Bone Mass Decreases in Morbidly Obese Women after Long Limb-Biliopancreatic Diversion and Marked Weight Loss Without Secondary Hyperparathyroidism. A Physiological Adaptation to Weight Loss?

Tsiftsis, D; Mylonas, Panagiotis; Mead, Nancy; Kalfarentzos, Fotis; Alexandrides, Theodore K.

doi:10.1007/s11695-009-9938-z

Cited by 55 publications

(52 citation statements)

References 35 publications

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“…Bone resorption is increased also after LSG, as demonstrated by a significant increase in N-telopeptide crosslinks (NTx) [102]. Marked weight loss after long limb-biliopancreatic diversion (BPD-LL) increases bone turnover [103] and increases in bone turnover are associated with percentage of lost BMI in patients who underwent biliopancreatic diversion [104].…”

Section: Effects Of Bariatric Surgery On Bone Turnovermentioning

confidence: 99%

“…The change in BMD was evident 1 year postsurgery and was associated with the degree of weight reduction [105]. The marked weight loss after long limbbiliopancreatic diversion (BPD-LL) has been associated with decrease in BMD 1 year after surgery [103], RYGB in morbidly obese patients decreases BMC and BMD 1 year postoperatively [106] and, similarly, in a study with follow-up for a year after gastric bypass surgery there was total hip BMD decrease as well as at the lumbar spine [107]. Fewer data are available for the relatively newer sleeve gastrectomy.…”

Section: Effects Of Bariatric Surgery On Bmdmentioning

confidence: 99%

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Obesity and bone metabolism

2018

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The interaction between obesity and bone metabolism is complex. The effects of fat on the skeleton are mediated by both mechanical and biochemical factors. Though obesity is characterized by higher bone mineral density, studies conducted on bone microarchitecture have produced conflicting results. The majority of studies indicate that obesity has a positive effect on skeletal strength, even though most likely the effects are site-dependent and, in fact, obese individuals might be at risk of certain types of fractures. Mechanical loading and higher lean mass are associated with improved outcomes, whereas systemic inflammation, observed especially with abdominal obesity, may exert negative effects. Weight loss interventions likely lead to bone loss over time. Pharmacological treatment options seem to be safe in terms of skeletal health; however, the skeletal effects of bariatric surgery are dependent on the type of surgical procedure. Malabsorptive procedures are associated with higher short-term adverse effects on bone health. In this narrative review, we discuss the effects of obesity and weight loss interventions on skeletal health.

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Section: Effects Of Bariatric Surgery On Bone Turnovermentioning

confidence: 99%

Section: Effects Of Bariatric Surgery On Bmdmentioning

confidence: 99%

Obesity and bone metabolism

2018

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“…With this type of surgery, loss of excess weight can go up to 70-80%. [76][77][78] Despite supplementation to a very good dose after this surgery, more than 50% of patients have a deficiency in vitamin D.…”

Section: 58mentioning

confidence: 99%

Vitamin D alteration associated with obesity and bariatric surgery

Lespessailles

Toumi

2017

Exp Biol Med (Maywood)

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Obesity and severe obesity constitute growing serious health problems reaching epidemic proportion in most countries with a prevalence increasing from 6.4 in 1975 to 14.9% in 2014. This present review summarizes currently available data on vitamin D deficiencies in the obese population before and after bariatric surgery. The important evidence emerging from our evaluation confirms that obese patients are at risk of multiple nutritional deficiencies, especially vitamin D deficiency, before bariatric surgery. Our survey confirms that the precise role of the gut microbiome and its associated changes on the vitamin D metabolism after the different bariatric surgery procedures has not yet been studied. Furthermore, whether differences in the microbiota may alter the therapeutic responses to vitamin D is not known. AbstractObesity and severe obesity constitute growing serious health problems reaching epidemic proportion in most countries. Interactions and relationships between obesity and bone tissue and its metabolism are complex but are more and more studied and recognized. Obesity is associated with an altered hormonal profile including particularly bone-regulating hormones like vitamin D. Bariatric surgery procedures, thanks to their effectiveness to achieve therapeutic endpoints for comorbidities associated with obesity, have had an increasing success. However, these surgeries by producing mechanical restriction and or malabsorption syndrome lead to nutritional deficiencies including vitamin D. In this review, we aim to (1) discuss the nutritional deficiency of vitamin D in the obese, (2) to summarize the different surgical options in bariatric surgery and to present the evidence concerning these procedures and their associated profile in vitamin D post-operative insufficiency, (3) to present the different recommendations in clinical practice to prevent or treat vitamin D deficiencies or insufficiencies in patients treated by bariatric surgery and finally to introduce emerging assumptions on the relationship between vitamin D, microbiota composition and circulating bile acids.

