Alagna, Sergio and Cossu, Maria Laura and Maninchedda, Paola and Alagna, Giuliano and Barra, A. and Barone, S. and Pileri, Piera Veronica and Sini, Annalisa L. and Piras, S. and Rovasio, Pier Paolo and Noya, Giuseppe and Masala, Antonio Giovanni Emilio (2006) Bone turnover markers in severely obese eumenorrhoic women undergoing bariatric surgery. Obesity and Metabolism, Vol. 2 , p. 201-204. eISSN 1826-7572. Article.
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Background and aims: a) To evaluate alterations in the circulating levels of osteocalcin (OC, a marker of osteoblastic activity) and carboxy terminal cross-linked telopeptide (ICTP, an indicator of osteoclastic function) in severely obese women under baseline conditions and after bariatric malabsorptive surgery (biliopancreatic diversion, BPD); b) To define any correlation between these parameters and some of the hormones involved in regulating bone metabolism: parathyroid hormone (PTH), gonadal and adrenal steroids, and leptin.
Methods: Design: Observational, 2-year postoperative study. Participants: Fifteen severely obese, eumenorrhoic women aged 25-43 years. Measurements: Determination of body composition using body impedance analysis (BIA), and serum levels of OC, ICTP, PTH, leptin (L), estradiol 17β (E2), progesterone (P) and dehydroepiandrosterone sulfate (DHEAS).
Results: The results are expressed as mean values ±SEM. Twenty-four months (±3 months) post-surgery, all of the patients showed a significant reduction in the BMI (from 46.5±2.5 to 36.2±1.6) and fat mass (from 44.1±0.8 to 37.1±0.9) (p<0.001). OC increased from 12±3.2 to 37.5± 5.2 ng/ml (p<0.0001) and ICTP from 6.2±0.7 to 14.9±1.9 μg/l (p<0.0001), and the high baseline leptin levels of 48.7±6.4 decreased to 19.9± 3.0 ng/ml (p<0.0001). There were no statistically significant changes in PTH, E2, P or DHEAS.
Conclusions: Two years after bariatric surgery, the weight loss in our patients was accompanied by an increase in the serum levels of two circulating bone turnover markers OC and ICTP. As there were no significant changes in PTH or steroid status, these findings may be related to the reduction in circulating L, which may play a direct role in regulating skeletal metabolism.
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