A Study on Metabolic Bone Disease before and after Distal Gastrectomy in Gastric Cancer Patients by Dual X-ray Mineral Absorptometry Measurements and Markers of Bone Metabolism

Kikuo Koufuji, Jinryo Takeda, Keishirou Aoyagi, Shoujirou Yano, Naotaka Murakami, Haruko Hori, Yasuhiro Terasaki and Kazuo Shirouz

Department of Surgery, Kurume University School of Medicine

We studied the effect of gastrectomy on bone minerals and bone metabolism in 9 male patients with gastric carcinoma who underwent distal gastrectomy with curability A. Bone mineral density (BMD) and BMD Y% which were measured by the dual X-ray mineral absorptiometry measurement (DXA) method. Serum bone specific alkaline phosphatase (B-Alp), intact-osteocalcin (I-OC), intact-parathyroid hormone (I-PTH), 1_α , 25 (OH) ₂D₃, Ca, P and urinary pyridinoline (Pyd), and deoxy-pyridinoline (D-Pyd) were evaluated before surgery, 6 and 12 months after surgery. A statistically significant correlation between preoperative BMD, BMD Y% and body weight was recognized (p<0.05).
A statistically significant correlation between preoperative Pyd, D-pyd and patients' age was also recognized (p<0.05). Both BMD and BMD Y%reduced after surgery. On the other hand, I-OC and B-Alp significantly increased at both 6 and 12 months after surgery (p<0.05). Pyd also significantly increasel 6 and 12 months after surgery. These results suggested that both osteogenesis and bone resorption increased in the early phase of the postoperative course of gastrectomy, so we have to consider carefully the prevention of bone disorders after gastrectomy.

Key words
gastric cancer, distal gastrectomy, dual X-ray absorptiometry, matabolic bone disease, markers of bone matabolism

Reprint requests
Kikuo Koufuji Department of Surgery, Kurume University School of Medicine 67 Asahi-machi, Kurume, 830-0011 JAPAN

Accepted
July 28, 1999

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