Purpose Potential negative effects of metabolic surgery on skeletal integrity remain a concern, since long-term data of different surgical approaches are poor. This study aimed to describe changes in bone metabolism in subjects with obesity undergoing both Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). Methods A single center, retrospective, observational clinical study on real-world data was performed enrolling subjects undergoing metabolic surgery. Results 123 subjects were enrolled (males 31: females 92; ages 48.2 ± 7.9 years). All patients were evaluated until 16.9 ± 8.1 months after surgery, while a small group was evaluated up to 4.5 years. All patients were treated after surgery with calcium and vitamin D integration. Both calcium and phosphate serum levels significantly increased after metabolic surgery and remained stable during follow-up. These trends did not differ between RYGB and SG (p = 0.245). Ca/P ratio decreased after surgery compared to baseline (p < 0.001) and this decrease remained among follow-up visits. While 24-h urinary calcium remained stable across all visits, 24-h urinary phosphate showed lower levels after surgery (p = 0.014), also according to surgery technique. Parathyroid hormone decreased (p < 0.001) and both vitamin D (p < 0.001) and C-terminal telopeptide of type I collagen (p = 0.001) increased after surgery. Conclusion We demonstrated that calcium and phosphorous metabolism shows slight modification even after several years since metabolic surgery, irrespective of calcium and vitamin D supplementation. This different set point is characterized by a phosphate serum levels increase, together with a persistent bone loss, suggesting that supplementation alone may not ensure the maintenance of bone health in these patients.

Long-term trajectories of bone metabolism parameters and bone mineral density (BMD) in obese patients treated with metabolic surgery: a real-world, retrospective study / Greco, Carla; Passerini, Francesca; Coluccia, Silvia; Teglio, Marta; Bondi, Mario; Mecheri, Fouzia; Trapani, Vincenzo; Volpe, Alessandro; Toschi, Patrizia; Madeo, Bruno; Simoni, Manuela; Rochira, Vincenzo; Santi, Daniele. - In: JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION. - ISSN 1720-8386. - 46:10(2023), pp. 2133-2146. [10.1007/s40618-023-02066-8]

Long-term trajectories of bone metabolism parameters and bone mineral density (BMD) in obese patients treated with metabolic surgery: a real-world, retrospective study.

Greco Carla;Simoni Manuela;Rochira Vincenzo
;
Santi Daniele
2023

Abstract

Purpose Potential negative effects of metabolic surgery on skeletal integrity remain a concern, since long-term data of different surgical approaches are poor. This study aimed to describe changes in bone metabolism in subjects with obesity undergoing both Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). Methods A single center, retrospective, observational clinical study on real-world data was performed enrolling subjects undergoing metabolic surgery. Results 123 subjects were enrolled (males 31: females 92; ages 48.2 ± 7.9 years). All patients were evaluated until 16.9 ± 8.1 months after surgery, while a small group was evaluated up to 4.5 years. All patients were treated after surgery with calcium and vitamin D integration. Both calcium and phosphate serum levels significantly increased after metabolic surgery and remained stable during follow-up. These trends did not differ between RYGB and SG (p = 0.245). Ca/P ratio decreased after surgery compared to baseline (p < 0.001) and this decrease remained among follow-up visits. While 24-h urinary calcium remained stable across all visits, 24-h urinary phosphate showed lower levels after surgery (p = 0.014), also according to surgery technique. Parathyroid hormone decreased (p < 0.001) and both vitamin D (p < 0.001) and C-terminal telopeptide of type I collagen (p = 0.001) increased after surgery. Conclusion We demonstrated that calcium and phosphorous metabolism shows slight modification even after several years since metabolic surgery, irrespective of calcium and vitamin D supplementation. This different set point is characterized by a phosphate serum levels increase, together with a persistent bone loss, suggesting that supplementation alone may not ensure the maintenance of bone health in these patients.
2023
46
10
2133
2146
Long-term trajectories of bone metabolism parameters and bone mineral density (BMD) in obese patients treated with metabolic surgery: a real-world, retrospective study / Greco, Carla; Passerini, Francesca; Coluccia, Silvia; Teglio, Marta; Bondi, Mario; Mecheri, Fouzia; Trapani, Vincenzo; Volpe, Alessandro; Toschi, Patrizia; Madeo, Bruno; Simoni, Manuela; Rochira, Vincenzo; Santi, Daniele. - In: JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION. - ISSN 1720-8386. - 46:10(2023), pp. 2133-2146. [10.1007/s40618-023-02066-8]
Greco, Carla; Passerini, Francesca; Coluccia, Silvia; Teglio, Marta; Bondi, Mario; Mecheri, Fouzia; Trapani, Vincenzo; Volpe, Alessandro; Toschi, Patr...espandi
File in questo prodotto:
File Dimensione Formato  
26_2023_JEI_Ca metabolism and metabolic surgery.pdf

Accesso riservato

Descrizione: 2023_JEI_Ca metabolism and metabolic surgery
Tipologia: Versione pubblicata dall'editore
Dimensione 879.05 kB
Formato Adobe PDF
879.05 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1300917
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 3
  • ???jsp.display-item.citation.isi??? 2
social impact