Calcium Intake and Metabolic Bone Disease After Eight Years of Roux-en-Y Gastric Bypass

Overview

Journal Obes Surg

Date 2008 Feb 1

PMID 18236122

Citations 19

Authors

Camila Duran de Campos

Lorenca Dalcanale

Denis Pajecki

Arthur B Garrido Jr

Alfredo Halpern

Affiliations

Soon will be listed here.

Abstract

Background: Roux-en-Y gastric bypass (RYGBP) has been found to be the most efficient way to lose weight and maintain the weight loss in morbid obesity. However, with the formation of a new stomach and the modification of intestinal anatomy, there are significant changes on physiological properties of these organs that lead to nutrient deficiency, including calcium. The objectives of this study were to evaluate calcium intake, bone metabolism, and prevalence of metabolic bone disease in women subjected to RYGBP after 8 years.

Methods: Food frequency questionnaire and 3-day dietary recall, laboratory tests of bone metabolism and bone mineral density were accessed.

Results: Calcium intake was below the recommendation in all women. Serum PTH and alkaline phosphatase were elevated, whereas vitamin D and urinary calcium were significantly lower. Also, a higher prevalence of metabolic bone disease than the one expected for the normal population at the same age was noted.

Conclusion: These data suggest that metabolic bone disease could be a complication of this type of surgery.

Citing Articles

Vitamin D status and supplementation before and after Bariatric Surgery: Recommendations based on a systematic review and meta-analysis.

Giustina A, Di Filippo L, Facciorusso A, Adler R, Binkley N, Bollerslev J Rev Endocr Metab Disord. 2023; 24(6):1011-1029.

PMID: 37665480 PMC: 10698146. DOI: 10.1007/s11154-023-09831-3.

Deficiency and Insufficiency of Vitamin D in Women of Childbearing Age: A Systematic Review and Meta-analysis.

Lucchetta R, Lemos I, Gini A, Cavicchioli S, Forgerini M, Varallo F Rev Bras Ginecol Obstet. 2022; 44(4):409-424.

PMID: 35211934 PMC: 9948108. DOI: 10.1055/s-0042-1742409.

Dietary Recommendations for Bariatric Patients to Prevent Kidney Stone Formation.

Ormanji M, Rodrigues F, Heilberg I Nutrients. 2020; 12(5).

PMID: 32429374 PMC: 7284744. DOI: 10.3390/nu12051442.

Adequate Multivitamin Supplementation after Roux-En-Y Gastric Bypass Results in a Decrease of National Health Care Costs: a Cost-Effectiveness Analysis.

Homan J, Schijns W, Janssen I, Berends F, Aarts E Obes Surg. 2019; 29(5):1638-1643.

PMID: 30725428 DOI: 10.1007/s11695-019-03750-6.

Bone structural changes after gastric bypass surgery evaluated by HR-pQCT: a two-year longitudinal study.

Shanbhogue V, Stoving R, Frederiksen K, Hanson S, Brixen K, Gram J Eur J Endocrinol. 2017; 176(6):685-693.

PMID: 28289103 PMC: 5425940. DOI: 10.1530/EJE-17-0014.

References

Slater G, Ren C, Siegel N, Williams T, Barr D, Wolfe B . Serum fat-soluble vitamin deficiency and abnormal calcium metabolism after malabsorptive bariatric surgery. J Gastrointest Surg. 2004; 8(1):48-55. DOI: 10.1016/j.gassur.2003.09.020. View

Shaker J, Norton A, Woods M, Fallon M, Findling J . Secondary hyperparathyroidism and osteopenia in women following gastric exclusion surgery for obesity. Osteoporos Int. 1991; 1(3):177-81. DOI: 10.1007/BF01625450. View

Lips P . Which circulating level of 25-hydroxyvitamin D is appropriate?. J Steroid Biochem Mol Biol. 2004; 89-90(1-5):611-4. DOI: 10.1016/j.jsbmb.2004.03.040. View

Goldner W, ODorisio T, Dillon J, Mason E . Severe metabolic bone disease as a long-term complication of obesity surgery. Obes Surg. 2002; 12(5):685-92. DOI: 10.1381/096089202321019693. View

