Comparison of the Absorption of Calcium Citrate and Calcium Carbonate in Patients With an RYGB, LSG, and OAGB
- Conditions
- Calcium Citrate AbsorptionCalcium Carbonate Absorption
- Interventions
- Drug: The absorption effect between calcium citrate and calcium carbonate
- Registration Number
- NCT06042985
- Lead Sponsor
- General Committee of Teaching Hospitals and Institutes, Egypt
- Brief Summary
The precise impact of calcium absorption in relation to RYGB, SG, and OAGB remains under-researched in terms of statistical power and the diversity of BMS procedures considered. Therefore, this presents a critical area for future investigation to improve patient outcomes in BMS.
- Detailed Description
Calcium, predominantly absorbed in the duodenum and proximal jejunum, relies heavily on vitamin D and an acidic environment to facilitate absorption. With the increasing prevalence of bariatric metabolic surgery (BMS) procedures and their malabsorptive effects, the likelihood of fat-soluble vitamin malabsorption becomes heightened. This stems from bypassing the stomach, key absorption sites in the intestine, and the inefficient mixing of bile salts.
BMS is often associated with several bone metabolism disorders, including the acceleration of bone remodeling and turnover, bone loss, and decreased bone mineral density (BMD). Postoperative calcium supplementation can mitigate this bone loss over time. For instance, a study demonstrated the beneficial effect of calcium citrate following Roux-en-Y gastric bypass (RYGB). However, the study's statistical power was insufficient; thus, the BMS field still awaits further conclusive and robust research to establish definitive guidelines, which was highlighted in another study.
Moreover, substantial changes in gut hormones, such as peptide YY (PYY), glucagon-like peptide-1, and ghrelin, have been observed following RYGB, sleeve gastrectomy (SG), and One Anastomosis Gastric Bypass (OAGB). While these hormonal changes are typically associated with BMS's numerous positive metabolic benefits, they may also contribute to bone loss.
Consequently, the precise impact of calcium absorption in relation to RYGB, SG, and OAGB remains under-researched in terms of statistical power and the diversity of BMS procedures considered. Therefore, this presents a critical area for future investigation to improve patient outcomes in BMS.
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 150
- Patients aged 18-75 years old
- After BMS surgery who had an RYGB, SG, or OAGB operation at least 12 months before the study.
- Patients will be selected at random from the hospital's electronic patient system.
- Patients on antacids during the study
- Patients onH2 receptor antagonists during the study
- Patients on proton pump inhibitors during the study
- Patients with a previous oophorectomy,
- Liver disease,
- Renal disease,
- Hypercalcemia,
- Hyperthyroidism,
- Hypothyroidism who require levothyroxine supplementation (Levothyroxine forms complexes with calcium)
- Parathyroid disorders
- Use of diuretics,
- Use of calcitonin,
- Use of corticosteroids,
- Use of anabolic steroids,
- Use of anticonvulsants within three months of the study
- Heavy smokers (>10 cigarettes/day)
- Abusing alcohol (>70 ml/day)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description RYGB arm: calcium citrate and calcium carbonate The absorption effect between calcium citrate and calcium carbonate The absorption effect between calcium citrate and calcium carbonate in patients with a RYGB LSG arm: calcium citrate and calcium carbonate The absorption effect between calcium citrate and calcium carbonate The absorption effect between calcium citrate and calcium carbonate in patients with a LSG OAGB arm: calcium citrate and calcium carbonate The absorption effect between calcium citrate and calcium carbonate The absorption effect between calcium citrate and calcium carbonate in patients with a OAGB
- Primary Outcome Measures
Name Time Method Elemental Calcium effects in blood serum (Peak Plasma Concentration (Cmax)) 8 hours In patients who have undergone bariatric surgery and are receiving elemental calcium supplementation in the form of citrate or carbonate, we observe variations in their blood serum with peak concentrations (Cmax)
These changes provide insights into how effectively the body absorbs and utilizes calcium following supplementation.Elemental Calcium effects in Urine excretion (time curve (AUC)) 8 hours In patients who have undergone bariatric surgery and are receiving elemental calcium supplementation in the form of citrate or carbonate, we observe variations in their cumulative excretion of urinary calcium over time (AUC).
These changes provide insights into how effectively the body absorbs and utilizes calcium following supplementation.Elemental Calcium effects in blood serum (Area under the plasma concentration) 8 hours In patients who have undergone bariatric surgery and are receiving elemental calcium supplementation in the form of citrate or carbonate, we observe variations in their blood serum with Area under the plasma concentration (AUC)
These changes provide insights into how effectively the body absorbs and utilizes calcium following supplementation.
- Secondary Outcome Measures
Name Time Method
Trial Locations
- Locations (1)
The surgical department of Medical Research Institute Hospital, Alexandria University
🇪🇬Alexandria, Egypt
The surgical department of Medical Research Institute Hospital, Alexandria University🇪🇬Alexandria, Egypt