Skeletal Health in Bariatric Surgery Patients
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
-
-
Alabama
-
Birmingham, Alabama, United States, 35233
- UAB Kirklin Clinic Digestive Health Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Adult females ≥ 19 years scheduled to undergo bariatric surgery (Roux en Y Gastric Bypass or Gastric Sleeve Surgery)
- Class II (BMI 35-39.9 kg/m2).
- Class III obesity (BMI ≥ 40 kg/m2).
- Scheduled to undergo bariatric surgery with the ability to provide informed consent.
Exclusion Criteria:
- Patients with a history of thyroid disorders, thyroidectomy and levothyroxine use.
- Patients with a history of known osteoporosis, steroid-induced osteoporosis, current or previous use of medications for osteoporosis.
- Patients with a history of gastrointestinal malabsorption.
- Patients with a history of renal diseases.
- Patients with a history of current or previous use of corticosteroids.
- Patients who have used tobacco products within a year of study enrollment.
- Patients with surgically-induced menopause e.g. bilateral salpingo-oophorectomy.
- Patients with a history of breast cancer, who have had or are currently on hormonal therapy or anti-hormonal therapy.
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Roux en Y Gastric Bypass Pre-menopausal
Pre-menopausal women undergoing Roux en Y Gastric Bypass
|
The investigator aims to determine changes in skeletal health after Roux en Y Gastric Bypass in pre-menopausal women.
Dual-energy x-ray absorptiometry (DXA) will be used to assess bone mineral density (BMD), including assessment for fracture risk (FRAX).
Trabecular Bone Score (TBS) software will be used to adjust FRAX scores for bone microstructure and an enhanced fracture risk probability.
Biochemical markers of bone metabolism and calcium homeostasis including serum bone alkaline phosphatase (BALP), osteocalcin, type 1 procollagen (P1NP), c-terminal telopeptide (CTX), calcium, albumin, parathyroid hormone (PTH), and 25-OH vitamin D will be assayed.
|
|
Roux en Y Gastric Bypass Post-menopausal
Post-menopausal women undergoing Roux en Y Gastric Bypass
|
The investigator aims to determine changes in skeletal health after Roux en Y Gastric Bypass in post-menopausal women.
Dual-energy x-ray absorptiometry (DXA) will be used to assess bone mineral density (BMD), including assessment for fracture risk (FRAX).
Trabecular Bone Score (TBS) software will be used to adjust FRAX scores for bone microstructure and an enhanced fracture risk probability.
Biochemical markers of bone metabolism and calcium homeostasis including serum bone alkaline phosphatase (BALP), osteocalcin, type 1 procollagen (P1NP), c-terminal telopeptide (CTX), calcium, albumin, parathyroid hormone (PTH), and 25-OH vitamin D will be assayed.
|
|
Sleeve Gastrectomy Pre-menopausal
Pre-menopausal women undergoing Sleeve Gastrectomy
|
The investigator aims to determine changes in skeletal health after Sleeve Gastrectomy in pre-menopausal women.
Dual-energy x-ray absorptiometry (DXA) will be used to assess bone mineral density (BMD), including assessment for fracture risk (FRAX).
Trabecular Bone Score (TBS) software will be used to adjust FRAX scores for bone microstructure and an enhanced fracture risk probability.
Biochemical markers of bone metabolism and calcium homeostasis including serum bone alkaline phosphatase (BALP), osteocalcin, type 1 procollagen (P1NP), c-terminal telopeptide (CTX), calcium, albumin, parathyroid hormone (PTH), and 25-OH vitamin D will be assayed.
|
|
Sleeve Gastrectomy Post-menopausal
Post-menopausal women undergoing Gastric Sleeve
|
The investigator aims to determine changes in skeletal health after Sleeve Gastrectomy in post-menopausal women.
Dual-energy x-ray absorptiometry (DXA) will be used to assess bone mineral density (BMD), including assessment for fracture risk (FRAX).
