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Metabolic bone disorders after gastrectomy: inevitable or preventable?

Abstract
Some authors have suggested that a relationship exists between gastrectomy for gastric cancer and metabolic bone disorders. However, few studies have investigated metabolic bone disorders after gastrectomy for gastric cancer in detail. Thus, we reviewed the findings of our recent prospective study and those of other reports on this subject. Osteoporosis and osteomalacia have been observed after gastrectomy and appear to be caused by reduced food intake and absorption, and steatorrhea. Moreover, the incidence of fracture is high after gastrectomy, although subtotal or total gastrectomy and reconstruction for gastric cancer have not been identified as significant risk factors for decreased bone mineral density (BMD). Recently, we reported that the BMD decreased significantly within 12 months after gastrectomy for gastric cancer in both male and female patients, but there was no significant gender-related difference in the rate of change in BMD. More than 1 year after gastrectomy, the steep decrease in the BMD stabilized and normal levels of 1,25(OH)2 vitamin D3 were maintained, despite the lack of precursor for 1,25(OH)2 vitamin D3 synthesis after gastrectomy. Alendronate therapy might be effective and prevent postgastrectomy metabolic bone disorders; however, the optimal treatment and prevention strategy for this bone disorder has not been delineated.
AuthorsYasushi Rino, Toru Aoyama, Yosuke Atsumi, Takanobu Yamada, Norio Yukawa
JournalSurgery today (Surg Today) Vol. 52 Issue 2 Pg. 182-188 (Feb 2022) ISSN: 1436-2813 [Electronic] Japan
PMID33630154 (Publication Type: Journal Article, Review)
Copyright© 2021. Springer Nature Singapore Pte Ltd.
Chemical References
  • Bone Density Conservation Agents
  • Calcitriol
  • Alendronate
Topics
  • Alendronate (administration & dosage)
  • Bone Density
  • Bone Density Conservation Agents (administration & dosage)
  • Bone Diseases, Metabolic (etiology, metabolism, prevention & control)
  • Calcitriol (metabolism)
  • Female
  • Gastrectomy (adverse effects)
  • Humans
  • Male
  • Osteomalacia
  • Osteoporosis
  • Postoperative Complications (etiology, prevention & control)
  • Stomach Neoplasms (surgery)

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