weakened bone mass can lead to osteopenia or osteoporosis, which increases the risk of fractures and can reduce overall quality of life. 17 As discussed above, although the ASMBS guidelines are intended for bariatric patients, using these guidelines for this analogous population is useful for monitoring and supplementing specific micronutrients.…”

Section: Why Emerging Adults Should Be Worried About the Ptg Diet And...mentioning

confidence: 99%

“…10,[14][15][16][17] Weakened bone mass can lead to osteopenia or osteoporosis, which increases the risk of fractures and can reduce overall quality of life. 17 As discussed above, although the ASMBS guidelines are intended for bariatric patients, using these guidelines for this analogous population is useful for monitoring and supplementing specific micronutrients. 6 ASMBS guidelines after Roux-en-Y gastric bypass recommend patients receive 1,200 to 1,500 mg/d elemental calcium as calcium citrate and adequate vitamin D supplementation to maintain 25-hydroxy vitamin D in the optimal range.…”

Section: Why Emerging Adults Should Be Worried About the Ptg Diet And...mentioning

confidence: 99%

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Emerging Adults Carrying a CDH1 Pathogenic or Likely Pathogenic Variant Face Diet and Lifestyle Challenges after Total Gastrectomy

Liu;¹,

Lopez²

2022

Journal of the Academy of Nutrition and Dietetics

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“…Patients who have undergone gastrectomy for cancer, alone or in combination with chemotherapy, have various potential risk factors for osteoporosis. Improved survival for both early and locally advanced gastric cancer has resulted in a parallel increase in the incidence of postoperative osteoporosis after gastrectomy 3 . Bone loss after cancer therapy is more rapid and severe compared with postmenopausal bone loss in women or normal age-related osteoporosis in men 4 .…”

Section: Introductionmentioning

confidence: 99%

Prediction of risk of osteoporosis after gastrectomy for gastric cancer

et al. 2021

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Introduction There are few guidelines for screening of osteoporosis in patients who have undergone gastrectomy. This study aimed to develop and validate a nomogram to predict the risk of osteoporosis after gastrectomy in patients with gastric cancer. Methods Bone densitometry results for 522 patients with gastric cancer and 2088 individuals from a health-promotion centre were compared using propensity score matching to develop a nomogram to predict osteoporosis after gastrectomy. External validation was performed using an independent data set. Results In the 10 years after gastrectomy 53.5 per cent of patients developed osteoporosis. In multivariable analysis, the odds ratios of subtotal gastrectomy and total gastrectomy were 5.46 and 8.69 (P < 0.001 for both). Seven risk factors (type of gastrectomy, age, sex, BMI, and serum levels of albumin, creatinine and phosphorus) were incorporated into the nomogram. The prediction accuracy of the nomogram in the development set was 0.830 (area under the curve (AUC)); (95 per cent c.i. 0.812 to 0.848). In the validation set, the AUC was 0.807 (95 per cent c.i. 0.741 to 0.873). Conclusion Gastrectomy was a risk factor for osteoporosis, and its incidence in the first 10 years after surgery was high. This nomogram can help clinicians to identify patients with gastric cancer most at risk of developing osteoporosis after surgery.

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The change of bone mineral density and bone metabolism after gastrectomy for gastric cancer: a meta-analysis

Cited by 20 publications

References 40 publications

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

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

Emerging Adults Carrying a CDH1 Pathogenic or Likely Pathogenic Variant Face Diet and Lifestyle Challenges after Total Gastrectomy

Prediction of risk of osteoporosis after gastrectomy for gastric cancer

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