scholarly journals Bone structural changes after gastric bypass surgery evaluated by HR-pQCT: a two-year longitudinal study

2017 ◽  
Vol 176 (6) ◽  
pp. 685-693 ◽  
Author(s):  
Vikram V Shanbhogue ◽  
René Klinkby Støving ◽  
Katrine Hartmund Frederiksen ◽  
Stine Hanson ◽  
Kim Brixen ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Bone Strength ◽  
Structural Changes ◽  
Bone Microarchitecture ◽  
Clinical Importance ◽  
Morbidly Obese ◽  
Mineral Density ◽  
Quantitative Ct ◽  
Increased Risk

Objective, design and methods Roux-en-Y gastric bypass (RYGB) has proved successful in attaining sustained weight loss but may lead to metabolic bone disease. To assess impact on bone mass and structure, we measured a real bone mineral density at the hip and spine by dual-energy X-ray absorptiometry, and volumetric BMD (vBMD) and bone microarchitecture at the distal radius and tibia by high-resolution peripheral quantitative CT in 25 morbidly obese subjects (15 females, 10 males) at 0, 12 and 24 months after RYGB. Bone turnover markers (BTMs), calciotropic and gut hormones and adipokines were measured at the same time points. Results After a 24.1% mean weight loss from baseline to month 12 (P < 0.001), body weight plateaued from month 12 to 24 (−0.9%, P = 0.50). However, cortical and trabecular vBMD and microarchitecture deteriorated through the 24 months, such that there was a 5 and 7% reduction in estimated bone strength at the radius and tibia respectively (both P < 0.001). The declines observed in the first 12 months were matched or exceeded by declines in the 12- to 24-month period. While a significant increase in BTMs and decrease in leptin and insulin were seen at 24 months, these changes were maximal at month 12 and stabilized from month 12 to 24. Conclusions Despite weight stabilization and maintenance of metabolic parameters, bone loss and deterioration in bone strength continued and were substantial in the second year. The clinical importance of these changes in terms of increased risk of developing osteoporosis and fragility fractures remain an important concern.

scholarly journals Continuous decline in bone mineral density and deterioration of bone microarchitecture 7 years after Roux-en-Y gastric bypass surgery

2020 ◽  
Vol 182 (3) ◽  
pp. 303-311 ◽  
Author(s):  
Stinus Hansen ◽  
Niklas Rye Jørgensen ◽  
Anne Pernille Hermann ◽  
Rene Klinkby Støving
Keyword(s):  
Bone Mineral Density ◽  
Gastric Bypass ◽  
Bone Strength ◽  
Bone Mineral ◽  
Bone Microarchitecture ◽  
Gastric Bypass Surgery ◽  
Bone Geometry ◽  
Mineral Density ◽  
Quantitative Ct ◽  
Post Surgery

Objective Roux-en-Y-gastric bypass (RYGB) surgery is an effective treatment for morbid obesity. A possible overlooked side effect is negative bone metabolic consequences. Design A seven-year prospective study following ten women and seven men after RYGB (baseline mean age 43 ± 8 years, BMI 42 ± 6 kg/m2). Methods Lumbar spine and total hip bone mineral density (BMD) using dual energy x-ray absorptiometry, distal radius and tibia bone geometry, volumetric BMD, microarchitecture and finite element estimated bone strength using high-resolution peripheral quantitative CT and biochemical markers of bone remodelling were assessed at baseline, 2 and 7 years. Results Compared to baseline, body weight was 24 ± 10% lower after 2 years and 21 ± 11% after 7 years. During the 7 years of follow-up, radius and tibia vBMD had declined 13 ± 8% and 8 ± 7% from baseline to 2 years and further 10 ± 7% and 7 ± 8% from 2 to 7 years (all P < 0.001). At both radius and tibia, cortical thickness declined and cortical porosity increased. From baseline to 7 years, there were clear indications of deteriorations of the trabecular network with fewer, more widely spaced and more in-homogeneously distributed trabeculae in both radius and tibia. Overall, declines in estimated bone strength of 16 ± 9% in radius and 16 ± 7% in tibia were observed (both P < 0.001). Conclusion Seven years after RYGB, evidence of continuous declines in BMD and ongoing deterioration of bone microarchitecture and reduced estimated bone strength compared to baseline and 2 years post-surgery results were found. These findings emphasize the need for regular assessment of bone health in patients with prior RYGB.

