Biochemical Evidence of Metabolic Bone Disease in Women Following Roux-Y Gastric Bypass for Morbid Obesity.
Twenty-six female patients were recalled for examination 10 years after a Roux-Y gastric bypass (RGB) procedure for morbid obesity, to determine whether there was biochemical and/or bone densitometry evidence of metabolic bone disease. These patients were compared with seven control patients who had achieved weight loss by dietary restriction. The serum calcium (4.3 +/- 0.03 vs 4.6 +/- 0.06 mEq/l; p = 0.002) was decreased in the RGB group. Both the serum alkaline phosphatase level (121.0 +/- 7.6 vs 87.3 +/- 8.3 U/I; p = 0.018) and the serum osteocalcin (12.6 +/- 1.2 vs 9.5 +/- 1.9 µg/ml; p = 0.078) level increased in the RGB group. The 1,25(OH) vitamin D level (50.5 +/- 2.5 vs 40.5 +/- 4.9 pg/ml; p = 0.152) was similar for both groups; the 25(OH) vitamin D level (24.3 +/- 1.6 vs 35.9 +/- 3.4 ng/ml; p = 0.008) was decreased in the RGB group as compared with the control group. Bone mineral density was elevated in three of the lumbar measurement sites, and marginally decreased (0.90 +/- 0.02 g/cm(2) vs 1.03 +/- 0.06 g/cm(2); p = 0.067) in the femoral neck of the RGB group compared with the controls. This biochemical pattern suggests the development of metabolic bone disease following the RGB.
Ott
MT
Colon and Rectal Clinic, University of Texas Medical Center, Houston, TX 77030 USA.
Fanti
P
Malluche
HH
Ryo
UY
Whaley
FS
Strodel
WE
Colacchi
TA