Changes in Bone Mineral Density in Patients with Type 2 Diabetes After Different Bariatric Surgery Procedures and the Role of Gastrointestinal Hormones

Guerrero-Pérez, Fernando; Casajoana, Anna; Gómez-Vaquero, Carmen; Virgili, N.; López-Urdiales, Rafael; Hernández-Montoliu, Laura; Pujol-Gebellí, Jordi; Osorio, Javier; Alves, Carolina Pantuzzo Leão; Pérez-Maraver, Manuel; Pellitero, Sílvia; Vidal‐Alabró, Anna; Fernández‐Veledo, Sonia; Vendrell, Joan; Vilarrasa, Núria

doi:10.1007/s11695-019-04127-5

Cited by 26 publications

(23 citation statements)

References 39 publications

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“…One-year outcomes and procedure complications, stratified according to the Clavien-Dindo classification, were previously described [33]. As a summary of earlier published data [27,33], at year one, TWL% was significantly greater in the mRYGB group compared to SG and GCP. At the end of the study, TWL% in the mRYGB group was −27.32 (7.87) vs. −18.00 (10.6) and −14.83 (7.84) in SG and GCP, respectively, p = 0.001.…”

Section: Resultsmentioning

confidence: 99%

“…Other factors like adipokines (leptin, adiponectin), muscle mass loss and bone marrow fat could be implicated [ 23 , 24 , 25 , 26 ]. All these modifications and their impact on bone might vary between different surgical procedures and are probably more pronounced after malabsorptive or, more accurately named, hypoabsortive techniques [ 15 , 17 , 27 ]. Some studies have compared BMD outcomes after different surgical procedures, although most of them in a non-randomized manner and at short-term (1–3 years of follow-up) [ 21 , 24 , 28 , 29 , 30 , 31 , 32 ].…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Effects in Bone Mineral Density after Different Bariatric Procedures in Patients with Type 2 Diabetes: Outcomes of a Randomized Clinical Trial

Guerrero-Pérez

Casajoana

Gómez-Vaquero

et al. 2020

JCM

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There is scant evidence of the long-term effects of bariatric surgery on bone mineral density (BMD). We compared BMD changes in patients with severe obesity and type 2 diabetes (T2D) 5 years after randomization to metabolic gastric bypass (mRYGB), sleeve gastrectomy (SG) and greater curvature plication (GCP). We studied the influence of first year gastrointestinal hormone changes on final bone outcomes. Forty-five patients, averaging 49.4 (7.8) years old and body mass index (BMI) 39.4 (1.9) kg/m2, were included. BMD at lumbar spine (LS) was lower after mRYGB compared to SG and GCP: 0.89 [0.82;0.94] vs. 1.04 [0.91;1.16] vs. 0.99 [0.89;1.12], p = 0.020. A higher percentage of LS osteopenia was present after mRYGB 78.6% vs. 33.3% vs. 50.0%, respectively. BMD reduction was greater in T2D remitters vs. non-remitters. Weight at fifth year predicted BMD changes at the femoral neck (FN) (adjusted R2: 0.3218; p = 0.002), and type of surgery (mRYGB) and menopause predicted BMD changes at LS (adjusted R2: 0.2507; p < 0.015). In conclusion, mRYGB produces higher deleterious effects on bone at LS compared to SG and GCP in the long-term. Women in menopause undergoing mRYGB are at highest risk of bone deterioration. Gastrointestinal hormone changes after surgery do not play a major role in BMD outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-Term Effects in Bone Mineral Density after Different Bariatric Procedures in Patients with Type 2 Diabetes: Outcomes of a Randomized Clinical Trial

Guerrero-Pérez

Casajoana

Gómez-Vaquero

et al. 2020

JCM

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“…Fukushima et al [ 39 ] has reported that serum ghrelin may be produced by osteoblasts and could be positively correlated with trabecular BMD. GLP-1, releasing from the colon after eating, exerts an important influence on glycolipid metabolic and food intake [ 21 ]. Bernardo et al [ 40 ] has showed that GLP-1 may facilitate bone formation deficiency and structural defects in rats with glucose intolerance.…”

Section: Discussionmentioning

confidence: 99%

“…Restrictive gastric volume leads to malabsorptive effect on vitamin D and calcium, further causes secondary hyperparathyroidism [ 20 ]. Several gastrointestinal hormones and adipocytokines were produced abnormally after SG, which have been proposed to be responsible for bone loss after bariatric surgery [ 17 , 21 – 26 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of sleeve gastrectomy on bone mass, microstructure of femurs and bone metabolism associated serum factors in obese rats

et al. 2021

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Background Sleeve gastrectomy (SG) is a profoundly effective operation for severe obese patients, but is closely associated with bone mass loss. Previous studies have reported changes of various serum factors which may be associated with bone mass loss after SG. However, those results are contradictory. In this study, we assessed the effects of SG on bone mass, microstructure of femurs, and changes in bone turnover markers (BTMs), serum adipokines, inflammatory factors and gastrointestinal hormones after SG in high-fat diet (HFD) induced obese rats. Methods Eight-week-old male Sprague–Dawley (SD) rats were fed with HFD to induce obesity. Then, SG and sham surgery were performed in anesthetized obese rats. SD rats in control group were fed with standard chow. Microstructure of femurs was scanned and analyzed by micro-computed tomography in control group, HFD sham group and HFD SG group. Serum inflammatory factors, adipokines markers, gastrointestinal hormones and BTMs were also measured. Results Bone mineral density (BMD) of trabecular bone in both HFD sham group and HFD SG group were remarkably decreased compared with control group. All serum BTMs were significantly higher in HFD SG group than HFD sham group. In the meantime, serum levels of several important inflammatory factors, gastrointestinal hormones and adipokines such as tumor necrosis factor-α (TNF-α), interleukin (IL)-6, monocyte chemoattractant protein-1(MCP-1), ghrelin, insulin and leptin in HFD SG group were remarkably reduced compared with HFD sham group, whereas glucagon-like peptide-1 (GLP-1), adiponectin, fibroblast growth factor (FGF)-19 and FGF-21 were dramatically increased after SG. Protein tyrosine phosphatase 1B (PTP1B) was significantly increased in the HFD sham group than control group. Spearman’s correlation analysis indicated that serum osteocalcin (OC) and 25-hydroxy vitamin D3 (25(OH)D3) were positively correlated with BMD of trabecular bone, whereas serum PTP1B and TNF-α were negatively related to BMD of trabecular bone. Conclusions SG aggravates bone mass loss and activates bone remodeling in obese rats. Levels of BTMs, adipokines, inflammatory factors, and gastrointestinal hormones could be affected by SG in obese rats. Serum PTP1B level might be associated with abnormal bone mass in obese rats.

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“…For example, when comparing SG to RYGB, achieved weight loss is less robust (9), with fewer nutrient deficiencies (10) and less pronounced increases in bone turnover (11,12,13). In the past decade, over a dozen studies have reported on change in BMD following SG using DXA (12,14,15,16,17,18,19,20,21,22,23,24), with primary design features and findings reported in Table 1. Six-, 12-, and 24-month percent change in total hip and lumbar spine BMD are also depicted graphically in Fig.…”

Section: Sleeve Gastrectomy and Bone Lossmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Bone complications of bariatric surgery: updates on sleeve gastrectomy, fractures, and interventions

Beavers

Greene

2020

European Journal of Endocrinology

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Despite well recognized improvements in obesity-related comorbidities, increasing evidence implicates bariatric surgery in the onset of adverse skeletal health outcomes. The purpose of this review is to provide a focused update in three critical areas: 1) emergent data on sleeve gastrectomy and bone loss, 2) evidence linking bariatric surgery to incident fracture, and 3) intervention strategies designed to mitigate surgical bone loss. Better understanding of these issues will inform our treatment of skeletal health for patients planning bariatric surgery.

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Changes in Bone Mineral Density in Patients with Type 2 Diabetes After Different Bariatric Surgery Procedures and the Role of Gastrointestinal Hormones

Cited by 26 publications

References 39 publications

Long-Term Effects in Bone Mineral Density after Different Bariatric Procedures in Patients with Type 2 Diabetes: Outcomes of a Randomized Clinical Trial

Long-Term Effects in Bone Mineral Density after Different Bariatric Procedures in Patients with Type 2 Diabetes: Outcomes of a Randomized Clinical Trial

Effects of sleeve gastrectomy on bone mass, microstructure of femurs and bone metabolism associated serum factors in obese rats

MANAGEMENT OF ENDOCRINE DISEASE: Bone complications of bariatric surgery: updates on sleeve gastrectomy, fractures, and interventions

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