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The effects of adolescent laparoscopic adjustable gastric band and sleeve gastrectomy on markers of bone health and bone turnover.

Authors
  • Weiner, Alyson1
  • Cowell, Amanda2
  • McMahon, Donald J3
  • Tao, Rachel1
  • Zitsman, Jeffrey4
  • Oberfield, Sharon E1
  • Fennoy, Ilene1
  • 1 Division of Pediatric Endocrinology, Columbia University Irving Medical Center, New York, New York, USA.
  • 2 Institute of Human Nutrition, Columbia University Irving Medical Center, New York, New York, USA.
  • 3 Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
  • 4 Division of Pediatric Surgery, Columbia University Irving Medical Center, New York, New York, USA.
Type
Published Article
Journal
Clinical obesity
Publication Date
Dec 01, 2020
Volume
10
Issue
6
Identifiers
DOI: 10.1111/cob.12411
PMID: 32896095
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

25-hydroxy vitamin D (25 OHD) deficiency and secondary hyperparathyroidism have been seen after metabolic and bariatric surgery, but data are lacking on the bone health outcomes of adolescent sleeve gastrectomy (SG). The purpose of this study was to examine bone-related nutrition after SG, compared to laparoscopic adjustable gastric band (LAGB), and trend bone turnover markers following SG. This is an observational study of 197 adolescents who underwent LAGB (n = 98) or SG (n = 99). Bone health labs were collected at baseline and 6 and/or 12 months after LAGB or SG, with additional analysis of bone turnover markers in the SG group. Calcium and 25 OHD levels increased at 6 and 12 months after LAGB and SG, with no difference between the surgeries. Parathyroid hormone levels decreased only in the SG group. SG patients had increased osteocalcin and carboxy-terminal cross-linking telopeptide of type 1 collagen (CTX) at 6 and 12 months post-SG, although CTX decreased between 6 and 12 months. Excess weight loss at 6 months predicted the rise in CTX, but the changes in osteocalcin and CTX could not be attributed to 25 OHD deficiency, hypocalcemia or hyperparathyroidism. Patients had improved 25 OHD levels post-surgery, which may be secondary to stringent vitamin supplementation guidelines. However, there were marked increases in bone turnover markers following SG. More studies are needed to evaluate the effects of SG on adolescent bone health and to correlate the early changes in bone turnover with bone mineral density and fracture risk. © 2020 World Obesity Federation.

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