Calcium regulation and bone mass loss after total gastrectomy in pigs.
OBJECTIVE
Total gastrectomy often results in postgastrectomy bone disease with decreased bone mass and increased fracture risk. To further elucidate the mechanisms of postgastrectomy bone disease, the authors investigated calcium metabolism and bone mineral density after total gastrectomy in pigs.


BACKGROUND
Postgastrectomy bone disease can present as osteomalacia, osteoporosis in excess of normal aging, or a combination of both. The underlying mechanisms are insufficiently understood and need further investigation.


METHODS
Growing minipigs were gastrectomized and compared with fed-matched, sham-operated control p gs for 1 year. Calcium absorption, serum calcium, parathyroid hormone, 25-(OH)-vitamin D, 1,25-(OH)2-vitamin D, alkaline phosphatase, and computed tomography bone mineral density were measured in three monthly intervals.


RESULTS
Total gastrectomy resulted in impaired calcium absorption, reduced serum calcium and 25-(OH)-vitamin D, increased parathyroid hormone and 1,25-(OH)2-vitamin, and reduced bone mineral density compared with fed-matched, sham-operated control pigs.


CONCLUSIONS
The authors data indicate that a reduced serum calcium activates counter-regulatory mechanisms, resulting in calcium mobilization from the bone. Possibly, calcium and vitamin D supplementation after total gastrectomy might prevent postgastrectomy bone mass loss.
Maier
G W
GW
University Hospital, Department of Abdominal and Transplantation Surgery, Tübingen, Germany.
Kreis
M E
ME
Zittel
T T
TT
Becker
H D
HD
D000818:Animals; D001835:Body Weight; D015519:Bone Density; D002118:Calcium / Q000378:metabolism*; D004435:Eating; D005260:Female; D005743:Gastrectomy; D013552:Swine; D013556:Swine, Miniature
D002118:Calcium