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Exercise Mitigates Bone Loss in Women With Severe Obesity After Roux-en-Y Gastric Bypass: A Randomized Controlled Trial.
Murai, Igor H; Roschel, Hamilton; Dantas, Wagner S; Gil, Saulo; Merege-Filho, Carlos; de Cleva, Roberto; de Sá-Pinto, Ana L; Lima, Fernanda; Santo, Marco A; Benatti, Fabiana B; Kirwan, John P; Pereira, Rosa M; Gualano, Bruno.
Afiliação
  • Murai IH; Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, School of Physical Education and Sport, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil.
  • Roschel H; Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, School of Physical Education and Sport, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil.
  • Dantas WS; Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil.
  • Gil S; Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, School of Physical Education and Sport, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil.
  • Merege-Filho C; Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, School of Physical Education and Sport, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil.
  • de Cleva R; Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, School of Physical Education and Sport, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil.
  • de Sá-Pinto AL; Gastroenterology Department, Digestive Surgery Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil.
  • Lima F; Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil.
  • Santo MA; Rheumatology Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil.
  • Benatti FB; Gastroenterology Department, Digestive Surgery Division, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil.
  • Kirwan JP; Applied Physiology & Nutrition Research Group, Laboratory of Assessment and Conditioning in Rheumatology, School of Physical Education and Sport, Hospital das Clínicas HCFMUSP, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil.
  • Pereira RM; School of Applied Sciences, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
  • Gualano B; Integrative Physiology and Molecular Metabolism Group, Pennington Biomedical Research Center, Baton Rouge, Louisiana.
J Clin Endocrinol Metab ; 104(10): 4639-4650, 2019 10 01.
Article em En | MEDLINE | ID: mdl-31322672
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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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Doenças Ósseas Metabólicas / Derivação Gástrica / Terapia por Exercício / Obesidade Tipo de estudo: Clinical_trials Limite: Adult / Female / Humans / Middle aged Idioma: En Revista: J Clin Endocrinol Metab Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Pós-Operatórias / Doenças Ósseas Metabólicas / Derivação Gástrica / Terapia por Exercício / Obesidade Tipo de estudo: Clinical_trials Limite: Adult / Female / Humans / Middle aged Idioma: En Revista: J Clin Endocrinol Metab Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos