The Impact of Vitamin D, Calcium, Protein Supplementation, and Physical Exercise on Bone Metabolism After Bariatric Surgery: The BABS Study
Muschitz C, Kocijan R, Haschka J, Zendeli A, Pirker T, Geiger C, Müller A, Tschinder B, Kocijan A, Marterer C, Nia A, Muschitz GK, Resch H, Pietschmann P
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 140 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Posiblemente financiado por la industria
- Empresa
- grant or pharmaceutical company
Según 1 financiador declarado.
Publicación
- Publicado
- 2015-09-09 · J Bone Miner Res · vol. 31 · número 3 · págs. 672–682
- Editorial
- Oxford University Press
- Citado
- 200 citas · más que el 99% de estudios similares · 11.8× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 38 trabajos
- Acceso
- De pago
- Áreas de investigación
- Bariatric Surgery and Outcomes · Bone health and osteoporosis research · Vitamin D Research Studies
- Palabras clave
- bariatric surgery, bone metabolism, bone mineral density, vitamin D supplementation, vitamin D3, calcium supplementation, protein supplementation, physical activity, Roux-en-Y gastric bypass, sleeve gastrectomy, obesity, bone turnover markers, sclerostin, DKK1, parathyroid hormone, trabecular bone score, lean body mass, bone loss prevention
- MeSH
- bone and bones, humans, calcium, dietary, vitamin d, dietary proteins, absorptiometry, photon, exercise, fasting, linear models, demography, bone remodeling, bone density, quality of life, dietary supplements, adult, female, male, bariatric surgery, biomarkers
14 autores
- Christian Muschitz🇦🇹Medical University of Vienna
- Roland Kocijan🇦🇹Medical University of Vienna
- Judith Haschka🇦🇹Medical University of Vienna
- Afrodite Zendeli🇦🇹Medical University of Vienna
- Thomas Pirker🇦🇹Medical University of Vienna
- Corinna Geiger🇦🇹Medical University of Vienna
- Andrea Müller🇦🇹Medical University of Vienna
- Bettina Tschinder🇦🇹Medical University of Vienna
- Annemarie Kocijan
- Christina Marterer🇦🇹Medical University of Vienna
- Arastoo Nia🇦🇹 · autor de correspondenciaMedical University of Vienna
- Gabriela Katharina Muschitz🇦🇹University of Vienna; Medical University of Vienna
- Heinrich Resch🇦🇹Medical University of Vienna
- Peter Pietschmann🇦🇹Medical University of Vienna
Resumen
El texto original del estudio, en el idioma en que se publicó.
Laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are common and effective methods to treat severe obesity, but these procedures can adversely influence bone metabolism and areal bone mineral density (aBMD). This was a prospective 24-month single-center interventional two-arm study in 220 women and similarly aged men (median age 40.7 years) with a body mass index (BMI) >38 kg/m(2) after RYGB and SG procedures. Patients were randomized into: 1) an intervention group receiving: 28,000 IU cholecalciferol/wk for 8 weeks before bariatric surgery, 16,000 IU/wk and 1000 mg calciummonocitrate/d after surgery, daily BMI-adjusted protein supplementation and physical exercise (Nordic walking, strength perseverance, and equipment training); 2) a non-intervention group: no preoperative loading, nutritional supplementation, or obligatory physical exercise. At study endpoint, when comparing the intervention group to the non-intervention group, the relative percentage changes of serum levels of sclerostin (12.1% versus 63.8%), cross-linked C-telopeptide (CTX, 82.6% versus 158.3%), 25-OH vitamin D (13.4% versus 18.2%), phosphate (23.7% versus 32%, p < 0.001 for all), procollagen type 1 amino-terminal propeptide (P1NP, 12% versus 41.2%), intact parathyroid hormone (iPTH, -17.3% versus -7.6%), and Dickkopf-1 (-3.9% versus -8.9%, p < 0.05 for all) differed. The decline in lumbar spine, total hip and total body aBMD, changes in BMI, lean body mass (LBM), as well as changes in trabecular bone score (TBS) values (p < 0.005 for all) were less, but significantly, pronounced in the intervention group. We conclude that vitamin D loading and ongoing vitamin D, calcium, and BMI-adjusted protein supplementation in combination with physical exercise decelerates the loss of aBMD and LBM after bariatric surgery. Moreover, the well-known increases of bone turnover markers are less pronounced.
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