The effect of partial gastrectomy on bone mineral metabolism.

The occurrence of postgastrectomy bone disease was studied in 42 patients who had been subjected to gastric surgery for duodenal or gastric ulceration 5-7 years earlier. Hypocalcemia, hypophosphatemia, and an increase in serum alkaline phosphatase were infrequent. No difference was observed in S-25OHD between the patients and controls, but S-24,25(OH)2D was higher in the patients. The bone mineral density (BMD) values showed no statistically significant difference between the patients and controls before or after the operation. There was a slight fall in BMD values during the follow-up period, but the decrease was similar in the patients and controls and was not statistically significant. The histomorphometric analysis revealed a greater amount of trabecular bone and osteoid in the patients. The means of the osteoid variables were well within normal limits, but a very slight increase in osteoid volume was observed in 4 of the 35 patients. It is concluded that a partial gastrectomy and vagotomy had not caused significant disturbances in bone mineral metabolism. The vitamin D status of the patients was good owing to the adequate dietary regimens that had been given to the patients.