Exercise Mitigates Bone Loss in Women With Severe Obesity After Roux-en-Y Gastric Bypass: A Randomized Controlled Trial.
J Clin Endocrinol Metab
; 104(10): 4639-4650, 2019 10 01.
Article
en En
| MEDLINE
| ID: mdl-31322672
ABSTRACT
CONTEXT Bone loss after bariatric surgery potentially could be mitigated by exercise. OBJECTIVE:
To investigate the role of exercise training (ET) in attenuating bariatric surgery-induced bone loss.DESIGN:
Randomized, controlled trial.SETTING:
Referral center for bariatric surgery. PATIENTS Seventy women with severe obesity, aged 25 to 55 years, who underwent Roux-en-Y gastric bypass (RYGB). INTERVENTION Supervised, 6-month, ET program after RYGB vs. standard of care (RYGB only).OUTCOMES:
Areal bone mineral density (aBMD) was the primary outcome. Bone microarchitecture, bone turnover, and biochemical markers were secondary outcomes.RESULTS:
Surgery significantly decreased femoral neck, total hip, distal radius, and whole body aBMD (P < 0.001); and increased bone turnover markers, including collagen type I C-telopeptide (CTX), procollagen type I N-propeptide (P1NP), sclerostin, and osteopontin (P < 0.05). Compared with RYGB only, exercise mitigated the percent loss of aBMD at femoral neck [estimated mean difference (EMD), -2.91%; P = 0.007;], total hip (EMD, -2.26%; P = 0.009), distal radius (EMD, -1.87%; P = 0.038), and cortical volumetric bone mineral density at distal radius (EMD, -2.09%; P = 0.024). Exercise also attenuated CTX (EMD, -0.20 ng/mL; P = 0.002), P1NP (EMD, -17.59 ng/mL; P = 0.024), and sclerostin levels (EMD, -610 pg/mL; P = 0.046) in comparison with RYGB. Exercise did not affect biochemical markers (e.g., 25(OH)D, calcium, intact PTH, phosphorus, and magnesium).CONCLUSION:
Exercise mitigated bariatric surgery-induced bone loss, possibly through mechanisms involving suppression in bone turnover and sclerostin. Exercise should be incorporated in postsurgery care to preserve bone mass.
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Banco de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
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Enfermedades Óseas Metabólicas
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Derivación Gástrica
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Terapia por Ejercicio
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Obesidad
Tipo de estudio:
Clinical_trials
Límite:
Adult
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
J Clin Endocrinol Metab
Año:
2019
Tipo del documento:
Article
País de afiliación:
Brasil