Bone Mineral Density, Parathyroid Hormone, and Vitamin D After Gastric Bypass Surgery: a 10-Year Longitudinal Follow-Up

Abstract Background The aim of the present study was to study longitudinal changes in bone mineral density (BMD), vitamin D, and parathyroid hormone (PTH) levels in females over a 10-year period after laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods Twenty-three women, mean age 43.4 ± 8.7 years and mean body mass index (BMI) 44.6 ± 5.17 kg/m2 at baseline, were included. BMD, BMI, S-calcium, S-25(OH)-vitamin D, and fP-PTH were measured preoperatively and 2, 5, and 10 years postoperatively. Results Ten years after surgery, BMD of the spine and femoral neck decreased by 20% and 25%, respectively. Changes in serum levels of vitamin D, PTH, and calcium over the same period were small. Conclusion After LRYGB with subsequent massive weight loss, a large decrease in BMD of the spine and femoral neck was seen over a 10-year postoperative period. The fall in BMD largely occurred over the first 5 years after surgery.

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SAT-LB64 Teriparatide and Its Bone Healing Power

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.2053 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Aneeta J Joseph ◽

Jesus L Penabad ◽

Antonio Pinero-Pilona

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Parathyroid Hormone ◽

Lumbar Spine ◽

Femoral Neck ◽

Bone Mineral ◽

Mineral Density ◽

Amino Terminal ◽

Traumatic Fracture ◽

C2 Fracture

Abstract Introduction: Teriparatide, a parathyroid hormone analog, is an important anabolic agent approved by the U.S. Food and Drug Administration to increase bone mineral density in osteoporotic patients. Parathyroid hormone (PTH) regulates calcium, phosphate, and active vitamin-D metabolites.The amino terminal peptide fragments of PTH has been known to increase bone mass and are being used in clinical practice for osteoporosis management (1). Current literature shows the efficacy of teriparatide in increasing bone density of lumbar spine and femoral neck, and decreasing the risk of vertebral and non-vertebral fractures both in postmenopausal women and men. It is also known to prevent fractures in patients with osteoporosis and promote healing of fractures (2). Case Description: A 79-year-old Hispanic female with history of osteopenia and major lumbar spine wedge compression fractures presented to our clinic for consultation. She was on ibandronate for the past four months and was having symptoms of pill esophagitis. Her last bone mineral density done on August 2017 revealed T-score of -2.5 at the lumbar spine, -1.5 at the left femoral neck, and 3.3% bone loss on the left femoral head. Rather than being started on teriparatide, zoledronic acid, or denosumab, she continued ibandronate along with calcium and vitamin D. Two months after the initial consultation, she sustained a traumatic fracture of the posterior arch and body of C2 bilaterally following a motor vehicle accident. There were discussions about starting anabolic treatment, as serial imaging did not show any significant improvement in the healing process despite the use of a collar. Two months after sustaining C2 fracture, she was started on teriparatide. Repeat cervical spine x-ray three months later showed complete healing of the C2 fracture. Discussion: There are a limited number of cases reported in regards to teriparatide induced healing of non-osteoporotic fractures (3). Our case is one of the very few reported to have shown complete radiographic and clinical healing of a traumatic, non-osteoporotic fracture after use of teriparatide for 12 weeks.

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Effect of Gastric Bypass on Bone Mineral Density, Parathyroid Hormone and Vitamin D: 5 Years Follow-up

Obesity Surgery ◽

10.1007/s11695-016-2114-3 ◽

2016 ◽

Vol 26 (5) ◽

pp. 1141-1145 ◽

Cited By ~ 31

Author(s):

Mustafa Raoof ◽

Ingmar Näslund ◽

Eva Rask ◽

Eva Szabo

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Gastric Bypass ◽

Parathyroid Hormone ◽

Bone Mineral ◽

Mineral Density

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Effects of Gastric Bypass Procedures on Bone Mineral Density, Calcium, Parathyroid Hormone, and Vitamin D

Journal of Gastrointestinal Surgery ◽

10.1016/j.gassur.2005.07.012 ◽

2005 ◽

Vol 9 (8) ◽

pp. 1106-1111 ◽

Cited By ~ 122

Author(s):

J JOHNSON ◽

J MAHER ◽

I SAMUEL ◽

D HEITSHUSEN ◽

C DOHERTY ◽

...

