Bone metabolism and risk of secondary hyperparathyroidism 12 months after gastric banding in obese pre-menopausal women

  • N. P
  • V. G
  • M. S
 et al. 
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OBJECTIVE: To evaluate, during the first postoperative year in obese pre-menopausal women, the effects of laparoscopic gastric banding on calcium and vitamin D metabolism, the potential modifications of bone mineral content and bone mineral density, and the risk of development of secondary hyperparathyroidism. SUBJECTS: Thirty-one obese pre-menopausal women aged between 25 and 52 y with a mean body mass index (BMI) of 43.6 kg/m2, scheduled for gastric banding were included. Patients with renal, hepatic, metabolic and bone disease were excluded. METHODS: Body composition and bone mineral density (BMD) were measured at baseline, 6 and 12 months after gastric banding using dual-energy X-ray absorptiometry. Serum calcium, phosphate, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, (gamma)-glutamyltransferase, bilirubin, urea, creatinine, uric acid, proteins, parathormone, vitamin D3, IGF-1, IGF-BP3 and telopeptide, as well as urinary telopeptide, were measured at baseline and 1, 3, 6, 9 and 12 months after surgery. RESULTS: After 1 y vitamin D3 remained stable and PTH decreased by 12%, but the difference was not significant. Serum telopeptide C increased significantly by 100% (P < 0.001). There was an initial drop of the IGF-BP3 during the first 6 months (P < 0.05), but the reduction was no longer significant after 1 y. The BMD of cortical bone (femoral neck) decreased significantly and showed a trend of a positive correlation with the increase of telopeptides (P < 0.06). The BMD of trabecular bone, at the lumbar spine, increased proportionally to the reduction of hip circumference and of body fat. CONCLUSION: There is no evidence of secondary hyperparathyroidism 1 y after gastric banding. Nevertheless biochemical bone markers show a negative remodelling balance, characterized by an increase of bone resorption. The serum telopeptide seems to be a reliable parameter, not affected by weight loss, to follow up bone turnover after gastroplasty.

Author-supplied keywords

  • adult
  • alanine aminotransferase
  • alkaline phosphatase
  • anthropometric parameters
  • article
  • aspartate aminotransferase
  • bilirubin
  • body composition
  • body fat
  • bone density
  • bone metabolism
  • bone mineral
  • bone remodeling
  • bone turnover
  • calcium
  • calcium blood level
  • calcium metabolism
  • clinical article
  • colecalciferol
  • controlled study
  • correlation analysis
  • cortical bone
  • creatinine
  • dual energy X ray absorptiometry
  • female
  • follow up
  • gamma glutamyltransferase
  • gastric banding
  • gastroplasty
  • hormone blood level
  • human
  • laparoscopic surgery
  • lumbar spine
  • obesity
  • osteolysis
  • parathyroid hormone
  • phosphate
  • phosphate blood level
  • postoperative complication
  • premenopause
  • priority journal
  • risk assessment
  • secondary hyperparathyroidism
  • somatomedin binding protein 1
  • somatomedin binding protein 3
  • trabecular bone
  • urea
  • urea blood level
  • uric acid blood level
  • urinalysis
  • vitamin D metabolism
  • vitamin blood level

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  • Pugnale N.

  • Giusti V.

  • Suter M.

  • Zysset E.

  • Heraief E.

  • Gaillard R.C.

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