HIGH PREVALENCE OF BONE DISORDERS AFTER GASTRECTOMY

BACKGROUND: Studies indicate that gastrectomy might alter calcium and bone metabolism resulting in bone disorders. No data are currently ava ilable on the prevalence of bone disorders after gastrectomy. METHODS: Sixty gastrectomy patients were investigated for serum parameters of calcium and bone metabolism 5 to 20 years postoperatively and compared to an age- and sex-matched healthy control population. Forty patients agreed to a radiological investigation of the spine by anterior-poste rior and lateral radiographs of the thoracic and lumbar spine and by c omputed tomography (CT) osteodensitometry. RESULTS: Serum calcium and 25-(OH)-vitamin D were decreased in gastrectomized patients, while par athyroid hormone and 1,25-(OH)(2)-vitamin D were increased. Serum para meters of calcium metabolism were altered in as many as 68% of patient s. We found 31 vertebral fractures in 13 patients, 30 grade 2 vertebra l deformities in 18 patients, and osteopenia in 15 patients, correspon ding to a prevalence of 33%, 45%, and 37% in gastrectomized patients, respectively. The overall rate of gastrectomy patients having vertebra l fractures and/or osteopenia was 55%. The risk of having a vertebral deformity was increased by more than sixfold after gastrectomy. Our st udy is the first report evaluating vertebral deformities in gastrectom ized patients, and the largest series of gastrectomized patients inves tigated by CT osteodensitometry. CONCLUSION: We found a high prevalenc e of bone disorders in gastrectomized patients, possibly resulting fro m disorders in calcium metabolism. Postgastrectomy bone disease might derive from a calcium deficit, which increases calcium release from bo ne and impairs calcification of newly build bone matrix. (C) 1997 by E xcerpta Medica, Inc.