Fujioka K . Follow-up of nutritional and metabolic problems after bariatric surgery. Diabetes Care. 2005; 28(2):481-4. DOI: 10.2337/diacare.28.2.481. View

Goode L, Brolin R, Chowdhury H, Shapses S . Bone and gastric bypass surgery: effects of dietary calcium and vitamin D. Obes Res. 2004; 12(1):40-7. DOI: 10.1038/oby.2004.7. View

El-Kadre L, Rocha P, de Almeida Tinoco A, Tinoco R . Calcium metabolism in pre- and postmenopausal morbidly obese women at baseline and after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2004; 14(8):1062-6. DOI: 10.1381/0960892041975505. View

Blake M, Fazio V, OBrien P . Assessment of nutrient intake in association with weight loss after gastric restrictive procedures for morbid obesity. Aust N Z J Surg. 1991; 61(3):195-9. DOI: 10.1111/j.1445-2197.1991.tb07591.x. View

Shuster M, Vazquez J . Nutritional concerns related to Roux-en-Y gastric bypass: what every clinician needs to know. Crit Care Nurs Q. 2005; 28(3):227-60. DOI: 10.1097/00002727-200507000-00003. View

10.

Bano G, Rodin D, Pazianas M, Nussey S . Reduced bone mineral density after surgical treatment for obesity. Int J Obes Relat Metab Disord. 1999; 23(4):361-5. DOI: 10.1038/sj.ijo.0800827. View

11.

De Prisco C, Levine S . Metabolic bone disease after gastric bypass surgery for obesity. Am J Med Sci. 2005; 329(2):57-61. DOI: 10.1097/00000441-200502000-00001. View

12.

Bell N . Bone loss and gastric bypass surgery for morbid obesity. J Clin Endocrinol Metab. 2004; 89(3):1059-60. DOI: 10.1210/jc.2003-032162. View

13.

Snow V, Barry P, Fitterman N, Qaseem A, Weiss K . Pharmacologic and surgical management of obesity in primary care: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2005; 142(7):525-31. DOI: 10.7326/0003-4819-142-7-200504050-00011. View

14.

Parfitt A, Podenphant J, Villanueva A, Frame B . Metabolic bone disease with and without osteomalacia after intestinal bypass surgery: a bone histomorphometric study. Bone. 1985; 6(4):211-20. DOI: 10.1016/8756-3282(85)90003-1. View

15.

Hey H, Sorensen O, Lund B . Delayed fracture healing following jejunoileal bypass surgery for obesity. Calcif Tissue Int. 1982; 34(1):13-5. DOI: 10.1007/BF02411201. View

16.

Tothill P, Avenell A . Errors in dual-energy X-ray absorptiometry of the lumbar spine owing to fat distribution and soft tissue thickness during weight change. Br J Radiol. 1994; 67(793):71-5. DOI: 10.1259/0007-1285-67-793-71. View

17.

Diniz M, Diniz M, Sanches S, Salgado P, Valadao M, Araujo F . Elevated serum parathormone after Roux-en-Y gastric bypass. Obes Surg. 2004; 14(9):1222-6. DOI: 10.1381/0960892042386959. View

18.

Montilla R, Aldrighi J, Marucci M . [Calcium/protein relation of women on the climacteric]. Rev Assoc Med Bras (1992). 2004; 50(1):52-4. DOI: 10.1590/s0104-42302004000100035. View

19.

Ott , Fanti , Malluche , Ryo , Whaley , Strodel . Biochemical Evidence of Metabolic Bone Disease in Women Following Roux-Y Gastric Bypass for Morbid Obesity. Obes Surg. 1992; 2(4):341-348. DOI: 10.1381/096089292765559936. View

20.

Coates P, Fernstrom J, Fernstrom M, Schauer P, Greenspan S . Gastric bypass surgery for morbid obesity leads to an increase in bone turnover and a decrease in bone mass. J Clin Endocrinol Metab. 2004; 89(3):1061-5. DOI: 10.1210/jc.2003-031756. View