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Gastric Bypass ◽

Parathyroid Hormone ◽

Bone Mineral ◽

Mineral Density

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P114 Effect of vitamin D on parathyroid hormone, serum calcium and bone mineral density in patients with primary hyperparathyroidism being managed conservatively

Rheumatology ◽

10.1093/rheumatology/keab247.110 ◽

2021 ◽

Vol 60 (Supplement_1) ◽

Author(s):

Mahrukh Khalid ◽

Vismay Deshani ◽

Khalid Jadoon

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Parathyroid Hormone ◽

Primary Hyperparathyroidism ◽

Bone Mineral ◽

Serum Calcium ◽

Mineral Density ◽

Neck Of Femur ◽

Vitamin D Levels ◽

Significant Difference

Abstract Background/Aims Vitamin D deficiency is associated with more severe presentation of primary hyperparathyroidism (PTHP) with high parathyroid hormone (PTH) levels and reduced bone mineral density (BMD). We analyzed data to determine if vitamin D levels had any impact on PTH, serum calcium and BMD at diagnosis and 3 years, in patients being managed conservatively. Methods Retrospective analysis of patients presenting with PHPT. Based on vitamin D level at diagnosis, patients were divided into two groups; vitamin D sufficient (≥ 50 nmol/L) and vitamin D insufficient (≤ 50 nmol/L). The two groups were compared for age, serum calcium and PTH levels at diagnosis and after mean follow up of 3 years. BMD at forearm and neck of femur (NOF) was only analyzed in the two groups at diagnosis, due to lack of 3 year’s data. Results There were a total of 93 patients, 17 males, mean age 70; range 38-90. Mean vitamin D level was 73.39 nmol/L in sufficient group (n = 42) and 34.48 nmol/L in insufficient group (n = 40), (difference between means -38.91, 95% confidence interval -45.49 to -32.33, p < 0.0001). There was no significant difference in age, serum calcium and PTH at the time of diagnosis. After three years, there was no significant difference in vitamin D levels between the two groups (mean vitamin D 72.17 nmol/L in sufficient group and 61.48 nmol/L in insufficient group). Despite rise in vitamin D level in insufficient group, no significant change was observed in this group in PTH and serum calcium levels. BMD was lower at both sites in vitamin D sufficient group and difference was statistically significant at NOF. Data were analyzed using unpaired t test and presented as mean ± SEM. Conclusion 50% of patients presenting with PHPT were vitamin D insufficient at diagnosis. Vitamin D was adequately replaced so that at 3 years there was no significant difference in vitamin D status in the two groups. Serum calcium and PTH were no different in the two groups at diagnosis and at three years, despite rise in vitamin D levels in the insufficient group. Interestingly, BMD was lower at forearm and neck of femur in those with sufficient vitamin D levels and the difference was statistically significant at neck of femur. Our data show that vitamin D insufficiency does not have any significant impact on PTH and calcium levels and that vitamin D replacement is safe in PHPT and does not impact serum calcium and PTH levels in the short term. Lower BMD in those with adequate vitamin D levels is difficult to explain and needs further research. Disclosure M. Khalid: None. V. Deshani: None. K. Jadoon: None.

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Nutritional factors associated with femoral neck bone mineral density in children and adolescents

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2901-9 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Guo-Hau Gou ◽

Feng-Jen Tseng ◽

Sheng-Hao Wang ◽

Pao-Ju Chen ◽

Jia-Fwu Shyu ◽

...

