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Bone health in long-term gastric cancer survivors: A prospective study of high-dose vitamin D supplementation using an easy administration scheme

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Abstract

Bone disease in long-term survivors after gastric cancer resection has received little research attention. This study aimed to investigate bone health after curative resection of gastric cancer and the consequences of high-dose vitamin D supplementation in patients with low levels of 25-(OH)-vitamin D. Disease-free patients at least 24 months after gastric cancer resection represented the study cohort. Serum markers of bone metabolism were assessed at baseline and at 3 and 12 months. Bone mineral density and presence of fractures were assessed by X-ray at baseline. Patients with 25-(OH)-vitamin D ≤30 ng/mL at baseline received 16,000 IU of vitamin D3 every 10 days during the 1-year follow-up. Forty patients were included in the study. Mean time from surgery was 48.9 (24–109) months. Vitamin D insufficiency and secondary hyperparathyroidism were observed in 38 and 20 patients, respectively. Densitometry showed osteoporosis in 14 women and seven men and prevalent fractures in 12 women and six men at baseline. After 3 months of vitamin D supplementation, 35 patients reached values of 25-(OH)-vitamin D over 30 ng/mL. After 12 months, 38 patients were in the normal range of 25-(OH)-vitamin D. At the same time, iPTH levels and markers of bone turnover (C-terminal cross-linked telopeptide of type-I collagen, serum concentrations of bone-specific alkaline phosphatase and osteocalcin) significantly decreased after vitamin D intervention. Oral administration of high doses of vitamin D is easily implemented and restored 25-(OH)-vitamin D and iPTH values, which are frequently disturbed after gastric cancer resection.

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Acknowledgements

The authors wish to acknowledge Joan Sancho, MD, for expert help in the statistical analysis, and Elaine Lilly, PhD, for English language editing.

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Authors and Affiliations

  1. Section of Gastrointestinal Surgery, Hospital Universitario del Mar, Hospital del Mar Medical Research Institute (IMIM), Universitat Autònoma de Barcelona, Barcelona, Spain

    Marta Climent, Manuel Pera, José M. Ramón & Luis Grande

  2. Service of Internal Medicine, Hospital Universitario del Mar, Hospital del Mar Medical Research Institute (IMIM), Universitat Autònoma de Barcelona, Barcelona, Spain

    Isabel Aymar & Xavier Nogués

  3. CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Barcelona, Spain

    Isabel Aymar & Xavier Nogués

  4. Internal Medicine Department, Musculoskeleta Research Unit Hospital del Mar Medical Research Institute (IMIM), Passeig Marítim 25-29, 08003, Barcelona, Spain

    Isabel Aymar & Xavier Nogués

Authors
  1. Marta Climent
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  2. Manuel Pera
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  3. Isabel Aymar
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  4. José M. Ramón
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  5. Luis Grande
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  6. Xavier Nogués
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Correspondence to Xavier Nogués.

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Climent, M., Pera, M., Aymar, I. et al. Bone health in long-term gastric cancer survivors: A prospective study of high-dose vitamin D supplementation using an easy administration scheme. J Bone Miner Metab 36, 462–469 (2018). https://doi.org/10.1007/s00774-017-0856-1

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  • DOI: https://doi.org/10.1007/s00774-017-0856-1

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