ECTS2013 Poster Presentations Calciotropic and phosphotropic hormones and mineral metabolism (33 abstracts)
The effect of gastric bypass treatment for obesity on hormones related to bone re-modeling and intestinal growth
Bolette Hartmann 1 , Henrik Vestergaard 1 , Peter Bonfils 2 , Marie Hansen 1 , Nicolai Albrechtsen 1 , Peter Eskildsen 2 , Andrea Floyd 2 , Annette Lykke Svenningsen 2 & Jens Juul Holst 1
1University of Copenhagen, Copenhagen, Denmark; 2The Hospital of Roskilde-Koege, Koege, Denmark.
Aim: The aim of the study was to investigate the relationship between gut hormones and bone re-modeling and intestinal growth by measuring meal stimulated changes in hormones and bone markers in blood samples collected from patients before and after gastric bypass (GBP).
Methods: Eighteen patients (12 females and 6 males) were included in the study, approved by the Municipal Ethical Committee of Copenhagen. All subjects were studied before surgery (~2 weeks), and 4 weeks and 6 months after. On each study day participants were weighed and given a liquid meal test consisting of 200 ml Fresubin Energy Drink (300 kcal) over 30 min and blood samples (15 ml) were collected before and frequently after the meal. At the first and final visits participants were DEXA scanned for body composition and bone mineral density (BMD) at hip and at spine. Plasma concentrations of glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide-2 (GLP-2), and parathyroid hormone (PTH) were measured together with markers of bone re-modeling (CTX-1 and P1NP).
Results: Pronounced weight losses were seen following GBP. BMI decreased from 41.0±4.7 to 31.3±4.61 m/kg2 over 6 months. BMD was reduced at both hip (−5.3±3.4%) and at spine (−2.5±2.0%) 6 months after GBP. Meal stimulated GLP-2 secretion increased significantly (~10 fold) after surgery whereas a minor decrease was seen in GIP secretion. A comparable meal induced reduction in PTH concentration was seen at all three visits with decreasing fasting levels after GBP. Significant meal induced decreases in CTX were observed at all visits, whereas P1NP was not influenced by the meal. However, levels of both CTX and P1NP were significantly increased after GBP.
Conclusion: GBP induced weight loss together with BMD loss. Increased bone resorption was seen after GBP despite increased GLP-2 and decreased PTH.
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