Impact of marked weight loss induced by bariatric surgery on bone mineral density and remodeling
Impact of marked weight loss induced by bariatric surgery on bone mineral density and remodeling
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DOI：
10.1590/s0100-879x2006005000074
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发表时间：
2007-04-01
影响因子：
2.3
通讯作者：
Paula, F.J.A
中科院分区：
文献类型：
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作者：
Pereira, F.A.;Castro, J.A.S. de;Paula, F.J.A
关于减肥手术(BS)和随后的体重减轻对骨骼的影响的数据有限。本研究的目的是在研究前平均9.8个月(OGG，N=16)，测定影响骨营养的绝经前妇女的骨密度(BMD)、骨重建代谢产物和激素。这些数据与正常体重女性(CG，N=11)和肥胖女性(OG，N=12)的数据进行了比较。每组8例，监测骨密度、血钙、磷、镁、甲状旁腺激素、25-羟基维生素D、胰岛素样生长因子-I(IGF-I)、骨钙素，尿钙、脱氧吡啶。在纵向研究中，每3个月重复一次生化测定，并在研究结束时测量骨密度。三组甲状旁腺激素水平相似。手术组IGF-I水平(CG=332+/-62vsOG=230+/-37vsOGG=128+/-19 ng/mL)显著低于非手术组。只有OGG患者的L1-L4骨密度显著下降6.2%，股骨颈下降10.2%，前臂下降5.1%。这些结果表明，即使在不受体重超负荷影响的部位，BS导致的体重减轻也与显著的骨量损失有关，IGF-I等激素因素与这一过程有关。
Data about the impact of bariatric surgery (BS) and subsequent weight loss on bone are limited. The objective of the present study was to determine bone mineral density (BMD), bone remodeling metabolites and hormones that influence bone trophism in premenopausal women submitted to BS 9.8 months, on average, before the study (OGg, N = 16). The data were compared to those obtained for women of normal weight (CG, N = 11) and for obese women (OG, N = 12). Eight patients in each group were monitored for one year, with the determination of BMD, of serum calcium, phosphorus, magnesium, parathyroid hormone, 25-hydroxyvitamin D, insulin- like growth factor-I (IGF-I) and osteocalcin, and of urinary calcium and deoxypyridinoline. The biochemical determinations were repeated every three months in the longitudinal study and BMD was measured at the end of the study. Parathyroid hormone levels were similar in the three groups. IGF-I levels ( CG = 332 +/- 62 vs OG = 230 +/- 37 vs OGg = 128 +/- 19 ng/mL) were significantly lower in the operated patients compared to the non-operated obese women. Only OGg patients presented a significant fall in BMD of 6.2% at L1-L4, of 10.2% in the femoral neck, and of 5.1% in the forearm. These results suggest that the weight loss induced by BS is associated with a significant loss of bone mass even at sites that are not influenced by weight overload, with hormonal factors such as IGF-I being associated with this process.