期刊
SURGERY FOR OBESITY AND RELATED DISEASES
卷 10, 期 5, 页码 878-884出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.soard.2014.01.021
关键词
Morbid obesity; Gastric bypass surgery; Bone turnover markers; Bone resorption; Metabolic bone disease; Metabolic acidosis; Peptide YY
类别
资金
- NIH [K08 DK089000-04, P30-AR46032, R03 DK100732-01]
- AUA Foundation Rising Star in Urology Research Award
- Veterans Affairs Grant [IK2 CX000549-03]
- Ethicon Endo-Surgery
- Astellas Global Development, Inc.
Background: Metabolic bone disease and bariatric surgery have long been interconnected. The objective of this study is to better understand the mechanisms of bone mass loss after Roux-en-Y gastric bypass (RYGB) surgery. We evaluated mineral homeostasis and bone mass in diet-induced obese (DIO) rats after RYGB or sham surgery. Methods: Twelve DIO male Sprague Dawley rats underwent RYGB (n = 8) or sham (n = 4) surgery at 21 weeks of age. Postoperatively, animals ate an ad libitum 40% fat, normal calcium diet and were euthanized 22 weeks later. Serum and urine chemistries, insulin, leptin, bone turnover markers (BTM), and calciotropic and gut hormones were measured before and 22 weeks after surgery. Femurs were analyzed using microcomputed tomography (mu CT). Results: Compared to sham, RYGB animals had lower serum bicarbonate, calcium, 25-hydroxyvitamin D, insulin, and leptin levels with higher serum parathyroid hormone, peptide YY, and urinary calcium at 43 weeks of age Sham control rats gained weight and had coupled decreases in formation (P1NP and OC) and unchanged resorption (CTX) BTMs. Comparatively, RYGB animals had higher serum CTX and OC but even lower P1NP levels than controls. mu CT revealed lower trabecular bone volume, number, and thickness and lower cortical bone volume, thickness, and moment of inertia relative to controls. Conclusion: In rats with DIO, long-term RYGB-associated bone resorption appears to be driven in part by vitamin D malabsorption and secondary hyperparathyroidism. Other mechanisms, such as chronic acidosis, changes in fat-secreted hormones, and persistently elevated gut-derived hormone peptide YY, may also contribute to observed bone mass differences. Further investigation of these potential contributors to bone loss may lead to new targets for skeletal maintenance after RYGB. (C) 2014 American Society for Metabolic and Bariatric Surgery. All rights reserved.
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