scholarly journals In Men With Obesity, T2DM Is Associated With Poor Trabecular Microarchitecture and Bone Strength, and Low Bone Turnover

2021 ◽  
Author(s):  
Francesca Vigevano ◽  
Giulia Gregori ◽  
Georgia Colleluori ◽  
Rui Chen ◽  
Vimlin Autemrongsawat ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Bone Strength ◽  
Type I Collagen ◽  
Failure Load ◽  
Bone Microarchitecture ◽  
Enzyme Linked Immunosorbent Assay ◽  
Type I ◽  
Mineral Density ◽  
Trabecular Microarchitecture ◽  
Increased Risk

Abstract Introduction Obesity and type 2 Diabetes (T2D) are both associated with greater bone mineral density (BMD) but increased risk of fractures. The effect of the combination of both conditions on bone metabolism, microarchitecture and strength in the obese population remains unknown. Methods Data from 112 obese men were collected. Bone turnover and biochemical markers were measured by enzyme-linked immunosorbent assay (ELISA), body composition and BMD at all sites were assessed by dual energy X-ray absorptiometry (DXA), whereas bone microarchitecture and strength (stiffness and failure load) were measured by high-resolution peripheral computed tomography (HR-pQCT). Data were compared among metabolically healthy obese (MHO) and metabolically unhealthy obese (MUHO) with and without T2D and between obese without and with T2D. Results Compared to MHO and MUHO without T2D, MUHO with T2D had significantly lower levels of osteocalcin ((7.49±3.0 and 6.03±2.47, vs 4.24±2.72 ng/ml, respectively, p=0.003) and C-terminal telopeptide of type I collagen (CTx) (0.28±0.10 and 0.29±0.13 vs. 0.21±0.15 ng/ml, respectively, p=0.02). Dividing our subjects simply into those with and without T2D showed that obese men with T2D had significantly lower levels of osteocalcin (p=0.003) and CTx (p=0.005), greater trabecular separation at the tibia and radius (p=0.03 and p=0.04, respectively) and lower tibial failure load and stiffness (both p=0.04), relative to obese men without T2D. Conclusion In men, the combination of obesity and T2D is associated with reduced bone turnover, poorer trabecular bone microarchitecture and bone strength compared to those who are obese but without T2D suggesting worse bone disease.

scholarly journals DXA parameters, Trabecular Bone Score (TBS) and Bone Mineral Density (BMD), in fracture risk prediction in endocrine-mediated secondary osteoporosis

Endocrine ◽  
2021 ◽  
Author(s):  
Enisa Shevroja ◽  
Francesco Pio Cafarelli ◽  
Giuseppe Guglielmi ◽  
Didier Hans
Keyword(s):  
Bone Mineral Density ◽  
Trabecular Bone ◽  
Bone Mineral ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Fragility Fractures ◽  
Endocrine Disorders ◽  
Mineral Density ◽  
Increased Risk

AbstractOsteoporosis, a disease characterized by low bone mass and alterations of bone microarchitecture, leading to an increased risk for fragility fractures and, eventually, to fracture; is associated with an excess of mortality, a decrease in quality of life, and co-morbidities. Bone mineral density (BMD), measured by dual X-ray absorptiometry (DXA), has been the gold standard for the diagnosis of osteoporosis. Trabecular bone score (TBS), a textural analysis of the lumbar spine DXA images, is an index of bone microarchitecture. TBS has been robustly shown to predict fractures independently of BMD. In this review, while reporting also results on BMD, we mainly focus on the TBS role in the assessment of bone health in endocrine disorders known to be reflected in bone.

