Early phase metabolic bone disorders after gastrectomy: influence of active vitamin D treatment

Metabolic bone disorders are recognized as one of the late complications after gastrectomy. However, the onset time and the extent of bone disorders are still unknown. We examined the influence of active vitamin D treatment on bone metabolism in the early period after gastrectomy. Sixty-three postgastrectomy patients were divided into two groups; active vitamin D treatment group [VD(+)] and no treatment group [VD(-)]. The level of serum calcium and phosphate was increased in the VD(+) group compared with the preoperative level, and parathyroid hormone (PTH-M) was decreased in the VD(+) group. Both 1,25-(OH)2D3 and bone-specific alkaline phosphatase (B-ALP) were increased in the VD(-) group. Cross-linked carboxyterminal telopeptide of type I collagen (I-CTP) was increased in the VD(+) group. There was no change in calcitonin in either group. In conclusion, metabolic bone disorders after gastrectomy have their onset in the early period, and active vitamin D treatment from the early period may be effective in preventing bone disorders.