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Bone disorder and vitamin D after gastric cancer surgery.

AbstractBACKGROUND/AIMS:
The present study was conducted to investigate the relationship between bone metabolic disorder after gastrectomy for gastric cancer and vitamin D metabolites or the hormones involved in calcium metabolism.
METHODOLOGY:
Twenty-one patients who had undergone gastrectomy for gastric cancer and had been followed for less than 10 years were assessed for bone disorder by microdensitometry. The levels of 1,25-dihydroxy vitamin D (1,25(OH)2VD), 25-hydroxy vitamin D (25(OH)VD), 24,25-dihydroxy vitamin D (24,25(OH)2VD), N-PTH, calcitonin, estradiol, osteocalcin, and ALP were measured and assessed for correlations with clinicopathological factors, including the operative procedure and the number of years since surgery.
RESULTS:
Bone disorder was found in 9 out of 21 patients (42.9%). The prevalence was significantly higher in patients who had undergone surgery more than 2 years before assessment, so there was a relationship between the period after surgery and bone disorder. Among the vitamin D metabolites, the level of 1,25(OH)2VD was normal in all patients, whereas 25(OH)VD was reduced in 6 out of 21 patients (28.6%) and 24,25(OH)2VD was reduced in 17 patients (81.0%). The 1,25(OH)2VD was significantly higher in the patients with Grade I to III bone disorder compared to the patients with normal bones or early bone disease. The 1,25(OH)2VD/25(OH)VD ratio was significantly higher in the patients without passage of food through the duodenum due to the reconstructive method, while the 25(OH)VD/24,25(OH)2VD ratio was significantly higher in the patients with remaining of duodenal food passage. PTH was decreased in about 50% of the patients, while calcitonin was normal in all patients. Estradiol was decreased in one female patient, while it was elevated in 10 of the 17 men (58.8%). The osteocalcin level was high in all patients irrespective of the period after surgery.
CONCLUSIONS:
After gastrectomy, the incidence of bone metabolic disorder increases with time. Changes of vitamin D metabolites, particularly 25(OH)VD and 24,25(OH)2VD, seem to be closely associated with post-gastrectomy bone disease.
AuthorsYasushi Rino, Yoshinori Takanashi, Yuji Yamamoto, Daisuke Inagaki, Masakazu Kawamoto, Hiroshi Harada, Akio Ashida, Hiroo Wada, Roppei Yamada, Takashi Ohshima, Shinsuke Hatori, Toshio Imada
JournalHepato-gastroenterology (Hepatogastroenterology) 2007 Jul-Aug Vol. 54 Issue 77 Pg. 1596-600 ISSN: 0172-6390 [Print] Greece
PMID17708309 (Publication Type: Journal Article)
Chemical References
  • Vitamin D
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Diseases, Metabolic (etiology, metabolism)
  • Female
  • Gastrectomy (adverse effects)
  • Humans
  • Male
  • Middle Aged
  • Stomach Neoplasms (surgery)
  • Vitamin D (metabolism)

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