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


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, γ-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.

DOI: 10.1038/sj.ijo.0802177
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@article{Pugnale2003BoneMA, title={Bone metabolism and risk of secondary hyperparathyroidism 12 months after gastric banding in obese pre-menopausal women}, author={Nathalie Pugnale and Vittorio Giusti and Michel Suter and E Zysset and Eric H{\'e}ra{\"{i}ef and R . C . Gaillard and Peter Burckhardt}, journal={International Journal of Obesity}, year={2003}, volume={27}, pages={110-116} }