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The role of serum osteoprotegerin and receptor–activator of nuclear factor-κB ligand in metabolic bone disease of women after obesity surgery

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Abstract

Metabolic bone disease may appear as a complication of obesity surgery. Because an imbalance in the osteoprotegerin and receptor–activator of nuclear factor-κB ligand system may underlie osteoporosis, we aimed to study this system in humans in the metabolic bone disease occurring after obesity surgery. In this study we included sixty women with a mean age of 47 ± 10 years studied 7 ± 2 years after bariatric surgery. The variables studied were bone mineral density, β-isomer of C-terminal telopeptide of type I collagen cross-links (a bone resorption marker), the bone formation markers osteocalcin and N-terminal propeptide of procollagen 1, serum osteoprotegerin and receptor–activator of nuclear factor-κB ligand. Serum osteoprotegerin inversely correlated with the bone remodeling markers osteocalcin, β-isomer of C-terminal telopeptide of type I collagen cross-links and N-terminal propeptide of procollagen 1. The osteoprotegerin and receptor–activator of nuclear factor-κB ligand ratio also correlated inversely with serum parathormone and osteocalcin. Bone mineral density at the lumbar spine was associated with age (β = −0.235, P = 0.046), percentage of weight loss (β = 0.421, P = 0.001) and osteoprotegerin and receptor–activator of nuclear factor-κB ligand ratio (β = 0.259, P = 0.029) in stepwise multivariate analysis (R 2 = 0.29, F = 7.49, P < 0.001). Bone mineral density at the hip site was associated only with percentage of weight loss (β = 0.464, P < 0.001) in stepwise multivariate regression (R 2 = 0.21, F = 15.1, P < 0.001). These data show that the osteoprotegerin and receptor–activator of nuclear factor-κB ligand system is associated with bone markers and bone mineral density at the lumbar spine after obesity surgery.

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Acknowledgments

We thank the nursing staff of the Department of Endocrinology and Nutrition for their help with the anthropometric and blood sampling of the patients. This work was supported by the Fundación para la Investigación Biomédica del Hospital Universitario Ramón y Cajal (FIBio-HRC 119/08).

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Author notes

  1. José A. Balsa

    Present address: Department of Endocrinology and Nutrition, Hospital Infanta Sofía, Madrid, Spain

Authors and Affiliations

  1. Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera de Colmenar Km. 9.1, 28034, Madrid, Spain

    José A. Balsa, Christian Lafuente, Jesús M. Gómez-Martín, Héctor F. Escobar-Morreale & José I. Botella-Carretero

  2. Department of Digestive and General Surgery, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain

    Julio Galindo, Roberto Peromingo, Francisca García-Moreno & Gloria Rodriguez-Velasco

  3. Department of Biochemistry-Research, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain

    Javier Martínez-Botas & Diego Gómez-Coronado

  4. Centro de Investigación Biomédica en Red-Fisiopatología de Obesidad y Nutrición (CIBERobn), Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain

    Javier Martínez-Botas, Diego Gómez-Coronado & José I. Botella-Carretero

  5. Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain

    Héctor F. Escobar-Morreale

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  1. José A. Balsa
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Correspondence to José I. Botella-Carretero.

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Conflict of interest

José A. Balsa, Christian Lafuente, Jesús M. Gómez-Martín, Julio Galindo, Roberto Peromingo, Francisca García-Moreno, Gloria Rodriguez-Velasco, Javier Martínez-Botas, Diego Gómez-Coronado, Héctor F. Escobar-Morreale declare no conflict of interest. José I. Botella-Carretero, the corresponding Author and Principal Investigator of this study, also declares no conflict of interest.

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Balsa, J.A., Lafuente, C., Gómez-Martín, J.M. et al. The role of serum osteoprotegerin and receptor–activator of nuclear factor-κB ligand in metabolic bone disease of women after obesity surgery. J Bone Miner Metab 34, 655–661 (2016). https://doi.org/10.1007/s00774-015-0712-0

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