Abstract
OBJECTIVE:
Data about the consequences of laparoscopic adjustable gastric banding (LAGB) on phospho-calcic and bone metabolism remain scarce.
SUBJECTS:
We studied a group of 37 obese premenopausal women (age: 24–52 y; mean BMI=43.7 kg/m2) who underwent LAGB.
METHODS:
Serum calcium, phosphate, alkaline phosphatase, parathormone (PTH), vitamin D3, serum C-telopeptides, IGFBP-3 and IGF-1 were measured at baseline, 6, 12, 18 and 24 months after surgery. Body composition, bone mineral content (BMC) and density (BMD) were measured using dual-X-ray absorptiometry (DXA) at baseline, 6, 12 and 24 months after surgery.
RESULTS:
There was no clinically significant decrease of calcemia; PTH remained stable. Serum telopeptides increased by 100% (P<0.001) and serum IGFBP-3 decreased by 16% (P<0.001) during the first 6 months, and then stabilized, whereas IGF-1 remained stable over the 2 y. BMC and BMD decreased, especially at the femoral neck; this decrease was significantly correlated with the decrease of waist and hip circumference.
CONCLUSIONS:
We concluded that there was no evidence of secondary hyperparathyroidism 24 months after LAGB. The observed bone resorption could be linked to the decrease of IGFBP-3, although this decrease could be attributable to other confounding factors. Serum telopeptides seem to be a reliable marker of bone metabolism after gastric banding. DXA must be interpreted cautiously during major weight loss, because of the artefacts caused by the important variation of fat tissue after LAGB.
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References
Glenny AM, O'Meara S, Melville A, Sheldon TA, Wilson C . The treatment and prevention of obesity: a systematic review of the literature. Int J Obes 1997; 21: 715–737.
Giusti V, Suter M, Heraief E, Gaillard RC, Burckhardt P . Rising role of obesity surgery caused by increase of morbid obesity, failure of conventional treatments and unrealistic expectations: trends from 1997 to 2001. Obes Surg 2003; 13: 693–698.
Sjostrom CD, Lissner L, Wedel H, Sjostrom L . Reduction in incidence of diabetes, hypertension and lipid disturbances after intentional weight loss induced by bariatric surgery: the SOS Intervention Study. Obes Res 1999; 7: 477–484.
Ben-Dov I, Grossman E, Stein A, Shachor D, Gaides M . Marked weight reduction lowers resting and exercise blood pressure in morbidly obese patients. Am J Hypertens 2000; 13: 251–255.
Shaker JL . Secondary hyperparathyroidism and osteopenia in women following gastric exclusion surgery for obesity. Osteoporosis 1991; 1: 177–181.
Goode LR, Brolin RE, Chowdhury HA, Shapses SA . Bone and gastric bypass surgery: effects of dietary calcium and vitamin D. Obes Res 2004; 12: 40–47.
Pugnale N, Giusti V, Suter M, Zysset E, Heraïef E, Gaillard RC, Burckhardt P . Bone metabolism and risk of secondary hyperparathyroidism 12 months after gastric banding in obese premenopausal women. Int J Obes Relat Metab Disord 2003; 27: 110–116.
Suter M, Giusti V, Heraïef E, Jayet C, Jayet A . Early results of laparoscopic gastric banding compared with open vertical banded gastroplasty. Obes Surg 1999; 9: 374–380.
Statistical Bulletin Metrop Life Insurance Co. No. 40, November–December 1959.
Jakicic JM, Donnelly JE, Jawad AF, Jacobsen DJ, Gunderson SC, Pascale R . Association between blood lipids and different measures of body fat distribution: effects of BMI and age. Int J Obes Metab Disord 1993; 17: 131–137.
Jensen MD, Kanaley JA, Roust LR, O'Brien PC, Braun JS, Dunn WL, Wahner HW . Assessment of body composition with use of dual-energy x-ray absorptiometry: evaluation and comparison with other methods. Mayo Clinic Proc 1993; 68: 867–873.
Johansson A, Forslund A, Sjodin A, Mallmin H, Hambraeus L, Ljunghall S . Determination of body composition: a comparison of dual-energy x-ray absorptiometry and hydrodensitometry. Am J Clin Nutr 1993; 57: 323–326.
Lees B, Stevenson JC . An evaluation of dual-energy x-ray absorptiometry and comparison with dual-photon absorptiometry. Osteoporosis Int 1992; 2: 146–152.
