Evaluation of Bone Disorders and Bone Metabolism Following Gastrectomy in Gastric Cancer Patients

Koji Soeda, Takenori Ochiai, Matsuo Nagata, Takao Suzuki, Kaichi Isono

Second Department of Surgery, Chiba University School of Medicine

This study was undertaken to investigate bone disorders and metabolism after gastrectomy in gastric cancer patients. Twelve patients in our out patient clinic who had no signs of clinical recurrence were evaluated. Their mean age was 64 years and their mean postoperative period was 33 months. The gastrectomy was partial in 7 cases and total in 5 cases. Symptoms of bone and joint disorders were noted in 6 cases and 3 cases of them developed that symptoms after gastrectomy. There were changes in roentgenograms of finger bones in the over-65-year-old group and the total gastrectomy group, but no differences were detected by the microdensitometry method. The over-65-year-old group showed increased levels of PTH-Intact and inorganic phosphrous, and decreased glomerular filtration rate (GFR) and serum calcium level. The total gastrectomy group showed higher levels of PTH-MID, osteocalcin and alkaline phosphatase (ALP) than the partial gastrectomy group. Furthermore, the level of osteocalcin correlated with the levels of PTH-MID and ALP. These results indicate that osteoporosis in the over-65-year-old group would increase following decreased GFR due to aging. We propose that bone metabolism in the total gastrectomy group would have a high turn-over rate in proportion to the increased synthesis of osteocalcin due to decreased calcium uptake.

Key words
bone disorders after gastrectomy, parathyroid hormone, glomerular filtration rate, osteocalcin, microdensitometry

Reprint requests
Koji Soeda Second Department of Surgery, Chiba University School of Medicine
1-8-1 Inohana, Thyuo-ku, Chiba 260 JAPAN

Accepted
July 6, 1992

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