Calcium metabolism in pre- and postmenopausal morbidly obese women at baseline and after laparoscopic Roux-en-Y gastric bypass.
BACKGROUND
The authors evaluated calcium metabolism in obese women, before and after menopause, at baseline and at 6 and 12 months after laparoscopic Roux-en-Y gastric bypass (LRYGBP). LRYGBP restricts food intake and produces physiological changes that may be similar to those after high Billroth II subtotal gastrectomy.


METHODS
Serum calcium (Ca), phosphate, bone-specific alkaline phosphatase (BSAP) and 25-hydroxyvitamin D3 (25-OH D) were measured at baseline and 12 months after LRYGBP. Urinary N-telopeptide (u-NTX) was measured at baseline and serum C-telopeptide (s-CTX) at 6 and 12 months after LRYGBP. Parathormone (PTH) was measured at baseline and 6 and 12 months after LRYGBP. Patients were divided into 2 groups: Group I (n=30) pre-menopausal women aged 18-42 y, and Group II (n=30) post-menopausal women aged 40-71 y. Patients with renal, hepatic, metabolic and bone disease, smoking women, as well as patients with u-NTX values at baseline >67 nMBCE/mMCr were excluded.


RESULTS
At baseline, PTH was elevated in 10% of patients in each group, correlated positively with BMI, and low serum calcium values were found in 30% of Group I and 16.7% of Group II. High values of serum C-telopetide were seen in Group I at 6 months after surgery and in Group II 12 months after LRYGBP. Group II showed a greater increase in BSAP at 12 months after LRYGBP. 25-OHD decreased in both groups, and a progressive increase in PTH was observed. Serum calcium did not change in both groups.


CONCLUSIONS
Calcium metabolism is altered in pre- and post-menopausal women following LRYGBP. Calcium and vitamin D supplementation is strongly advised in all patients.
Department of Surgery, São José do Avaí Hospital, Itaperuna, RJ, Brazil.
Luciana J
LJ
El-Kadre
Paulo Roberto Savassi
PR
Rocha
Augusto C
AC
de Almeida Tinoco
Renam C
RC
Tinoco
D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D002118:Calcium / Q000378:metabolism*; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D009767:Obesity, Morbid / Q000378:metabolism* / Q000601:surgery; D017698:Postmenopause / Q000378:metabolism; D011184:Postoperative Period; D017697:Premenopause / Q000378:metabolism; D016896:Treatment Outcome
D002118:Calcium