Bone Structural Changes and Estimated Strength After Gastric Bypass Surgery Evaluated by HR-pQCT

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• 作者：Katrine Diemer Frederiksen ; Stine Hanson ; Stinus Hansen…
• 关键词：Roux ; en ; Y gastric bypass ; Obesity ; Bone microarchitecture ; Bone strength ; HR ; pQCT
• 刊名：Calcified Tissue International
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：98
• 期：3
• 页码：253-262
• 全文大小：466 KB
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• 作者单位：Katrine Diemer Frederiksen (1)
  Stine Hanson (1)
  Stinus Hansen (1) (2)
  Kim Brixen (1)
  Jeppe Gram (3)
  Niklas Rye Jørgensen (2) (4)
  René Klinkby Støving (1) (5)
  
  1. Department of Endocrinology, Odense University Hospital, Kløvervænget 6, 1.sal, 5000, Odense C, Denmark
  2. Institute of Clinical Research, University of Southern Denmark, J.B. Winsløwsvej 19, 5000, Odense C, Denmark
  3. Department of Endocrinology, Hospital of Southwest Denmark, Finsensgade 35, 6700, Esbjerg, Denmark
  4. Research Center for Ageing and Osteoporosis, Department of Clinical Biochemistry, Rigshospitalet, Ndr. Ringvej 57, 2600, Glostrup, Denmark
  5. Center for Eating Disorders, Odense University Hospital, Kløvervænget 6, 8. sal, 5000, Odense C, Denmark
  
• 刊物类别：Biomedical and Life Sciences
• 刊物主题：Life Sciences
  Biochemistry
  Endocrinology
  Orthopedics
  Cell Biology
  
• 出版者：Springer New York
• ISSN：1432-0827

文摘

Roux-en-Y gastric bypass surgery (RYGB) is an effective treatment of morbid obesity, with positive effects on obesity-related complications. The treatment is associated with bone loss, which in turn might increase fracture risk. The aim of this study was to evaluate changes in bone mineral density (BMD) and bone architecture assessed using dual-energy X-ray absorptiometry (DXA) and high-resolution peripheral quantitative computed tomography (HR-pQCT), 6 and 12 months after RYGB, and correlate them to changes in selected biochemical markers. A prospective cohort study included 25 morbidly obese patients (10 males, 15 females). Patients were examined with DXA of the hip and spine, HR-pQCT of radius and tibia, and blood sampling before and 6 and 12 months after RYGB. Patients lost in average 33.5 ± 12.1 kg (25.8 ± 8.5 %) in 12 months. In tibia, we found significant loss of total, cortical and trabecular volumetric BMD after 12 months (all p < 0.001). Microarchitectural changes involved lower trabecular number, increased trabecular separation, and network inhomogeneity along with thinning of the cortex. Estimated bone failure load was decreased after 12 months (p = 0.005). We found only minor changes in radius. Results demonstrate significant alterations of bone microarchitecture suggesting an accelerated endosteal resorption along with disintegration of the trabecular structure which resulted in a loss of estimated bone strength in tibia. Such changes may underlie the recently reported increased risk of fracture in bariatric patients after surgery. We only observed bone structural changes in the weight-bearing bone, which indicates that mechanical un-loading is the primary mediator. Keywords Roux-en-Y gastric bypass Obesity Bone microarchitecture Bone strength HR-pQCT