Changes in bone metabolism after gastric cancer surgery in men: A prospective observational study.

10 Background: Several reports have showed that bone disorders occur after gastric cancer surgery, however there are few studies that compared pre- and postoperative bone mineral density of the same patient. The purpose of this study was to assess changes in bone metabolism after gastric cancer surgery prospectively. Methods: We prospectively enrolled 39 men undergoing gastrectomy for early gastric cancer. We excluded women to avoid the effect of menopause. Patients with severe kidney disease requiring dialysis treatment, patients with severe liver disease and patients with treatment with bisphosphonates or any other bone-active drugs were also excluded. Dual energy X-ray absorptiometry (DEXA) was performed before and 1 and 2 years after surgery to evaluate bone mineral density (BMD). The serum levels of 1,25-dihydroxy vitamin D (1,25(OH)2VD), 25-hydroxy vitamin D (25(OH)VD), estradiol, and alkaline phosphatase (ALP) were measured before surgery and every three months until two years after surgery. Results: DEXA revealed that BMD was significantly decreased by 0.036±0.033 g/cm2 at 12 months after gastrectomy (P < 0.001). The serum ALP was significantly increased by 38.88±6.42 IU/l at 24 months after surgery (P = 0.013), and there was a marginally significant correlation between the changes in BMD and the changes in the serum ALP at 24 months after surgery; the correlation coefficient was -0.30 (P = 0.090). The serum 25(OH)VD was significantly decreased by 4.88±6.42 ng/ml at 24 months after surgery (P < 0.001), however there was no significant correlation between the changes in BMD and the changes in the serum 25(OH)VD. The serum 1,25(OH)2VD and estradiol were not significantly changed before and after surgery. The factor significantly correlated to the reductions of BMD at 12 months after surgery included preoperative lower body mass index (BMI); the correlation coefficients was 0.37 (P = 0.025). Conclusions: This study showed a significant reduction in the BMD of gastric cancer patients at 12 months after gastrectomy and suggested that low preoperative BMI could be a high risk factor for the bone disorder after gastric cancer surgery.

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Management of bone metabolism in epilepsy

Ideggyógyászati Szemle ◽

10.18071/isz.74.0257 ◽

2021 ◽

Vol 74 (7-8) ◽

pp. 257-265

Author(s):