Pouilles JM, Tremollieres F, Todorovsky N, Ribot C . Precision and sensitivity of dual-energy x-ray absorptiometry in spinal osteoporosis. J Bone Miner Res 1991; 6: 997–1002.
Hans D, Rizzoli R, Thiebaud D, Lippuner K, Allaoua S, Genton L, Luzuy F, Krieg MA, Jaeger P, Slosman DO . Reference data in a Swiss population. Discordance in patient classification using T-score among calcaneum, spine and femur. J Clin Densitom 2001; 4: 291–298.
Cundy T, Evans MC, Kay RG, Dowman M, Wattie D, Reid IR . Effects of vertical-banded gastroplasty on bone and mineral metabolism in obese patients. Br J Surg 1996; 83: 1468–1472.
Coates PS, Fernstrom JD, Fernstrom MH, Schauer PR, 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: 1061–1065.
Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF . Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 2000; 72: 690–693.
Luyckx FH, Desaive C, Thiry A, Dewe W, Scheen AJ, Gielen JE, Lefebvre PJ . Liver abnormalities in severely obese subjects: effect of drastic weight loss after gastroplasty. Int J Obes Relat Metab Disord 1998; 22: 222–226.
Scacchi M, Pincelli AI, Cavagnini F . Growth hormone in obesity. Int J Obes Relat Metab Disord 1999; 23: 260–271.
Ferry Jr RJ, Cerri RW, Cohen P . Insulin-like growth factor binding proteins: new proteins, new functions. Horm Res 1999; 51: 53–67.
Mohan S, Baylink DJ . IGF-binding proteins are multifunctional and act via IGF-dependent and -independent mechanisms. J Endocrinol 2002; 175: 19–31.
Ljunghall S, Johansson AG, Burman P, Kämpe O, Lindh E, Karlsson FA . Low plasma levels of insulin-like growth factor (IGF-1) in male patients with idiopathic osteoporosis. J Intern Med 1992; 232: 59–64.
Johansson AG, Eriksen EF, Lindh E, Langdahl B, Blum WF, Lindahl A, Ljunggren Ö, Ljunghall S . Reduced serum levels of the growth hormone-dependent IGF binding protein and a negative balance at the level of individual remodeling units in idiopathic osteoporosis in men. J Clin Endocrinol Metab 1997; 82: 2795–2798.
Kurland ES, Rosen CJ, Cosman F, McMahon D, Chan F, Shane E, Lindsay R, Dempster D, Bilezikian JP . Insulin-like growth factor-1 in men with idiopathic osteoporosis. J Clin Endocrinol Metab 1997; 82: 2799–2805.
Thiebaud D, Burckhardt P, Costanza M, Sloutskis D, Gilliard D, Quinodoz F, Jacquet AF, Burnand B . Importance of albumin, 25(OH) vitamin D and IGFBP-3 as risk factors in elderly women and men with hip fracture. Osteopor Int 1997; 7: 457–462.
Mundy GR . Bone remodelling and mechanism of bone loss in osteoporosis. In: Meunier PJ (ed). Osteoporosis: diagnosis and management, vol 2. Martin Dunitz Ltd; 1998. pp. 17–35.
Edelstein SL, Barrett-Connor E . Relation between body size and bone mineral density in elderly men and women. Am J Epidemiol 1993; 138: 160–169.
Van Loan MD, Johnson HL, Barbieri TE . Effect of weight loss on bone mineral content and bone mineral density in obese women. Am J Clin Nutr 1998; 67: 734–738.
Pietrobelli A, Wang Z, Formica C, Heymsfield SB . Dual-energy x-ray absorptiometry: fat estimation errors due to variation in soft tissue hydration. Am J Physiol 1998; 274: E808–E816.
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; 667: 71–75.
Spector E, LeBlanc A, Shackelford L . Hologic QDR 2000 whole body scans: a comparison of three combinations of scan modes and analysis software. Osteoporosis Int 1995; 5: 440–445.
Madsen OR, Jensen JE, Sorensen OH . Validation of a dual energy X-ray absorptiometer: measurement of bone mass and soft tissue composition. Eur J Appl Physiol Occup Physiol 1997; 75: 554–558.
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Giusti, V., Gasteyger, C., Suter, M. et al. Gastric banding induces negative bone remodelling in the absence of secondary hyperparathyroidism: potential role of serum C telopeptides for follow-up. Int J Obes 29, 1429–1435 (2005). https://doi.org/10.1038/sj.ijo.0803040
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DOI: https://doi.org/10.1038/sj.ijo.0803040
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