Trabecular Bone Score (TBS) software will be used to adjust FRAX scores for bone microstructure and an enhanced fracture risk probability.
Biochemical markers of bone metabolism and calcium homeostasis including serum bone alkaline phosphatase (BALP), osteocalcin, type 1 procollagen (P1NP), c-terminal telopeptide (CTX), calcium, albumin, parathyroid hormone (PTH), and 25-OH vitamin D will be assayed.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Determine and quantify changes in bone mineral density after bariatric surgery (Roux en Y vs. Gastric Sleeve) in pre- and post-menopausal women.
Time Frame: Baseline
|
Dual-energy x-ray absorptiometry (DXA) will be used to assess bone mineral density, BMD (in g/cm2) of the lumbar spine (L1-L4), total hip, femoral neck, distal radius, sub-total whole body (excluding only the head), and whole body.
T scores will be evaluated and Z scores will be evaluated.
T-scores between +1 and -1 is considered normal or healthy, T-scores between -1 and -2.5 indicates that you have low bone mass, although not low enough to be diagnosed with osteoporosis, T-scores of -2.5 or lower indicates that you have osteoporosis.
For premenopausal women under the age of 50, the Z-score is used for diagnosis.
Using the criteria defined by the International Society for Clinical Densitometry: If the Z-score is -2.0 or lower, the result will be below the expected range for age.
If the Z score is above -2.0, the result is will be defined as within the expected range for age.
|
Baseline
|
|
Determine and quantify changes in bone mineral density after bariatric surgery (Roux en Y vs. Gastric Sleeve) in pre- and post-menopausal women.
Time Frame: Baseline to 12 months
|
Dual-energy x-ray absorptiometry (DXA) will be used to assess bone mineral density, BMD (in g/cm2) of the lumbar spine (L1-L4), total hip, femoral neck, distal radius, sub-total whole body (excluding only the head), and whole body.
T scores will be evaluated and Z scores will be evaluated.
T-scores between +1 and -1 is considered normal or healthy, T-scores between -1 and -2.5 indicates that you have low bone mass, although not low enough to be diagnosed with osteoporosis, T-scores of -2.5 or lower indicates that you have osteoporosis.
For premenopausal women under the age of 50, the Z-score is used for diagnosis.
Using the criteria defined by the International Society for Clinical Densitometry: If the Z-score is -2.0 or lower, the result will be below the expected range for age.
If the Z score is above -2.0, the result is will be defined as within the expected range for age.
|
Baseline to 12 months
|
|
Determine and quantify changes in bone mineral density after bariatric surgery (Roux en Y vs. Gastric Sleeve) in pre- and post-menopausal women.
Time Frame: Baseline to 24 months
|
Dual-energy x-ray absorptiometry (DXA) will be used to assess bone mineral density, BMD (in g/cm2) of the lumbar spine (L1-L4), total hip, femoral neck, distal radius, sub-total whole body (excluding only the head), and whole body.
T scores will be evaluated and Z scores will be evaluated.
T-scores between +1 and -1 is considered normal or healthy, T-scores between -1 and -2.5 indicates that you have low bone mass, although not low enough to be diagnosed with osteoporosis, T-scores of -2.5 or lower indicates that you have osteoporosis.
For premenopausal women under the age of 50, the Z-score is used for diagnosis.
Using the criteria defined by the International Society for Clinical Densitometry: If the Z-score is -2.0 or lower, the result will be below the expected range for age.
If the Z score is above -2.0, the result is will be defined as within the expected range for age.
|
Baseline to 24 months
|
|
Fracture risk assessment in pre and post-menopausal women undergoing bariatric surgery (Roux en Y vs. Gastric Sleeve).