Firdevs Ezgi Uçan Tokuç ◽

Fatma Genç ◽

Abidin Erdal ◽

Yasemin Biçer Gömceli

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Bone Metabolism ◽

Bone Mineral ◽

Outpatient Clinic ◽

Bone Mineralization ◽

Mineral Density ◽

Low Bone Mineral Density ◽

Increased Risk ◽

Significant Difference

Many systemic problems arise due to the side effects of antiepileptic drugs (AEDs) used in epilepsy patients. Among these adverse effects are low bone mineral density and increased fracture risk due to long-term AED use. Although various studies have supported this association with increased risk in recent years, the length of this process has not been precisely defined and there is no clear consensus on bone density scanning, intervals of screening, and the subject of calcium and vitamin D supplementation. In this study, in accordance with the most current recommendations, our applications and data, including the detection of possible bone mineralization disorders, treatment methods, and recommendations to prevent bone mineralization disorders, were evaluated in epilepsy patients who were followed up at our outpatient clinic. It was aimed to draw attention to the significance of management of bone metabolism carried out with appropriate protocols. Epilepsy patients were followed up at the Antalya Training and Research Hospital Department of Neurology, Epilepsy Outpatient Clinic who were at high risk for osteoporosis (use of valproic acid [VPA] and enzyme-inducing drugs, using any AED for over 5 years, and postmenopausal women) and were evaluated using a screening protocol. According to this protocol, a total of 190 patients suspected of osteoporosis risk were retrospectively evaluated. Four patients were excluded from the study due to secondary osteoporosis. Of the 186 patients who were included in the study, 97 (52.2%) were women and 89 (47.8%) were men. Prevalence of low bone mineral density (BMD) was 42%, in which osteoporosis was detected in 11.8% and osteopenia in 30.6% of the patients. Osteoporosis rate was higher at the young age group (18-45) and this difference was statistically significant (p=0.018). There was no significant difference between male and female sexes according to osteoporosis and osteopenia rates. Patients receiving polytherapy had higher osteoporosis rate and lower BMD compared to patients receiving monotherapy. Comparison of separate drug groups according to osteoporosis rate revealed that osteoporosis rate was highest in patient groups using VPA+ carbamazepine (CBZ) (29.4%) and VPA polytherapy (19.4%). Total of osteopenia and osteoporosis, or low BMD, was highest in VPA polytherapy (VPA+ non-enzyme-inducing AED [NEID]) and CBZ polytherapy (CBZ+NEID) groups, with rates of 58.3% and 55.1%, respectively. In addition, there was no significant difference between drug groups according to bone metabolism markers, vitamin D levels, and osteopenia-osteoporosis rates. Assuming bone health will be affected at an early age in epilepsy patients, providing lifestyle and diet recommendations, avoiding polytherapy including VPA and CBZ when possible, and evaluating bone metabolism at regular intervals are actions that should be applied in routine practice.

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

Obesity Surgery ◽

10.1007/s11695-020-04912-7 ◽

2020 ◽

Vol 30 (12) ◽

pp. 4995-5000

Author(s):

Mustafa Raoof ◽

Ingmar Näslund ◽

Eva Rask ◽

Eva Szabo

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Gastric Bypass ◽

Parathyroid Hormone ◽

Femoral Neck ◽

Bone Mineral ◽

Gastric Bypass Surgery ◽

Serum Levels ◽

Massive Weight Loss ◽

Mineral Density

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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Relationship between Body Mass Composition, Bone Mineral Density, Skin Fibrosis and 25(OH) Vitamin D Serum Levels in Systemic Sclerosis

PLoS ONE ◽

10.1371/journal.pone.0137912 ◽

2015 ◽

Vol 10 (9) ◽

pp. e0137912 ◽

Cited By ~ 12

Author(s):

Addolorata Corrado ◽

Ripalta Colia ◽

Angiola Mele ◽

Valeria Di Bello ◽

Antonello Trotta ◽

...

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Systemic Sclerosis ◽

Body Mass ◽

Bone Mineral ◽

Serum Levels ◽

Mass Composition ◽

Mineral Density ◽

25 Oh Vitamin D ◽

Body Mass Composition

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

Bone Reports ◽

10.1016/j.bonr.2020.100427 ◽

2020 ◽

Vol 13 ◽

pp. 100427

Author(s):

Young-Kyun Lee ◽

Deog-Yoon Kim ◽

Yong-Chan Ha ◽

Youjin Lee ◽

Dong Won Byun ◽

...

Keyword(s):

Gastric Cancer ◽

Bone Mineral Density ◽

Bone Metabolism ◽

Bone Mineral ◽

Meta Analysis ◽

Mineral Density

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Diagnosed changes of bone mineral density and level of calciotropic hormones in children with juvenile hyperthyroidism

Modern pediatrics. Ukraine ◽

10.15574/sp.2021.115.23 ◽

2021 ◽

pp. 23-30

Author(s):

