Osteoporosis, metabolic aberrations, and increased risk for vertebral fractures after partial gastrectomy.

A case-control study compared 129 men with earlier partial gastrectomy (operation during the period 1952-1961) with 216 men from a community-based population study. All were born 1910-1915 and the mean age was 72 years. Men with a previous partial gastrectomy had vertebral fractures in 19% compared with 4% (P < 0.01) in the control population. Bone mineral density (BMD) in the right calcaneus measured with dual energy photon absorptiometry was 20% lower in men with a Billroth II operation (P < 0.001) and 8% lower with a Billroth I operation (ns). In comparison with the controls, the men subjected to partial gastrectomy had higher serum concentrations of osteocalcin and alkaline phosphatase activity, a lower serum concentration of 25-hydroxyvitamin D (25OHD) and a lower body mass index (BMI). There were no difference in serum concentrations of free calcium, intact parathyroid hormone (PTH), or free thyroxine. The smoking prevalence was significantly higher in men with partial gastrectomy than in controls. Smokers had significantly lower serum concentrations of intact PTH and 25OHD than nonsmokers and also lower BMD and BMI. The relationships between intact PTH on one hand, and ionized calcium (inverse relationship) and osteocalcin (direct relationship) on the other were preserved in smokers, however. Gastroscopy was performed in 78 men with multiple biopsies in the gastric remnant and also in the small intestine. All but two subjects had chronic gastritis. Examination of sternal bone marrow smears showed that 40% of the Billroth-operated men lacked bone marrow reticular iron.(ABSTRACT TRUNCATED AT 250 WORDS)

Peptic ulcer disease in older age groups in Gothenburg in 1985: the association with smoking.

The prevalences of peptic ulcer and smoking were assessed by a questionnaire sent to 6726 residents of Gothenburg selected at random from the birth cohorts 1945, -35, -25, -15, and -05. The point prevalence of peptic ulcer was in all age groups significantly higher among smokers than among non-smokers. The incidence of peptic ulcer in 1985 was deduced from records of ulcers detected at gastroscopy and/or radiography and/or emergency surgery (n = 1402). Smoking habits and previous episodes of peptic ulcer disease were evaluated. The estimated risk of getting peptic ulcer was significantly higher among smokers in all age groups and of both sexes than among non-smokers. Among non-smokers the risk of getting peptic ulcer was significantly higher in men than in women, whereas the risk among smokers showed no sex difference. In people aged 35-84 years, 25.4% (n = 101) of ulcers diagnosed for the first time and 42.0% (n = 246) of relapsing ulcers were estimated to be caused by smoking. The number of smoking years, however, could not be shown to influence the risk of peptic ulcer.

Incidence of peptic ulcer disease in Gothenburg, 1985.

OBJECTIVE: To determine the incidence and age distribution of peptic ulcer disease in adults in Gothenburg. DESIGN: Retrospective study of patients with symptoms over one year. SETTING: All gastroenterology and x ray departments. PATIENTS: Any patient found to have an active ulcer crater during 1985. MAIN OUTCOME MEASURES: Sex, age, past history of gastrointestinal ulcers, and smoking habit. RESULTS: In 1985, 1402 peptic ulcers were diagnosed in 1137 adults. Over half (403; 54%) of the ulcers in men and 393 (60%) ulcers in women were in patients aged over 60. All types of ulcer showed increasing incidence with age. The sex ratio of patients aged 40-50 with peptic ulcers was 1:1. Nearly half (109; 48%) of ulcers diagnosed for the first time in men and 129 (57%) of such ulcers in women were in patients aged over 60. Elderly men and women were also more likely to develop haemorrhage. CONCLUSIONS: In Gothenburg there is a surprisingly high incidence of peptic ulcer disease, which increases considerably with age, possibly explained by the availability of modern diagnostic techniques as 1121 (80%) ulcers had been diagnosed by gastroscopy. Compared with earlier studies there was no difference in the incidence between men and women aged 40-50.