Ultrasonic Value is Not Useful to Detect Bone Changes Following a Biliopancreatic Diversion |
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Authors: | Oscar Lozano Alcalde Antonio Martín Duce Fernando Aguado Bustos Rosa Fernández Torres Marta Galván Huarte Jorge Gómez González Crispín Gigante Pérez |
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Institution: | 1.Department of Nursery,Alcalá de Henares University, Príncipe de Asturias Hospital,Madrid,Spain;2.Department of General Surgery,Príncipe de Asturias Hospital,Madrid,Spain;3.Department of Radiology,Príncipe de Asturias Hospital,Madrid,Spain;4.Department of Anatomy, Densitometry Unit,Alcalá de Henares University,Madrid,Spain;5.Madrid,Spain |
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Abstract: | To study the evolution of the bone mass by ultrasonic transmission after biliopancreatic diversion. Forty eight morbid obese
patients were prospectively studied during 36 months following the Larrad biliopancreatic diversion. The bone metabolism was
studied by PTHi and the urinary pirydinolines. The bone mass by echography and bone densitometry, which correlate to the levels
of PTHi and pyridinolines. After 3 years the bone mass decreased from 50.15 +/− 7.31 kg/m2, preoperatively, to 34.03 +/− 4.53 kg/m2 (p < 0.001). There was an increase of the PTHi value (from 71.4 +/− 79.6 to 91.65 +/− 43.06 pg/ml) (p = 0.01), and the urinary pirydinolines (from 7.93 +/− 4.06 an 11.4 +/− 10.12 nM/mM) (p < 0.05). The ultrasonic transmission speed increased (from 1,990.93 +/− 62.38 to 2,035.25 +/− 53.98 m/s). However, the bone
mineral content (BMC) did not show changes (from 3,016.5 +/− 562.8 to 2,909.6 +/− 304.2 g), as well as the Bone Mineral Density
(BMD) (of 1,174.2 +/− 98.8 g/cm2). Neither correlation was found between the BMD (r = 0.212; p = 0.6), the BMC (r =−0.125; p = 0.768), and the T-score (r = 0.592, p = 0.093). The study of the bone mass through ultrasonic transmission speed revealed low sensitivity during the assessment
of the morbid obese patients. A percentage of cases of osteopenia were observed despite the fact that they are not reflected
in the bone content or in the bone mass. Ultrasonic evaluation of bone mass has no value in the morbidly obese, by the clear
negative correlation between ultrasound velocity and thickness of soft tissue. |
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