Intestinal Calcium Absorption Decreases After Laparoscopic Sleeve Gastrectomy Despite Optimization of Vitamin D Status
Published by Oxford University Press on behalf of the Endocrine Society 2022..
CONTEXT: Laparoscopic sleeve gastrectomy (LSG), now the most commonly performed bariatric operation, is a highly effective treatment for obesity. While Roux-en-Y gastric bypass is known to impair intestinal fractional calcium absorption (FCA) and negatively affect bone metabolism, LSG's effects on calcium homeostasis and bone health have not been well characterized.
OBJECTIVE: We determined the effect of LSG on FCA, while maintaining robust 25-hydroxyvitamin D (25OHD) levels and recommended calcium intake.
DESIGN, SETTING, PARTICIPANTS: Prospective pre-post observational cohort study of 35 women and men with severe obesity undergoing LSG.
MAIN OUTCOMES: FCA was measured preoperatively and 6 months postoperatively with a gold-standard dual stable isotope method. Other measures included calciotropic hormones, bone turnover markers, and bone mineral density (BMD) by dual-energy X-ray absorptiometry and quantitative computed tomography.
RESULTS: Mean ± SD FCA decreased from 31.4 ± 15.4% preoperatively to 16.1 ± 12.3% postoperatively (P < 0.01), while median (interquartile range) 25OHD levels were 39 (32-46) ng/mL and 36 (30-46) ng/mL, respectively. Concurrently, median 1,25-dihydroxyvitamin D level increased from 60 (50-82) pg/mL to 86 (72-107) pg/mL (P < 0.01), without significant changes in parathyroid hormone or 24-hour urinary calcium levels. Bone turnover marker levels increased substantially, and areal BMD decreased at the proximal femur. Those with lower postoperative FCA had greater areal BMD loss at the total hip (ρ = 0.45, P < 0.01).
CONCLUSIONS: FCA decreases after LSG, with a concurrent rise in bone turnover marker levels and decline in BMD, despite robust 25OHD levels and with recommended calcium intake. Decline in FCA could contribute to negative skeletal effects following LSG.
| Errataetall: |
CommentIn: J Clin Endocrinol Metab. 2022 Nov 24;:. - PMID 36423216 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:108 |
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| Enthalten in: |
The Journal of clinical endocrinology and metabolism - 108(2023), 2 vom: 17. Jan., Seite 351-360 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wu, Karin C [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 19.01.2023 Date Revised 26.04.2023 published: Print CommentIn: J Clin Endocrinol Metab. 2022 Nov 24;:. - PMID 36423216 Citation Status MEDLINE |
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| doi: |
10.1210/clinem/dgac579 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM347120628 |
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| 100 | 1 | |a Wu, Karin C |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Intestinal Calcium Absorption Decreases After Laparoscopic Sleeve Gastrectomy Despite Optimization of Vitamin D Status |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 19.01.2023 | ||
| 500 | |a Date Revised 26.04.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: J Clin Endocrinol Metab. 2022 Nov 24;:. - PMID 36423216 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published by Oxford University Press on behalf of the Endocrine Society 2022. | ||
| 520 | |a CONTEXT: Laparoscopic sleeve gastrectomy (LSG), now the most commonly performed bariatric operation, is a highly effective treatment for obesity. While Roux-en-Y gastric bypass is known to impair intestinal fractional calcium absorption (FCA) and negatively affect bone metabolism, LSG's effects on calcium homeostasis and bone health have not been well characterized | ||
| 520 | |a OBJECTIVE: We determined the effect of LSG on FCA, while maintaining robust 25-hydroxyvitamin D (25OHD) levels and recommended calcium intake | ||
| 520 | |a DESIGN, SETTING, PARTICIPANTS: Prospective pre-post observational cohort study of 35 women and men with severe obesity undergoing LSG | ||
| 520 | |a MAIN OUTCOMES: FCA was measured preoperatively and 6 months postoperatively with a gold-standard dual stable isotope method. Other measures included calciotropic hormones, bone turnover markers, and bone mineral density (BMD) by dual-energy X-ray absorptiometry and quantitative computed tomography | ||
| 520 | |a RESULTS: Mean ± SD FCA decreased from 31.4 ± 15.4% preoperatively to 16.1 ± 12.3% postoperatively (P < 0.01), while median (interquartile range) 25OHD levels were 39 (32-46) ng/mL and 36 (30-46) ng/mL, respectively. Concurrently, median 1,25-dihydroxyvitamin D level increased from 60 (50-82) pg/mL to 86 (72-107) pg/mL (P < 0.01), without significant changes in parathyroid hormone or 24-hour urinary calcium levels. Bone turnover marker levels increased substantially, and areal BMD decreased at the proximal femur. Those with lower postoperative FCA had greater areal BMD loss at the total hip (ρ = 0.45, P < 0.01) | ||
| 520 | |a CONCLUSIONS: FCA decreases after LSG, with a concurrent rise in bone turnover marker levels and decline in BMD, despite robust 25OHD levels and with recommended calcium intake. Decline in FCA could contribute to negative skeletal effects following LSG | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Research Support, U.S. Gov't, Non-P.H.S. | |
| 650 | 4 | |a bariatric surgery | |
| 650 | 4 | |a bone mineral density | |
| 650 | 4 | |a bone turnover markers | |
| 650 | 4 | |a calcium absorption | |
| 650 | 4 | |a laparoscopic sleeve gastrectomy | |
| 650 | 4 | |a vitamin D | |
| 650 | 7 | |a Calcium |2 NLM | |
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| 650 | 7 | |a Vitamin D |2 NLM | |
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| 700 | 1 | |a Cao, Sisi |e verfasserin |4 aut | |
| 700 | 1 | |a Weaver, Connie M |e verfasserin |4 aut | |
| 700 | 1 | |a King, Nicole J |e verfasserin |4 aut | |
| 700 | 1 | |a Patel, Sheena |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Tiffany Y |e verfasserin |4 aut | |
| 700 | 1 | |a Black, Dennis M |e verfasserin |4 aut | |
| 700 | 1 | |a Kingman, Hillary |e verfasserin |4 aut | |
| 700 | 1 | |a Shafer, Martin M |e verfasserin |4 aut | |
| 700 | 1 | |a Rogers, Stanley J |e verfasserin |4 aut | |
| 700 | 1 | |a Stewart, Lygia |e verfasserin |4 aut | |
| 700 | 1 | |a Carter, Jonathan T |e verfasserin |4 aut | |
| 700 | 1 | |a Posselt, Andrew M |e verfasserin |4 aut | |
| 700 | 1 | |a Schafer, Anne L |e verfasserin |4 aut | |
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