May 2015 Vol. 3 No. 5

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Original Research Article

Changes in Bone Metabolism/Mineral Density Twelve Months after Laparoscopic Sleeve Gastrectomy in Morbidly Obese Pre-menopausal Women

Amany A. Mousa^1*, Tharwat S. Kandil², Ehsan M. Rizk³ and Gehan A. Shaker⁴

¹MD, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Egypt
²MD, Department of Gastrointestinal Surgery, Faculty of Medicine, Mansoura University, Egypt
³MD, Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Egypt
⁴MD, Department of Physiology, Faculty of Medicine, Mansoura University, Egypt

*Corresponding Author’s Email: aamousa2002@yahoo.com
Tel: 00201063929961

Accepted April 27, 2015

Abstract

Bariatric surgery for weight loss may result in nutritional deficiencies affecting bone metabolism. Laparoscopic Sleeve gastrectomy (LSG) is expected to have fewer nutritional sequelae. However, there is little information about bone metabolism after LSG. This study aimed to evaluate changes in bone metabolism and mineral density in morbidly obese women six months after LSG. Thirty two morbidly obese, premenopausal women were evaluated at baseline and 12 months after LSG for: BMD by dual-energy X-ray absorptiometry, serum collagen-type I N telopeptide (NTX-s) and N-terminal propetide of collagen type I (PINP) as markers of bone metabolism, 25 hydroxyvitamin D and intact parathyroid hormone (iPTH). Vitamin D was low in 46.8% and iPTH was high in 34.3% with elevated NTX-s and PINP. Twelve months after LSG, there was a significant increase in vitamin D, a significant decrease in iPTH and in markers of bone metabolism that correlated with weight loss. BMD was not significantly changed in spine and radius but minimally decreased in femur neck. Significant vitamin D deficiency and increase in bone turnover markers exist in morbidly obese premenopausal women. LSG was shown to improve vitamin D status and bone turnover owing to the significant weight loss with a negligible effect on BMD.

Keywords: Bone metabolism, laparoscopic sleeve gastrectomy, mineral density