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Obes Surg. 2018 Nov 26. doi: 10.1007/s11695-018-3617-x. [Epub ahead of print]

Effects of Biliopancreatic Diversion on Bone Turnover Markers and Association with Hormonal Factors in Patients with Severe Obesity.

Author information

1
Endocrinology and Nephrology Unit, CHU de Québec Research Centre, 2705, Boulevard Laurier, Québec City, QC, G1V 4G2, Canada.
2
CHU de Sherbrooke Research Centre, Sherbrooke, Canada.
3
Department of Medicine, Université de Sherbrooke, Sherbrooke, Canada.
4
Clinical and Evaluative Research Platform, CHU de Québec-Université Laval Research Centre, Québec City, QC, Canada.
5
Department of Medicine, Université Laval, Québec City, Canada.
6
Québec Heart and Lung Institute Research Centre, Québec City, Canada.
7
Institute of Nutrition and Functional Foods, Université Laval, Quebec City, QC, Canada.
8
Department of Surgery, Université Laval, Québec City, Canada.
9
Endocrinology and Nephrology Unit, CHU de Québec Research Centre, 2705, Boulevard Laurier, Québec City, QC, G1V 4G2, Canada. claudia.gagnon@crchudequebec.ulaval.ca.
10
Department of Medicine, Université Laval, Québec City, Canada. claudia.gagnon@crchudequebec.ulaval.ca.
11
Québec Heart and Lung Institute Research Centre, Québec City, Canada. claudia.gagnon@crchudequebec.ulaval.ca.
12
Institute of Nutrition and Functional Foods, Université Laval, Quebec City, QC, Canada. claudia.gagnon@crchudequebec.ulaval.ca.

Abstract

BACKGROUND:

This study evaluated early and medium-term changes in bone turnover markers, and their associations with weight loss, total bone mineral density (BMD), and hormonal changes after biliopancreatic diversion (BPD).

METHODS:

Ancillary study from a one-year prospective cohort of 16 individuals assessed before, 3 days, 3 and 12 months after BPD. Bone turnover markers (C-terminal telopeptide (CTX), intact osteocalcin (OC), sclerostin, and osteoprotegerin (OPG)) and several hormones were measured at each visit. Total BMD by DXA was assessed at baseline, 3 and 12 months after BPD. Three participants were lost to follow-up.

RESULTS:

CTX increased significantly at 3 days (+ 66%), 3 months (+ 219%), and 12 months (+ 295%). OC decreased at 3 days (- 19%) then increased at 3 months (+ 69%) and 12 months (+ 164%). Change in sclerostin was only significant between 3 days and 3 months (+ 13%), while change in OPG was significant between baseline and 3 days (+ 48%) and baseline and 12 months (+ 45%). CTX increase correlated negatively with weight loss at 3 (r = - 0.63, p = 0.009) and 12 months (r = - 0.58, p = 0.039), and total BMD decrease (r = - 0.67, p = 0.033) at 12 months. Change in insulin and adiponectin correlated with changes in bone turnover markers independently of weight loss.

CONCLUSION:

BPD causes an earlier and greater increase in bone resorption over bone formation markers and a decrease in total BMD. Sclerostin did not increase as expected following extensive weight loss. Changes in insulin and adiponectin seem to play a role in the activation of bone remodeling after BPD.

KEYWORDS:

Bariatric surgery; Biliopancreatic diversion; Biochemical markers of bone turnover; Bone mineral density; Hormones

PMID:
30478790
DOI:
10.1007/s11695-018-3617-x

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