Time Frame: Baseline
|
Assessment of fracture risk using the WHO Fracture Risk Assessment Tool (FRAX) will be used to assess the 10-year fracture risk probability (in %)
|
Baseline
|
|
Fracture risk assessment in pre and post-menopausal women undergoing bariatric surgery (Roux en Y vs. Gastric Sleeve).
Time Frame: Baseline to 12 months
|
Assessment of fracture risk using the WHO Fracture Risk Assessment Tool (FRAX) will be used to assess the 10-year fracture risk probability (in %)
|
Baseline to 12 months
|
|
Fracture risk assessment in pre and post-menopausal women undergoing bariatric surgery (Roux en Y vs. Gastric Sleeve).
Time Frame: Baseline to 24 months
|
Assessment of fracture risk using the WHO Fracture Risk Assessment Tool (FRAX) will be used to assess the 10-year fracture risk probability (in %)
|
Baseline to 24 months
|
|
TBS adjustment of FRAX scores for an enhanced fracture risk probability in pre and post-menopausal women undergoing bariatric surgery (Roux en Y vs. Gastric Sleeve).
Time Frame: Baseline
|
The Trabecular Bone Score (TBS) is derived from the texture of the DXA image and has been shown to be related to fracture risk.
Trabecular Bone Score (TBS) software will be used to adjust fracture risk (FRAX) scores to obtain TBS scores (in gradient risk).
FRAX adjusted TBS scores (in gradient of risk) ranges from 1.1% -1.9% coefficient of variation (C.V.)
|
Baseline
|
|
TBS adjustment of FRAX scores for an enhanced fracture risk probability in pre and post-menopausal women undergoing bariatric surgery (Roux en Y vs. Gastric Sleeve).
Time Frame: Change from baseline to 12 months
|
The Trabecular Bone Score (TBS) is derived from the texture of the DXA image and has been shown to be related to fracture risk.
Trabecular Bone Score (TBS) software will be used to adjust fracture risk (FRAX) scores to obtain TBS scores (in gradient risk).
FRAX adjusted TBS scores (in gradient of risk) ranges from 1.1% -1.9% coefficient of variation (C.V.)
|
Change from baseline to 12 months
|
|
TBS adjustment of FRAX scores for an enhanced fracture risk probability in pre and post-menopausal women undergoing bariatric surgery (Roux en Y vs. Gastric Sleeve).
Time Frame: Change from baseline to 24 months
|
The Trabecular Bone Score (TBS) is derived from the texture of the DXA image and has been shown to be related to fracture risk.
Trabecular Bone Score (TBS) software will be used to adjust fracture risk (FRAX) scores to obtain TBS scores (in gradient risk).
FRAX adjusted TBS scores (in gradient of risk) ranges from 1.1% -1.9% coefficient of variation (C.V.)
|
Change from baseline to 24 months
|
|
TBS assessment of bone microstructure in pre and post-menopausal women undergoing bariatric surgery (Roux en Y vs. Gastric Sleeve).
Time Frame: Baseline
|
The Trabecular Bone Score (TBS) is derived from the texture of the DXA image and has been shown to be related to bone microarchitecture.
Trabecular Bone Score (TBS) software will be used to assess bone microstructure.
TBS ≤1.2 defines degraded microarchitecture, TBS between 1.20 and 1.35 is partially degraded microarchitecture, and TBS ≥1.35 is considered normal.
|
Baseline
|
|
TBS assessment of bone microstructure in pre and post-menopausal women undergoing bariatric surgery (Roux en Y vs. Gastric Sleeve).
Time Frame: Change from baseline to 12 months
|
The Trabecular Bone Score (TBS) is derived from the texture of the DXA image and has been shown to be related to bone microarchitecture.
Trabecular Bone Score (TBS) software will be used to assess bone microstructure.
TBS ≤1.2 defines degraded microarchitecture, TBS between 1.20 and 1.35 is partially degraded microarchitecture, and TBS ≥1.35 is considered normal.
|
Change from baseline to 12 months
|
|
TBS assessment of bone microstructure in pre and post-menopausal women undergoing bariatric surgery (Roux en Y vs. Gastric Sleeve).
