Changes in Bone Mineral Density in Patients with Type 2 Diabetes After Different Bariatric Surgery Procedures and the Role of Gastrointestinal Hormones.
Adult
Bariatric Surgery
/ adverse effects
Bone Density
/ physiology
Bone Remodeling
Bone and Bones
/ metabolism
Diabetes Mellitus, Type 2
/ complications
Female
Femur Neck
Follow-Up Studies
Gastrointestinal Hormones
/ blood
Ghrelin
/ blood
Glucagon
/ blood
Glucagon-Like Peptide 1
/ blood
Humans
Insulin
/ blood
Male
Middle Aged
Obesity, Morbid
/ complications
Treatment Outcome
Bariatric surgery
Bone mineral density
Gastrointestinal hormones
Journal
Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
pubmed:
20
8
2019
medline:
26
6
2020
entrez:
18
8
2019
Statut:
ppublish
Résumé
To compare changes in bone mineral density (BMD) in patients with morbid obesity and type 2 diabetes (T2D) a year after being randomized to metabolic gastric bypass (mRYGB), sleeve gastrectomy (SG), and greater curvature plication (GCP). We also analyzed the association of gastrointestinal hormones with skeletal metabolism. Forty-five patients with T2D (mean BMI 39.4 ± 1.9 kg/m After surgery, the decrease at femoral neck (FN) was similar but at lumbar spine (LS), it was greater in the mRYGB group compared with SG and GCP - 7.29 (4.6) vs. - 0.48 (3.9) vs. - 1.2 (2.7)%, p < 0.001. Osteocalcin and alkaline phosphatase increased more after mRYGB. Bone mineral content (BMC) at the LS after surgery correlated with fasting ghrelin (r = - 0.412, p = 0.01) and AUC for GLP-1 (r = - 0.402, p = 0.017). FN BMD at 12 months correlated with post-surgical fasting glucagon (r = 0.498, p = 0.04) and insulin AUC (r = 0.384, p = 0.030) and at LS with the AUC for GLP-1 in the same time period (r = - 0.335, p = 0.049). However, in the multiple regression analysis after adjusting for age, sex, and BMI, the type of surgery (mRYGB) remained the only factor associated with BMD reduction at LS and FN. mRYGB induces greater deleterious effects on the bone at LS compared with SG and GCP, and gastrointestinal hormones do not play a major role in bone changes.
Sections du résumé
BACKGROUND
To compare changes in bone mineral density (BMD) in patients with morbid obesity and type 2 diabetes (T2D) a year after being randomized to metabolic gastric bypass (mRYGB), sleeve gastrectomy (SG), and greater curvature plication (GCP). We also analyzed the association of gastrointestinal hormones with skeletal metabolism.
METHODS
Forty-five patients with T2D (mean BMI 39.4 ± 1.9 kg/m
RESULTS
After surgery, the decrease at femoral neck (FN) was similar but at lumbar spine (LS), it was greater in the mRYGB group compared with SG and GCP - 7.29 (4.6) vs. - 0.48 (3.9) vs. - 1.2 (2.7)%, p < 0.001. Osteocalcin and alkaline phosphatase increased more after mRYGB. Bone mineral content (BMC) at the LS after surgery correlated with fasting ghrelin (r = - 0.412, p = 0.01) and AUC for GLP-1 (r = - 0.402, p = 0.017). FN BMD at 12 months correlated with post-surgical fasting glucagon (r = 0.498, p = 0.04) and insulin AUC (r = 0.384, p = 0.030) and at LS with the AUC for GLP-1 in the same time period (r = - 0.335, p = 0.049). However, in the multiple regression analysis after adjusting for age, sex, and BMI, the type of surgery (mRYGB) remained the only factor associated with BMD reduction at LS and FN.
CONCLUSIONS
mRYGB induces greater deleterious effects on the bone at LS compared with SG and GCP, and gastrointestinal hormones do not play a major role in bone changes.
Identifiants
pubmed: 31420830
doi: 10.1007/s11695-019-04127-5
pii: 10.1007/s11695-019-04127-5
doi:
Substances chimiques
Gastrointestinal Hormones
0
Ghrelin
0
Insulin
0
Glucagon-Like Peptide 1
89750-14-1
Glucagon
9007-92-5
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
180-188Références
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