Increase of Bone Resorption and the Parathyroid Hormone in Postmenopausal Women in the Long-term after Roux-en-Y Gastric Bypass
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Date
2009
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Abstract
The effects of Roux-en-Y Gastric Bypass (RYGB) on bone in the long-term remains unclear. We assessed bone metabolism and bone mineral density (BMD) 1 to 5 years after RYGB.
We designed a retrospective cohort study in 26 postmenopausal women (58.0 +/- 3.9 years old) with RYGB 3.5 +/- 1.1 years before (body mass index (BMI) 29.5 +/- 3.8 kg/m(2), presurgery 43.6 +/- 5.5 kg/m(2)) and 26 nonoperated women (57.5 +/- 4.7 years old, BMI 29.2 +/- 4.1 kg/m(2)) matched by age and BMI. The main measures were BMD, serum carboxy telopeptide (CTx), total alkaline phosphatases (ALP), parathyroid hormone (PTH), 25-hydroxyvitamin D (25OHD), and ghrelin.
RYGB group, compared to nonoperated women, had higher CTx (0.71 +/- 0.21 vs. 0.43 +/- 0.15 ng/ml; P < 0.01) and PTH (68.3 +/- 35 vs. 49.4 +/- 16 pg/ml; P = 0.02). There were no differences between RYGB and nonoperated women in: calcium and vitamin D intake (759 +/- 457 vs. 705 +/- 460 mg/day; 176 +/- 160 vs. 111 +/- 86 UI/day), ghrelin (763 +/- 336 vs. 621 +/- 274 pg/ml), ALP (101 +/- 22 vs. 94 +/- 25 UI/l), 25OHD (18.8 +/- 7.6 vs. 17.4 +/- 5.9 ng/ml), lumbar spine BMD (1.059 +/- 0.32 vs. 1.071 +/- 0.207 g/cm(2)), or femoral neck BMD (0.892 +/- 0.109 vs. 0.934 +/- 1.1 g/cm(2)).
RYGB is associated to high bone resorption and hyperparathyroidism prevalence in postmenopausal women in the long-term. This occurs independently of the intake of calcium, vitamin D status, or ghrelin and does not seem to affect BMD after RYGB.
We designed a retrospective cohort study in 26 postmenopausal women (58.0 +/- 3.9 years old) with RYGB 3.5 +/- 1.1 years before (body mass index (BMI) 29.5 +/- 3.8 kg/m(2), presurgery 43.6 +/- 5.5 kg/m(2)) and 26 nonoperated women (57.5 +/- 4.7 years old, BMI 29.2 +/- 4.1 kg/m(2)) matched by age and BMI. The main measures were BMD, serum carboxy telopeptide (CTx), total alkaline phosphatases (ALP), parathyroid hormone (PTH), 25-hydroxyvitamin D (25OHD), and ghrelin.
RYGB group, compared to nonoperated women, had higher CTx (0.71 +/- 0.21 vs. 0.43 +/- 0.15 ng/ml; P < 0.01) and PTH (68.3 +/- 35 vs. 49.4 +/- 16 pg/ml; P = 0.02). There were no differences between RYGB and nonoperated women in: calcium and vitamin D intake (759 +/- 457 vs. 705 +/- 460 mg/day; 176 +/- 160 vs. 111 +/- 86 UI/day), ghrelin (763 +/- 336 vs. 621 +/- 274 pg/ml), ALP (101 +/- 22 vs. 94 +/- 25 UI/l), 25OHD (18.8 +/- 7.6 vs. 17.4 +/- 5.9 ng/ml), lumbar spine BMD (1.059 +/- 0.32 vs. 1.071 +/- 0.207 g/cm(2)), or femoral neck BMD (0.892 +/- 0.109 vs. 0.934 +/- 1.1 g/cm(2)).
RYGB is associated to high bone resorption and hyperparathyroidism prevalence in postmenopausal women in the long-term. This occurs independently of the intake of calcium, vitamin D status, or ghrelin and does not seem to affect BMD after RYGB.
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Keywords
Bariatric surgery, Gastric bypass, Hyperparathyroidism, Bone, Obesity, Menopause