Time Frame: Change from baseline to 24 months
|
The Trabecular Bone Score (TBS) is derived from the texture of the DXA image and has been shown to be related to bone microarchitecture.
Trabecular Bone Score (TBS) software will be used to assess bone microstructure.
TBS ≤1.2 defines degraded microarchitecture, TBS between 1.20 and 1.35 is partially degraded microarchitecture, and TBS ≥1.35 is considered normal.
|
Change from baseline to 24 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline
|
Serum bone alkaline phosphatase (BALP in U/L) will be assayed
|
Baseline
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 6 months
|
Serum bone alkaline phosphatase (BALP in U/L) will be assayed
|
Baseline to 6 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 12 months
|
Serum bone alkaline phosphatase (BALP in U/L) will be assayed
|
Baseline to 12 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 24 months
|
Serum bone alkaline phosphatase (BALP in U/L) will be assayed
|
Baseline to 24 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline
|
Osteocalcin (in ng/mL) will be assayed.
|
Baseline
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 6 months
|
Osteocalcin (in ng/mL) will be assayed.
|
Baseline to 6 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 12 months
|
Osteocalcin (in ng/mL) will be assayed.
|
Baseline to 12 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 24 months
|
Osteocalcin (in ng/mL) will be assayed.
|
Baseline to 24 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline
|
Type 1 procollagen (P1NP, in mcg/L) will be assayed.
|
Baseline
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 6 months
|
Type 1 procollagen (P1NP, in mcg/L) will be assayed.
|
Baseline to 6 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 12 months
|
Type 1 procollagen (P1NP, in mcg/L) will be assayed.
|
Baseline to 12 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 24 months
|
Type 1 procollagen (P1NP, in mcg/L) will be assayed.
|
Baseline to 24 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline
|
C-terminal telopeptide (CTX, in pg/mL) will be assayed.
|
Baseline
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 6 months
|
C-terminal telopeptide (CTX, in pg/mL) will be assayed.
|
Baseline to 6 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 12 months
|
C-terminal telopeptide (CTX, in pg/mL) will be assayed.
|
Baseline to 12 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 24 months
|
C-terminal telopeptide (CTX, in pg/mL) will be assayed.
|
Baseline to 24 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline
|
Calcium (in mg/dL), albumin (in, g/dL) will be assayed.
|
Baseline
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 6 months
|
Calcium (in mg/dL), albumin (in, g/dL) will be assayed.
|
Baseline to 6 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 12 months
|
Calcium (in mg/dL), albumin (in, g/dL) will be assayed.
|
Baseline to 12 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 24 months
|
Calcium (in mg/dL), albumin (in, g/dL) will be assayed.
|
Baseline to 24 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline
|
Parathyroid hormone (PTH, in pg/mL) will be assayed.
|
Baseline
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 6 months
|
Parathyroid hormone (PTH, in pg/mL) will be assayed.
|
Baseline to 6 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 12 months
|
Parathyroid hormone (PTH, in pg/mL) will be assayed.
|
Baseline to 12 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 24 months
|
Parathyroid hormone (PTH, in pg/mL) will be assayed.
|
Baseline to 24 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline
|
25-OH vitamin D (in ng/mL) will be assayed.
|
Baseline
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 6 months
|
25-OH vitamin D (in ng/mL) will be assayed.
|
Baseline to 6 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 12 months
|
25-OH vitamin D (in ng/mL) will be assayed.
|
Baseline to 12 months
|
|
Determine and quantify changes in biochemical markers of bone metabolism and calcium homeostasis.
Time Frame: Baseline to 24 months
|
25-OH vitamin D (in ng/mL) will be assayed.
|
Baseline to 24 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Jayleen G Grams, MD,PhD, University of Alabama at Birmingham
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- IRB-300000701
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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