Changes in bone metabolism after bariatric surgery by gastric bypass or sleeve gastrectomy

Ivaska, Kaisa K.; Huovinen, Ville; Soinio, Minna; Hannukainen, Jarna C.; Saunavaara, Virva; Salminen, Paulina; Helmiö, Mika; Parkkola, Riitta; Nuutila, Pirjo; Kiviranta, Riku

doi:10.1016/j.bone.2016.11.001

Cited by 90 publications

(81 citation statements)

References 41 publications

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“…and was decreased further by 4 weeks (Supplemental Figure 4C), whereas cortical bone loss in obese mice was not observed until 4 weeks after surgery (Supplemental Figure 4D). Circulating bone turnover markers TRACP5b and CTX-1 were significantly higher 4 weeks after surgery in these obese mice (Supplemental Figure 4E), which is consistent with circulating turnover markers in obese VSG patients (25,26). Effects of VSG on proximal and distal tibial BMATs were also very rapid, with loss observed 2 weeks after surgery (Supplemental Figure 4F).…”

Section: Figure 3 Loss Of Bone After Vsg Is Due To Decreased Bone Fosupporting

confidence: 71%

G-CSF partially mediates effects of sleeve gastrectomy on the bone marrow niche

Li¹,

Hardij²,

Evers³

et al. 2019

Journal of Clinical Investigation

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Section: Figure 3 Loss Of Bone After Vsg Is Due To Decreased Bone Fosupporting

confidence: 71%

G-CSF partially mediates effects of sleeve gastrectomy on the bone marrow niche

Li¹,

Hardij²,

Evers³

et al. 2019

Journal of Clinical Investigation

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“…These RYGB participants, 2 of whom had diabetes, were compared with 10 individuals who underwent sleeve gastrectomy, in whom marrow fat content increased. Similarly, Ivaska and colleagues found no significant 6‐month change in vertebral marrow fat content in 7 RYGB patients or 14 sleeve gastrectomy patients . In contrast, we were able to detect a relationship between change in marrow fat content and BMD loss and to further explore the relationship between glycemic change and marrow fat because of our somewhat larger sample size and study design including stratified enrollment by diabetes status.…”

Section: Discussionmentioning

confidence: 46%

“…Similarly, Ivaska and colleagues found no significant 6-month change in vertebral marrow fat content in 7 RYGB patients or 14 sleeve gastrectomy patients. (62) In contrast, we were able to detect a relationship between change in marrow fat content and BMD loss and to further explore the relationship between glycemic change and marrow fat because of our somewhat larger sample size and study design including stratified enrollment by diabetes status. Larger studies with the consideration of diabetes status are needed to confirm our findings.…”

Section: Discussionmentioning

confidence: 84%

Bone Marrow Fat Changes After Gastric Bypass Surgery Are Associated With Loss of Bone Mass

Kim

Schwartz

et al. 2017

Journal of Bone and Mineral Research

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Bone marrow fat is a unique fat depot that may regulate bone metabolism. Marrow fat is increased in states of low bone mass, severe underweight, and diabetes. However, longitudinal effects of weight loss and improved glucose homeostasis on marrow fat are unclear, as is the relationship between marrow fat and BMD changes. We hypothesized that after Roux-en-Y gastric bypass (RYGB) surgery, marrow fat changes are associated with BMD loss. We enrolled 30 obese women, stratified by diabetes status. Before and 6 months after RYGB, we measured BMD by DXA and QCT and vertebral marrow fat content by magnetic resonance spectroscopy. At baseline, those with higher marrow fat had lower BMD. Postoperatively, total body fat declined dramatically in all participants. Effects of RYGB on marrow fat differed by diabetes status (p=0.03). Nondiabetic women showed no significant mean change in marrow fat (+1.8%, 95% CI −1.8% to +5.4%, p=0.29), although those who lost more total body fat were more likely to have marrow fat increases (r=−0.70, p=0.01). In contrast, diabetic women demonstrated a mean marrow fat change of −6.5% (95% CI −13.1% to 0%, p=0.05). Overall, those with greater improvements in hemoglobin A1c had decreases in marrow fat (r=0.50, p=0.01). Increases in IGF-1, a potential mediator of the marrow fat-bone relationship, were associated with marrow fat declines (r=−0.40, p=0.05). Spinal volumetric BMD decreased by 6.4% ±5.9% (p<0.01), and femoral neck areal BMD decreased by 4.3% ±4.1% (p<0.01). Marrow fat and BMD changes were negatively associated, such that those with marrow fat increases had more BMD loss at both spine (r=−0.58, p<0.01) and femoral neck (r=−0.49, p=0.01), independent of age and menopause. Our findings suggest that glucose metabolism and weight loss may influence marrow fat behavior, and marrow fat may be a determinant of bone metabolism.

