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Bariatric Roux-En-Y Gastric Bypass Surgery: Adipocyte Proteins Involved in Increased Bone Remodeling in Humans

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Abstract

Purpose

Bariatric surgery has been associated with bone remodeling changes. The action of adipokines on the expression of receptor activator of nuclear factor kappa β ligand (RANKL) and osteoprotegerin (OPG) and on an increase in sclerostin could be related to these changes.

Materials and Methods

This study aimed to assess the repercussions of weight loss, fat mass (FM), and fat-free mass (FFM) loss and biochemical and hormonal changes on bone remodeling markers after Roux-en-Y gastric bypass (RYGB). Anthropometric data, parathyroid hormone (PTH), bone-specific alkaline phosphatase (BSAP), collagen type 1 C-telopeptide (CTX), 25-hydroxy vitamin D (25-OH-VitD), leptin, adiponectin, RANKL, OPG, and sclerostin of 30 menstruating women were measured preoperatively (Pre), and 3, 12, and 24 months (m) after RYGB.

Results

Leptin (34.4 (14.7; 51.9) vs. 22.5 (1.9; 52.7) ng/mL) and OPG (3.6 (1.1; 11.5) vs. 3.4 (1.5; 6) pmol/L) decreased, and adiponectin (7.4 (1.7; 18.4) vs. 13.8 (3.0; 34.6) μg/mL), CTX (0.2 (0.1; 2.2) vs. 0.6 (0.4; 6.0) ng/mL), RANKL (0.1 (0.0; 0.5) vs. 0.3 (0.0; 2.0) pmol/L), and sclerostin (21.7 (3.2; 75.1) vs. 34.8 (6.4; 80.5) pmol/L) increased after 3 m. BSAP increased after 12 m (10.1 (5.4; 18.9) vs. 13.9 (6.9; 30.2) μg/mL) (p < 0.005). CTX correlated positively with adiponectin at 24 m and inversely with leptin Pre; OPG at 3 m; weight, FM, FFM, and leptin at 24 m. RANKL correlated directly with weight at 3 m. Sclerostin correlated inversely with weight Pre and FM at 3 m. BSAP correlated negatively with 25-OH-VitD at 12 m, and positively with PTH at 24 m.

Conclusions

RYGB induced weight loss, and biochemical, hormonal, and body composition changes are associated with higher bone remodeling.

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Acknowledgments

This project was supported by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), process number 2009/50169-6. The authors gratefully acknowledge the statistical support of Dr HRC Nunes and are grateful to the surgeons and nursing staff of the Surgery Department, Clinical Hospital, FMB, Unesp.

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Authors and Affiliations

  1. Internal Medicine Department (MFGB, ALM, CRN, LG, GMFSM), Botucatu Medical School, São Paulo State University, FMB-Unesp, Botucatu, Brazil

    Maria Fernanda G Biagioni, Adriana L Mendes, Célia Regina Nogueira, Loraine Gollino & Gláucia MFS Mazeto

  2. Internal Medicine Department, Botucatu Medical School, São Paulo State University, FMB-Unesp, Rubião Júnior District, no number, Botucatu, SP, 18618-970, Brazil

    Maria Fernanda G Biagioni

  3. Surgery Department (CVL), Botucatu Medical School, São Paulo State University, FMB-Unesp, Botucatu, Brazil

    Celso V Leite

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  1. Maria Fernanda G Biagioni
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  2. Adriana L Mendes
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Correspondence to Maria Fernanda G Biagioni.

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The study was approved by the local Research Ethics Committee (protocol number 3710-2010) and was conducted according to the principles of the 1964 Helsinki Declaration. Informed consent was obtained from all individual participants included in the study.

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The authors declare that they have no conflict of interest.

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Biagioni, M.F.G., Mendes, A.L., Nogueira, C.R. et al. Bariatric Roux-En-Y Gastric Bypass Surgery: Adipocyte Proteins Involved in Increased Bone Remodeling in Humans. OBES SURG 27, 1789–1796 (2017). https://doi.org/10.1007/s11695-017-2546-4

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