GLP-1 and Adiponectin: Effect of Weight Loss After Dietary Restriction and Gastric Bypass in Morbidly Obese Patients with Normal and Abnormal Glucose Metabolism

2008 ◽  
Vol 19 (3) ◽  
pp. 313-320 ◽  
Author(s):  
Camila Puzzi de Carvalho ◽  
Daniela Miguel Marin ◽  
Aglécio Luiz de Souza ◽  
José Carlos Pareja ◽  
Elintom Adami Chaim ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Glucose Metabolism ◽  
Dietary Restriction ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Abnormal Glucose Metabolism

scholarly journals Association of Circulating Irisin Concentrations with Weight Loss after Roux-en-Y Gastric Bypass Surgery

2019 ◽  
Vol 16 (4) ◽  
pp. 660 ◽  
Author(s):  
Yeon Lee ◽  
Yoonseok Heo ◽  
Ji-Ho Choi ◽  
Sunghyouk Park ◽  
Kyoung Kim ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Excess Weight Loss ◽  
Gastric Bypass Surgery ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Preoperative Serum ◽  
One Year

Irisin is a myokine with potential anti-obesity properties that has been suggested to increase energy expenditure in obese patients. However, there is limited clinical information on the biology of irisin in humans, especially in morbidly obese patients undergoing bariatric surgery. We aimed to assess the association of circulating irisin concentrations with weight loss in obese patients undergoing bariatric surgery. This was a pilot, single-centre, longitudinal observational study. We recruited 25 morbidly obese subjects who underwent Roux-en-Y gastric bypass surgery (RYGBP), and blood samples from 12 patients were taken to measure serum irisin concentrations before, and one and nine months after surgery. Their clinical characteristics were measured for one year. The preoperative serum irisin concentration (mean 1.01 ± 0.23 μg/mL, range 0.73–1.49) changed bidirectionally one month after RYGBP. The mean concentration at nine months was 1.11 ± 0.15 μg/mL (range 0.92–1.35). Eight patients had elevated irisin levels compared with their preoperative values, but four did not. Elevations of irisin levels nine months, but not one month, after surgery, were associated with lower preoperative levels (p = 0.016) and worse weight reduction rates (p = 0.006 for the percentage excess weight loss and p = 0.032 for changes in body mass index). The preoperative serum irisin concentrations were significantly correlated with the percentage of excess weight loss for one year (R2 = 0.612; p = 0.04) in our study. Our results suggest that preoperative circulating irisin concentrations may be at least in part associated with a weight loss effect of bariatric surgery in morbidly obese patients. Further large-scale clinical studies are needed to ratify these findings.

PL-206: Protein intake compliane of morbidly obese patients undergoing laparoscopic Roux-en-Y gastric bypass and its effect on weight loss, leptin and albumin

2010 ◽  
Vol 6 (3) ◽  
pp. S11-S12
Author(s):  
Kristine O'Hara ◽  
Bruce Bernstein ◽  
Ravi Chhatrala ◽  
Balaji Jangam ◽  
Judy Carty ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Protein Intake ◽  
Morbidly Obese ◽  
Obese Patients

scholarly journals Factors associated with secondary hyperparathyroidism in premenopausal women undergoing Roux-en-Y gastric bypass for the treatment of obesity

2010 ◽  
Vol 54 (2) ◽  
pp. 233-238 ◽  
Author(s):  
Renata Simões de Vasconcelos ◽  
Maíra Viégas ◽  
Thyciara Fontenele Marques ◽  
Erik Trovão Diniz ◽  
Cynthia Salgado Lucena ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Secondary Hyperparathyroidism ◽  
Serum Calcium ◽  
Vertebral Fractures ◽  
Case Series ◽  
Premenopausal Women ◽  
Surgical Patients ◽  
Morbidly Obese ◽  
X Rays ◽  
Mineral Density

OBJECTIVE: To evaluate bone metabolism, bone density (BMD) and vertebral fractures in morbidly obese individuals. SUBJECTS AND METHODS: Case series of 29 premenopausal obese patients, 15 of whom had been submitted to bariatric surgery. Serum calcium, albumin, PTH and 25-hydroxy vitamin D (25OHD) were measured as well as bone densitometry of the lumbar spine and proximal femur, and lateral spine x-rays. RESULTS: High parathyroid hormone (PTH) levels were recorded in 46.6% of the surgical patients and in 21.4% of the non-surgical patients (p = 0.245); 26.7% of the former and 28.6% of the latter revealed levels 25OHD < 30 ng/mL (p = 1.000). Calcium intake was higher in the surgical group (p = 0.004) along with lower serum calcium concentrations (p = 0.019). There were no significant differences in bone mineral density (BMD) or in the prevalence of vertebral fractures between groups. CONCLUSION: In premenopausal women undergoing Roux-en-Y gastric bypass there is important intestinal calcium mal absorption which seems to be the main factor causing secondary hyperparathyroidism.

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