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.