Evidence map›Paper›PMID 19727982›Full record

Trial reportObesity surgery2009

Bone mass decreases in morbidly obese women after long limb-biliopancreatic diversion and marked weight loss without secondary hyperparathyroidism. A physiological adaptation to weight loss?

Dimitrios D A Tsiftsis, Panagiotis Mylonas, Nancy Mead, Fotis Kalfarentzos, Theodore K Alexandrides

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Obesity surgery, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 2 pooled it
4.4field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 61 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. The Skeletal Consequences of Bariatric Surgery.Current osteoporosis reports · 2020
    Review
  5. Article
  6. Article
  7. Article
  8. Observational
  9. Review
  10. Article
  11. Review
  12. Article
  13. Fracture Risk After Bariatric Surgery: Roux-en-Y Gastric Bypass Versus Adjustable Gastric Banding.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2017
    Article
  14. Vitamin D alteration associated with obesity and bariatric surgery.Experimental biology and medicine (Maywood, N.J.) · 2017
    Review
  15. Article
  16. Article
  17. Article
  18. Review
  19. Bone metabolism after bariatric surgery.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2014
    Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Dimitrios D A TsiftsisDepartment of Surgery, School of Medicine, University of Patras, Patras, Greece.
Panagiotis Mylonas
Nancy Mead
Fotis Kalfarentzos
Theodore K Alexandrides
University of Patras · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate the effect of marked weight loss after long limb-biliopancreatic diversion (BPD-LL) on bone mass and serum calcium, 25-OH-vitamin D, and PTH levels in relation to calcium supplementation. BACKGROUND DATA: BPD is the most effective type of bariatric surgery, but it is followed by bone mass loss, mainly attributed to calcium and vitamin D malabsorption leading to secondary hyperparathyroidism.

methodsTwo groups, each consisting of 26 healthy, morbidly obese, premenopausal women, underwent BPD-LL. Both groups received high-calcium diets, 200 IU of vitamin D and 100 mg elemental calcium daily and group B, in addition to an extra 2 g of calcium. Bone density and biochemical markers were measured before and 12 months after BPD-LL.

resultsOne year after surgery, both groups had lost an average of 55 kg of body weight; albumin-corrected calcium concentration did not change. 25-OH-vitamin D levels in group A were 17.34 +/- 8.90 pre- and 20.51 +/- 14.71 microg/L postoperatively (p = 0.058), and in group B, 15.70 +/- 9.46 and 13.52 +/- 8.16 microg/L (p = 0.489), respectively. PTH levels in group A were 38.5 +/- 12.2 before and 51.2 +/- 32.8 pg/ml after surgery (p = 0.08), and in group B, 48.1 +/- 26.3 and 52.9 +/- 29.2 pg/ml (p = 0.147), respectively. Bone formation markers (alkaline phosphatase, osteocalcin and procollagen type 1), as well as the bone resorption marker CTx, increased significantly in both groups. Bone mineral density T score was 0.862 +/- 0.988 in group A and 0.851 +/- 1.44 in group B and declined postoperatively to -0.123 +/- 1.082 and 0.181 +/- 1.285, respectively.

conclusionsMarked weight loss after BPD-LL leads to increased bone turnover and normalization of the increased bone mass without calcium or vitamin D malabsorption and without the appearance of secondary hyperparathyroidism. We conclude that the bone mass reduction is a normal adaptation to the decreased loading of the bone following weight loss.

Indexed as

Adaptation, PhysiologicalBiliopancreatic DiversionAdultBiomarkersBone and BonesBone DensityBone Density Conservation AgentsCalciumDietary SupplementsFemaleHumansHyperparathyroidism, SecondaryObesity, MorbidParathyroid HormoneTreatment OutcomeVitamin D25-hydroxyvitamin DBiomarkersBone Density Conservation AgentsCalciumParathyroid HormoneVitamin D

Identifiers

PMID19727982
OpenAlexW2016729582

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.