Abstract
Twenty-nine men who had undergone Billroth I gastrectomy and 19 men who had undergone Billroth II gastrectomy were studied to examine the changes in their calcium regulating hormones and bone mineral content following surgery. The serum calcium and phosphate concentrations in the patients with Billroth I and Billroth II were normal. The Billroth II group had an elevated level of serum alkaline phosphatase and reduced bone mineral content. The 24,25(OH)2D concentration was reduced (P<0.01) and 25(OH)D and 1,25(OH)2D concentrations were increased (P<0.01,P<0.05, respectively) in the Billroth II group. It was suggested by our study that the Billroth II patients had a reduced bone mineral content and an elevated 1,25(OH)2D concentration. Therefore, the pathophysiology of postgastrectomy bone metabolic disease is not due to vitamin D deficiency, but may instead be due to reduced calcium absorption in the intestine.
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Sarasin VC (1941) Osteomalacie und hypochrome Anemie nach Magenresektion. Gastroenterologia 66:734–738
Eddy RL (1971) Metabolic bone disease after gastrectomy. Am J Med 50:442–449
Tougaard L (1977) Bone composition and vitamin D after Polya gastrectomy. Acta Med Scand 202:47–50
Duncombe UM, Reeve J (1981) Calcium homeostasis in digestive disorders. Clin Gastroenterol 65:653–670
Fukuda M, Hirota M, Sato S (1986) Bone lesions and dental caries after gastrectomy — Evaluation of milk intolerance and operative procedure. Jpn J Surg 16:36–41
Arnaud CD, Goldsmith RS, Bordier DJ, Sizemore GW (1974) Influence of immunoheterogeneity of circulating parathyroid hormone on results of radioimmunoassays of serum in man. Am J Med 56:785–793
Shepard RM (1979) Determination of vitamin D and its metabolites in plasma from normal and anephric man. Biochem J 182:55–69
Inoue T, Kusida K, Miyamoto S, Sumi Y (1983) Quantitative assessment of bone density on X-ray picture. J Jpn Orthop Assn 57:1923–1936
Imawari M, Kozawa K, Akanuma Y, Koizumi S, Itakura H, Kosaka K (1980) Serum 25-hydroxyvitamin D and vitamin D binding protein levels and mineral metabolism after partial gastrectomy. Gastroenterology 79:255–258
Gacs G, Barltrop D (1977) Significance on Ca-soap formation for calcium absorption in the rat. Gut 18:64–68
Nilas L, Christiansen C, Christiansen J (1985) Regulation of vitamin D and calcium metabolism after gastrectomy. Gut 26:252–257
Morgan DE, Paterson CR, Woods CG, Pulvertaft CN, Fourman P (1965) Search for osteomalacia in 1228 patients after gastrectomy and other operations on the stomach. Lancet II:1086–1091
Nishimura O, Furumoto T, Kouno K, Sumikawa M, Hisaki T, Odachi T, Mizumoto K, Kishimoto H, Yamamoto K (1986) Bone disorder following partial and total gastrectomy with reference to bone mineral content. Jpn J Surg 16:98–105
Klein KB, Orwoll ES, Kiebernan DA, Meier DE, McClung MR, Parfitt AM (1987) Metabolic bone disease in asymptomatic men after partial gastrectomy with Billroth II anastomosis. Gastroenterology 92:608–616
Compston JE, Vedi S, Gianetta E, Watson G, Civaller ID, Scopinaro N (1984) Bone histomorphometry and vitamin D status after biliopancreatic bypass for obesity. Gastroenterology 1984; 87:350–356
Hoikka V, Alhava EM, Savolainen K, Karfalainen P, Pariainen M (1982) The effect of partial gastrectomy on bone mineral metabolism. Scand J Gastroenterol 17:257–261
Nilas L, Christiansen C (1985) Influence of PTH and 1,25(OH)2D on calcium homeostasis and bone mineral content after gastric surgery. Calcif Tissue Int 37:461–466
Kozawa K, Imawari M, Shimazu H, Kobori O, Osuga T, Morioka Y (1984) Vitamin D status after total gastrectomy. Dig Dis Sci 29:411–416
Koga S, Tsuchiya S, Mutou T (1990) Bone disease after gastric surgery Cooperative, multihospital study in Japan. Dig Surg 7:19–25
Paakkonen M, Alhava EM, Karjalainen P (1982) Bone mineral and intestinal calcium absorption after partial gastrectomy. Scand J Gastroenterol 1982; 17:369–372
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Kobayashi, S., Takahashi, C., Kuroda, T. et al. Calcium regulating hormones and bone mineral content in patients after subtotal gastrectomy. Surg Today 24, 295–298 (1994). https://doi.org/10.1007/BF02348555
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DOI: https://doi.org/10.1007/BF02348555