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“…Others have found no association between change in marrow fat and bone loss in patients undergoing bariatric surgery. (18,19) The degree of bone loss that we report per each SD greater BMAT content is an increased loss of spine trabecular BMD of 0.9 mg/cm 3 /year. Other studies have reported that a difference in spine trabecular vBMD of about −0.04 mg/cm 3 /year is associated with increased risk of nonspine fracture (HR = 1.47), (20) hip fracture (HR = 1.8), and clinical spine fracture (HR = 3.7).…”

Section: Discussionmentioning

confidence: 78%

Greater Bone Marrow Adiposity Predicts Bone Loss in Older Women

Woods

Ewing

Sigurðsson

et al. 2019

Journal of Bone and Mineral Research

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Bone marrow adiposity (BMA) is associated with aging and osteoporosis, but whether BMA can predict bone loss and fractures remains unknown. Using data from the Age Gene/Environment Susceptibility (AGES)-Reykjavik study, we investigated the associations between 1 H-MRS-based measures of vertebral bone marrow adipose tissue (BMAT), annualized change in bone density/ strength by quantitative computed tomography (QCT) and DXA, and secondarily, with incident clinical fractures and radiographic vertebral fractures among older adults. The associations between BMAT and annualized change in bone density/strength were evaluated using linear regression models, adjusted for age, body mass index (BMI), diabetes, estradiol, and testosterone. Cox proportional hazards models were used to evaluate the associations between baseline BMAT and incident clinical fractures, and logistic regression models for incident vertebral fractures. At baseline, mean AE SD age was 80.9 AE 4.2 and 82.6 AE 4.2 years in women (n = 148) and men (n = 150), respectively. Mean baseline BMAT was 55.4% AE 8.1% in women and 54.1% AE 8.2% in men. Incident clinical fractures occurred in 7.4% of women over 2.8 years and in 6.0% of men over 2.2 years. Incident vertebral fractures occurred in 12% of women over 3.3 years and in 17% of men over 2.7 years. Each 1 SD increase in baseline BMAT was associated with a 3.9 mg 2 /cm 4 /year greater loss of spine compressive strength index (p value = .003), a 0.9 mg/cm 3 /year greater loss of spine trabecular BMD (p value = .02), and a 1.2 mg/cm 3 /year greater loss of femoral neck trabecular BMD (p value = .02) in women. Among men, there were no associations between BMAT and changes in bone density/strength. There were no associations between BMAT and incident fractures in women or men. In conclusion, we found greater BMAT is associated with greater loss of trabecular bone at the spine and femoral neck, and greater loss of spine compressive strength, in older women.n 326 WOODS ET AL. 29. Kennell JA, MacDougald OA. Wnt signaling inhibits adipogenesis through beta-catenin-dependent and -independent mechanisms. J Biol Chem. 2005;280(25):24004-10. 30. Ma YH, Schwartz AV, Sigurdsson S, et al. Circulating sclerostin associated with vertebral bone marrow fat in older men but not women.

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Changes in bone metabolism after bariatric surgery by gastric bypass or sleeve gastrectomy

Cited by 90 publications

References 41 publications

G-CSF partially mediates effects of sleeve gastrectomy on the bone marrow niche

G-CSF partially mediates effects of sleeve gastrectomy on the bone marrow niche

Bone Marrow Fat Changes After Gastric Bypass Surgery Are Associated With Loss of Bone Mass

Greater Bone Marrow Adiposity Predicts Bone Loss in Older Women

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