The following is a summary of “Intestinal Calcium Absorption Decreases After Laparoscopic Sleeve Gastrectomy Despite Optimization of Vitamin D Status,” published in the February 2023 issue of Endocrinology & Metabolism by Wu, et al.
Laparoscopic sleeve gastrectomy (LSG) is a popular surgery for treating obesity. However, while the effect of the Roux-en-Y gastric bypass surgery on calcium homeostasis and bone health is well documented, the effect of LSG on bone health has yet to be extensively studied.
For a study, researchers sought to examine the impact of laparoscopic sleeve gastrectomy (LSG), which is currently the most common bariatric surgery for treating obesity, on calcium metabolism and bone health. Although Roux-en-Y gastric bypass is known to impair intestinal fractional calcium absorption and negatively affect bone metabolism, the impact of LSG on calcium homeostasis and bone health has not been well-characterized.
To investigate this issue, they conducted a prospective pre-post observational cohort study of 35 women and men with severe obesity who underwent LSG. They measured fractional calcium absorption (FCA), calciotropic hormones, bone turnover markers, and bone mineral density (BMD) before and six months after surgery.
The findings showed that Mean ± SD FCA decreased significantly from 31.4 ± 15.4% preoperatively to 16.1 ± 12.3% postoperatively (P < 0.01), while 25OHD levels remained robust with a median of 39 (32-46) ng/mL preoperatively and 36 (30-46) ng/mL postoperatively. Meanwhile, 1,25-dihydroxy vitamin D levels increased significantly from 60 (50-82) pg/mL to 86 (72-107) pg/mL (P < 0.01) after the surgery.
The study also found that bone turnover marker levels increased significantly, and areal BMD decreased at the proximal femur. In addition, those with lower postoperative FCA had greater areal BMD loss at the total hip (ρ = 0.45, P < 0.01).
In conclusion, LSG led to a decrease in FCA and an increase in bone turnover marker levels, along with a decline in BMD, despite robust 25OHD levels and recommended calcium intake. The decline in FCA may contribute to negative skeletal effects following LSG.
Reference: academic.oup.com/jcem/article-abstract/108/2/351/6748484?redirectedFrom=fulltext