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“…After diet-and exercise-induced weight loss, both increased [9][10][11] and unaltered 12,13 circulating levels of 25OHD have been reported. Likewise, after major weight loss by bariatric surgery, both temporary [14][15][16] and long-term increases [16][17][18] in circulating levels of 25OHD have been reported, along with reports of no changes one year after surgery. 13,19 Taken together, these findings indicate that body weight is an important factor for circulating 25OHD levels.…”

Section: Introductionmentioning

confidence: 96%

Expression of vitamin D-metabolizing enzymes in human adipose tissue—the effect of obesity and diet-induced weight loss

et al. 2012

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OBJECTIVE: Low vitamin D (VD) levels are common in obesity. We hypothesized that this may be due to metabolism of VD in adipose tissue (AT). Thus, we studied (1) whether the VD-metabolizing enzymes were expressed differently in AT of lean and obese individuals and in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT), and (2) whether their expression was influenced by weight loss. METHODS: Samples of SAT and VAT were analyzed for expression of the vitamin-D-25-hydroxylases CYP2R1, CYP2J2, CYP27A1 and CYP3A4, the 25-vitamin-D-1a-hydroxylase CYP27B1, the catabolic vitamin-D-24-hydroxylase CYP24A1, and the vitamin D receptor, using reverse transcriptase-PCR. Moreover, plasma 25-hydroxy-vitamin D (25OHD) level was measured and related to the expression of these enzymes. Samples of SAT and VAT from 20 lean women and 20 obese women, and samples of SAT from 17 obese subjects before and after a 10% weight loss were analyzed. RESULTS: A plasma 25OHD level o50 nmol l À 1 was highly prevalent in both lean (45%) and obese (90%) women (Po0.01). Plasma 25OHD increased by 27% after weight loss in the obese individuals (Po0.05). Expression levels of the 25-hydroxylase CYP2J2 and the 1a-hydroxylase CYP27B1 were decreased by 71% (Po0.0001) and 49% (Po0.05), respectively, in SAT of the obese. CYP24A1 did not differ between lean and obese women, but the expression was increased by 79% (Po0.05) after weight loss. CONCLUSION: Obesity is characterized by a decreased expression of the 25-hydroxylase CYP2J2 and the 1a-hydroxylase CYP27B1 in SAT, whereas the catabolic CYP24A1 does not differ between lean and obese women. However, the expression of CYP24A1 is increased after weight loss. Accordingly, AT has the capacity to metabolize VD locally, and this can be dynamically altered during obesity and weight loss. INTRODUCTIONLow levels of circulating 25-hydroxy-vitamin D (25OHD) are associated with increased fat mass and body mass index, 1-5 but the underlying mechanism for this association is not fully elucidated. 6 Vitamin D (VD) is stored in adipose tissue (AT), and release of VD from AT is proposed to serve as an endogenous source of VD during the winter, when cutaneous production is low or absent in several parts of the world. 7 As low circulating levels of 25OHD are common in association with the obese state, 8 several studies have examined the effect of weight loss on circulating levels of 25OHD. However, results are inconsistent. After diet-and exercise-induced weight loss, both increased 9-11 and unaltered 12,13 circulating levels of 25OHD have been reported. Likewise, after major weight loss by bariatric surgery, both temporary 14-16 and long-term increases [16][17][18] in circulating levels of 25OHD have been reported, along with reports of no changes one year after surgery. 13,19 Taken together, these findings indicate that body weight is an important factor for circulating 25OHD levels. Several other explanations for the low levels of 25OHD in obesity have been proposed: a decreased exposure to sun light, 20 ...

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Bone Mass Decreases in Morbidly Obese Women after Long Limb-Biliopancreatic Diversion and Marked Weight Loss Without Secondary Hyperparathyroidism. A Physiological Adaptation to Weight Loss?

Cited by 55 publications

References 35 publications

Obesity and bone metabolism

Obesity and bone metabolism

Vitamin D alteration associated with obesity and bariatric surgery

Expression of vitamin D-metabolizing enzymes in human adipose tissue—the effect of obesity and diet-induced weight loss

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