Urinary excretion of deoxypyridinoline increases after gastrointestinal surgery.
OBJECTIVE
We investigated the effect of gastrointestinal surgery on bone metabolism with special reference to nutrition status and the systemic inflammatory response (SIR).


METHODS
We assessed bone resorption by measuring the urinary excretion of deoxypyridinoline (D-Pyr), a specific marker that reflects the amount of degraded collagen. Twenty patients who underwent gastrectomy or colectomy were enrolled in this study. Daily energy intake, nitrogen, calcium, and phosphate balances, and urinary D-Pyr were examined preoperatively and for 14 days after the operation. The nutritional risk index and prealbumin were measured for nutrition assessment, and SIR was evaluated daily based on scorings of body temperature, pulse rate, respiratory rate, and white blood cell number according to our criteria.


RESULTS
Urinary D-Pyr excretion had already increased on postoperative day 1 and continued to increase until postoperative day 14. The amounts of postoperative urinary excretion of D-Pyr correlated positively with the SIR scores and the amount of urinary excretion of cortisol, one of the stress-response hormones, and inversely with pre- and postoperative nutritional risk indices. In addition, the patients who experienced complications during the postoperative period excreted larger amounts of D-Pyr.


CONCLUSIONS
Because the amount of excreted D-Pyr reflects the loss of the bone matrix, these results may indicate that bone resorption increases after gastrointestinal surgery. The extent of resorption was parallel to the degree of SIR and nutrition status.
Kani
Tomiko
T
Department of Clinical Nutrition, Mie University Hospital, Tsu City, Mie, Japan.
Miki
Chikao
C
Tonouchi
Hitoshi
H
Akehi
Yuko
Y
Ono
Junko
J
D000328:Adult; D000368:Aged; D000596:Amino Acids / Q000652:urine*; D015415:Biomarkers / Q000652:urine; D001862:Bone Resorption / Q000652:urine; D001842:Bone and Bones / Q000503:physiopathology*; D003082:Colectomy; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011183:Postoperative Complications / Q000503:physiopathology* / Q000652:urine; D018746:Systemic Inflammatory Response Syndrome / Q000503:physiopathology* / Q000652:urine
D000596:Amino Acids; D015415:Biomarkers; C036020:deoxypyridinoline