Changes in bone metabolism after gastric cancer surgery in male patients: a prospective observational study
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Several retrospective studies have shown that bone disorders occur after gastric cancer surgery. This study was designed to prospectively evaluate the changes in bone metabolism after gastrectomy for gastric cancer.
We prospectively enrolled 39 men with early gastric cancer who underwent gastrectomy. We excluded women to avoid the effects of menopause. We employed dual energy X-ray absorptiometry (DEXA) to measure bone mineral density (BMD) of the lumbar spine. DEXA was performed before and 1 and 2 years after surgery. The serum levels of alkaline phosphatase (ALP), 1,25-dihydroxy vitamin D [1,25(OH)2VD], 25-hydroxy vitamin D [25(OH)VD], and estradiol were measured before surgery and every 3 months until 2 years after surgery.
DEXA revealed that BMD significantly decreased by 0.036 ± 0.033 g/cm2 12 months after gastrectomy (P < 0.001) and by 0.046 ± 0.040 g/cm2 24 months after gastrectomy (P < 0.001). The serum ALP level significantly increased by 38.31 ± 103.8 IU/L 24 months after surgery (P = 0.013). The serum 25(OH)VD level significantly decreased by 4.88 ± 6.42 ng/ml 24 months after surgery (P < 0.001), whereas the serum 1,25(OH)2VD levels were consistently in the normal range. The serum estradiol level significantly increased by 2.94 ± 7.49 pg/ml 12 months after gastrectomy (P = 0.035). A lower preoperative body mass index (BMI) significantly correlated with the reduction in BMD 12 months after surgery; the correlation coefficient was 0.37 (P = 0.025).
This study showed that a significant decrease in BMD was observed for up to 24 months after gastrectomy, not only 12 months.
KeywordsGastrectomy Bone mineral density T score Osteoporosis
This study was funded by the Ministry of Education, Culture, Sports, Science and Technology of Japan, which provided Grants-in-aid for Scientific Research, the Japan Society for the Promotion of Science (19591553).
Compliance with ethical standards
Conflict of interest
We are indebted to the following organizations for providing funding for this study: Daiichi Sankyo, Inc., Tsumura & Co., Johnson and Johnson, Taiho Pharmaceutical Co., Ltd., Covidien Japan, Inc., Asahi Kasei Pharma Corporation, Kyowa Hakko Kirin Co. Ltd., and Yakult Honsha Co., Ltd..
Human rights statement
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.
Informed consent was obtained from all patients for being included in the study.
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