Study of endocrinal, biochemical and radiological changes after roux-en Y gastric bypass in patients with clinically severe obesity

ABSTRACT

Study of endocrinal, biochemical and radiological changes after Roux-en Y gastric bypass in patients with clinically severe obesity. Our study included 30 patients with clinically severe obesity, RYGB was done for all patients. Daily postoperative oral supplementation with 1000 mg of calcium and 800 IU of vitamin D was done for each patient. Body weight, BMI, also Total body fat, Total lean tissue mass, Bone Mineral content [BMD], Bone Mineral density [BMD], Total bone area [TBA] [using DEXA], also, serum calcium, parathyroid hormone [PTH], 25-OH vitamin D, 24 hours urinary calcium and bone specific Alkaline phosphatase [BSAP] were assessed preoperatively and one year after surgery. In our study females comprised 73% of cases. The mean age was 35 +/- 8.8 years. One year after RYGB Body weight [BW] decreased significantly from 132.8 +/- 26.5 to 90.3 +/- 17.3 kg [p = 0.000]. Body Mass Index [BMI] decreased significantly from 48 +/- 7.3 to 32.6 +/- 4.1 kg/m[2] [p= 0.000]. Also, parameters of skeletal health changes were determined after one year. BMC decreased significantly from 2968.6 +/- 71.4 to 2700.8 +/- 45.4 gm [p = 0.000] BMD decreased significantly from 1.2600 + 0.03 to 1.2197 +/- 0.015 gm/cm[2] [p= 0.000]. TBA decreased significantly from 2356.2 +/- 35.4 to 2216.3 +/- 43.5 cm[2] [p= 0.000]. Serum calcium, 24 hours urinary calcium and BSAP were non significantly decreased while OH-vitamin D and PTH were non significantly increased after surgery. From this study, RYGB gives very good results as regards reduction of body weight. Postoperative supplementation with calcium and vitamin D partially correct osteoporosis. Further studies are needed to determine the exact dose of calcium and vitamin D that may abort bone resorption. From this study, it is shown that Roux-en-Y gastric bypass operation gives very good results as regards reduction of body weight in morbidly obese patients. Postoperative supplementation with calcium and vitamin D partially correct osteoporosis. So, These patients need periodic follow up for Bone Mineral Density [BMD], PTH, calcium, serum vitamin D and markers of bone resorption and formation specially postmenopausal female