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Femoral Neck ◽

Children And Adolescents ◽

Bone Mineral ◽

Age Group ◽

Mineral Density ◽

Nutrient Intakes ◽

Nutritional Factors ◽

Daily Total

Abstract Background Nutritional factors including vitamin D, magnesium, and fat are known to affect bone mineral accrual. This study aimed to evaluate associations between dietary nutrient intakes (both macronutrients and micronutrients) and bone mineral density (BMD) in children and adolescents. Methods Data for this cross-sectional, population-based study were derived from the National Health and Nutrition Examination Survey (NHANES). Participants aged from 8 to 19 years were included. The primary outcome was femoral neck BMD. Results Multivariate analyses revealed that for participants aged 8 to 11, daily sodium intake was significantly and positively associated with femoral neck BMD (B = 0.9 × 10− 5, p = 0.031); in particular, subgroup analyses by sex found that in male participants aged 8–11, daily total cholesterol intake (B = 5.3 × 10− 5, p = 0.030) and calcium intake (B = − 2.0 × 10− 5, p < 0.05) were significantly associated with femoral neck BMD in a positive and negative manner, respectively, but neither were observed in female participants of this age group. In contrast, daily intakes of vitamin D and magnesium were significantly and positively associated with femoral neck BMD in female participants aged 8–11 (B = 246.8 × 10− 5 and 16.3 × 10− 5, p = 0.017 and 0.033, respectively). For participants aged 16 to 19, daily total fat intake was significantly and negatively associated with femoral neck BMD (B = − 58 × 10− 5, p = 0.048); further stratification by sex found that magnesium and sodium intakes were significantly and positively associated with femoral neck BMD only in females of this age group (B = 26.9 × 10− 5 and 2.1 × 10− 5, respectively; both p < 0.05). However, no significant associations between daily nutrient intakes and femoral neck BMD were identified in participants aged 12–15 before or after subgroup stratification. Conclusion The study found that associations of specific nutrition-related variables with BMD of the femoral neck is dependent upon age and gender.

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Relationships between vitamin D, parathyroid hormone and bone mineral density in inflammatory bowel disease

Journal of Internal Medicine ◽

10.1046/j.1365-2796.1996.420765000.x ◽

1996 ◽

Vol 239 (2) ◽

pp. 131-137 ◽

Cited By ~ 69

Author(s):

J. SILVENNOINEN

Keyword(s):

Bone Mineral Density ◽

Inflammatory Bowel Disease ◽

Vitamin D ◽

Parathyroid Hormone ◽

Bone Mineral ◽

Bowel Disease ◽

Mineral Density ◽

Inflammatory Bowel

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Vitamin D Status and Its Relationship with Bone Mineral Density and Parathyroid Hormone in Southeast Asian Adults with Low Bone Density

Endocrine Practice ◽

10.4158/ep10202.or ◽

2011 ◽

Vol 17 (2) ◽

pp. 226-234 ◽

Cited By ~ 11

Author(s):

Manju Chandran ◽

Hans Hoeck ◽

Hung Wong ◽

Rong Zhang ◽

Hans Dimai

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Parathyroid Hormone ◽

Bone Density ◽

Bone Mineral ◽

Southeast Asian ◽

Vitamin D Status ◽

Mineral Density ◽

Low Bone Density

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Bone Mineral Density and Turnover After Sleeve Gastrectomy and Gastric Bypass: A Randomized Controlled Trial (Oseberg)

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa808 ◽

2020 ◽

Author(s):

Dag Hofsø ◽

Thor Olav Widerøe Hillestad ◽

Erling Halvorsen ◽

Farhat Fatima ◽

Line Kristin Johnson ◽

...

Keyword(s):

Bone Mineral Density ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Lumbar Spine ◽

Femoral Neck ◽

Bone Turnover ◽

Bone Mineral ◽

Bone Turnover Markers ◽

Mineral Density ◽

Turnover Markers

Abstract Context Bariatric surgery, particularly Roux-en-Y gastric bypass (RYGB), is associated with an increased risk of osteoporotic fractures. It is unknown whether RYGB or sleeve gastrectomy (SG) have different effects on bone health. Objective To compare changes in bone mineral density and markers of bone turnover 1 year after SG and RYGB. Design, Setting, Patients, and Interventions Randomized, triple-blind, single-center trial at a tertiary care center in Norway. The primary outcome was diabetes remission. Patients with severe obesity and type 2 diabetes were randomized and allocated (1:1) to SG or RYGB. Main Outcome Measures Changes in areal bone mineral density (aBMD) and bone turnover markers. Results Femoral neck, total hip, and lumbar spine aBMD, but not total body aBMD, decreased significantly more after RYGB (n = 44) than after SG (n = 48) (mean [95% confidence interval] between group differences -2.8% [-4.7 to -0.8], -3.0% [-5.0 to -0.9], -4.2% [-6.4 to -2.1], and -0.5% [-1.6 to 0.6], respectively). The increase in procollagen type 1 N-terminal propeptide (P1NP) and C-telopeptide of type I collagen (CTX-1) were approximately 100% higher after RYGB than after SG (between group difference at 1 year, both P < 0.001). The changes in femoral neck, total hip, and lumbar spine aBMDs and the changes in P1NP and CTX-1 were independently associated with the surgical procedure (all P < 0.05) and not weight change. Conclusions Roux-en-Y gastric bypass was associated with a greater reduction in aBMD and a greater increase in bone turnover markers compared with SG. This finding could suggest greater skeletal fragility after RYGB.

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