S.T. Muratova ◽

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Alkaline Phosphatase ◽

Bone Metabolism ◽

Bone Mineral ◽

Inverse Correlation ◽

Dual Energy ◽

Mineral Density ◽

Calciotropic Hormones ◽

X Ray

The development of the skeletal system occur during childhood. Thyroid hormones play an important role in the skeleton's maturation and maintenance of the structure and mass of bones. Juvenile hyperthyroidism affects bone metabolism. This study aimed to identify abnormalities in bone mineral density and the level of calciotropic hormones in juvenile hyperthyroidism to further improve the diagnosis of complications of juvenile hyperthyroidism. Materials and methods. The study was conducted by 21 health controls and 71 children and adolescents with juvenile hyperthyroidism. Anthropometric indicators were calculated using the WHO Anthro Plus personal computer software. Thyroid status and thyroid antibodies, osteocalcin, parathyroid hormone, vitamin D, calcium, phosphorus, alkaline phosphatase were determined using a closed-type immunochemistry analyzer Cobas e 411 Hitachi company Hoffman Le Roche (Switzerland) and its reagents. Bone mineral density was evaluated by dual-energy absorptiometry on a Stratos X-ray densitometer from Diagnostic Medical Systems, France. Results. In juvenile hypertrichosis, in comparison with the control, significantly low values of vitamin D and calcium in the blood serum were noted, the mean values of osteocalcin and alkaline phosphatase were substantially higher. There was no significant difference in the levels of parathyroid hormone and phosphorus in the blood serum in the compared groups. In 45.1% of patients, a decrease in bone mass was diagnosed compared to the age norm. A reliable direct correlation of vitamin D and calcium with bone density was revealed in all X-ray densitometry parameters and a reliable inverse correlation of osteocalcin, alkaline phosphatase and bone mineral density. Osteocalcin had a stronger inverse correlation with all dual-energy X-ray absorptiometry parameters and became a better biomarker than alkaline phosphatase. Conclusions. There is a decrease in bone mineral density in children with juvenile hyperthyroidism. Changes in the level of calciotropic hormones indicate a deranged bone metabolism. Serum osteocalcin can be used as a biomarker of bone metabolism in children with juvenile hyperthyroidism. It is recommended to assess the bones' condition during the initial examination of children with juvenile hyperthyroidism. The study was carried out following the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the parents of the children was obtained for the research. The author declares no conflicts of interest. Key words: juvenile hyperthyroidism, children, adolescents, bone mineral density; dual energy X-ray absorptiometry, osteocalcin, vitamin D.

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The influence of habitual salt intake on bone remodelling in young healthy people

Slovenian Medical Journal ◽

10.6016/zdravvestn.3192 ◽

2021 ◽

pp. 1-10

Author(s):

Erna Davidović-Cvetko ◽

Anita Matić ◽

Jasminka Milas-Ahić ◽

Ines Drenjančević

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Bone Metabolism ◽

Bone Mineral ◽

Biochemical Markers ◽

Bone Remodelling ◽

Sodium Intake ◽

Healthy People ◽

Type I ◽

Mineral Density

Introduction: Sodium alters calcium metabolism by increasing calcium excretion, thus possibly influencing bone metabolism. The hypothesis of the present study is that amount of dietary sodium intake affects the bone remodelling. This study aimed to assess whether a habitual intake of sodium has an effect on peak bone mass and biochemical indicators of bone metabolism. Subjects and Methods: In a cross-sectional study that involved 41 young men and women, six biochemical markers were assessed from blood samples using ELISA: osteocalcin, C-terminal procollagen type I peptide, receptor activator kappa B ligand, pyridinoline, parathyroid hormone, and osteoprotegerin, while bone mineral density (BMD) and bone mineral content (BMC) were measured by dual x-ray absorptiometry. Subjects were divided into two groups according to habitual sodium intake (low-Na and high-Na group) assessed by questionnaire. Results: No difference was found between groups of low and high Na intake in BMD and BMC, or in biochemical markers of bone metabolism. Since the groups differed in Ca intake, energy and vitamin D, adjustments were made for those cofounders. Regression analysis showed that only the dietary intake of vitamin D was associated with dual femur BMD and BMC, and no correlation was found between bone remodelling indicators and Na intake after adjustment for vitamin D intake. Conclusion: The present results could not confirm that habitual sodium intake above recommended levels affects bone remodelling processes or decreases bone mineral density in young healthy people if combined with adequate calcium intake.

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