P Tondapu1, D Provost, B Adams-Huet, T Sims, C Chang, K Sakhaee. 1. Department of Internal Medicine, Charles and Jane Pak Center for Mineral Metabolism, UT Southwestern Medical Center, Dallas, TX 75390-8885, USA.
Abstract
INTRODUCTION:Roux-en-Y gastric bypass (RYGB) restricts food intake. Consequently, patients consume less calcium. In addition, food no longer passes through the duodenum, the main site of calcium absorption. Therefore, calcium absorption is significantly impaired. The goal of this study is to compare two common calcium supplements in gastric bypass patients. METHOD:Nineteen patients were enrolled in a randomized, double-blinded, crossover study comparing the absorption of calcium from calcium carbonate and calcium citrate salts. Serum and urine calcium levels were assessed for peak values (C (max)) and cumulative calcium increment (area under the curve [AUC]). Serum PTH was assessed for minimum values (PTH(min)) and cumulative PTH decrement (AUC). Statistical analysis was performed using a repeated analysis of variance model. RESULTS:Eighteen subjects completed the study. Calcium citrate resulted in a significantly higher serum C (max) (9.4 + 0.4 mg/dl vs. 9.2 + 0.3 mg/dl, p = 0.02) and serum AUC (55 + 2 mg/dl vs. 54 + 2 mg/dl, p = 0.02). Calcium citrate resulted in a significantly lower PTH(min) (24 + 11 pg/ml vs. 30 + 13 pg/ml, p = 0.01) and a higher AUC (-32 + 51 pg/ml vs. -3 + 56 pg/ml, p = 0.04). There was a non-significant trend for higher urinary AUC in the calcium citrate group (76.13 + 36.39 mg/6 h vs. 66.04 + 40.82, p = 0.17). CONCLUSION:Calcium citrate has superior bioavailability than calcium carbonate in RYGB patients.
RCT Entities:
INTRODUCTION: Roux-en-Y gastric bypass (RYGB) restricts food intake. Consequently, patients consume less calcium. In addition, food no longer passes through the duodenum, the main site of calcium absorption. Therefore, calcium absorption is significantly impaired. The goal of this study is to compare two common calcium supplements in gastric bypass patients. METHOD: Nineteen patients were enrolled in a randomized, double-blinded, crossover study comparing the absorption of calcium from calcium carbonate and calcium citrate salts. Serum and urine calcium levels were assessed for peak values (C (max)) and cumulative calcium increment (area under the curve [AUC]). Serum PTH was assessed for minimum values (PTH(min)) and cumulative PTH decrement (AUC). Statistical analysis was performed using a repeated analysis of variance model. RESULTS: Eighteen subjects completed the study. Calcium citrate resulted in a significantly higher serum C (max) (9.4 + 0.4 mg/dl vs. 9.2 + 0.3 mg/dl, p = 0.02) and serum AUC (55 + 2 mg/dl vs. 54 + 2 mg/dl, p = 0.02). Calcium citrate resulted in a significantly lower PTH(min) (24 + 11 pg/ml vs. 30 + 13 pg/ml, p = 0.01) and a higher AUC (-32 + 51 pg/ml vs. -3 + 56 pg/ml, p = 0.04). There was a non-significant trend for higher urinary AUC in the calcium citrate group (76.13 + 36.39 mg/6 h vs. 66.04 + 40.82, p = 0.17). CONCLUSION:Calcium citrate has superior bioavailability than calcium carbonate in RYGB patients.
Authors: Jason M Johnson; James W Maher; Eric J DeMaria; Robert W Downs; Luke G Wolfe; John M Kellum Journal: Ann Surg Date: 2006-05 Impact factor: 12.969
Authors: Mariana Cifuentes; Claudia S Riedt; Robert E Brolin; M Paul Field; Robert M Sherrell; Sue A Shapses Journal: Am J Clin Nutr Date: 2004-07 Impact factor: 7.045
Authors: Lars Sjöström; Anna-Karin Lindroos; Markku Peltonen; Jarl Torgerson; Claude Bouchard; Björn Carlsson; Sven Dahlgren; Bo Larsson; Kristina Narbro; Carl David Sjöström; Marianne Sullivan; Hans Wedel Journal: N Engl J Med Date: 2004-12-23 Impact factor: 91.245
Authors: Wayne K Nelson; Scott G Houghton; Dawn S Milliner; John C Lieske; Michael G Sarr Journal: Surg Obes Relat Dis Date: 2005-08-26 Impact factor: 4.734
Authors: Penelope S Coates; John D Fernstrom; Madelyn H Fernstrom; Philip R Schauer; Susan L Greenspan Journal: J Clin Endocrinol Metab Date: 2004-03 Impact factor: 5.958
Authors: Anne M Kenny; Karen M Prestwood; Bradley Biskup; Bertha Robbins; Enid Zayas; Alison Kleppinger; Joseph A Burleson; Lawrence G Raisz Journal: Osteoporos Int Date: 2004-01-13 Impact factor: 4.507
Authors: J Fleischer; E M Stein; M Bessler; M Della Badia; N Restuccia; L Olivero-Rivera; D J McMahon; S J Silverberg Journal: J Clin Endocrinol Metab Date: 2008-07-22 Impact factor: 5.958
Authors: Giselle G Hamad; Joseph C Helsel; James M Perel; Gina M Kozak; Mary C McShea; Carolyn Hughes; Andrea L Confer; Dorothy K Sit; Carol A McCloskey; Katherine L Wisner Journal: Am J Psychiatry Date: 2012-03 Impact factor: 18.112