Format

Send to

Choose Destination
Obes Surg. 2019 Aug 16. doi: 10.1007/s11695-019-04127-5. [Epub ahead of print]

Changes in Bone Mineral Density in Patients with Type 2 Diabetes After Different Bariatric Surgery Procedures and the Role of Gastrointestinal Hormones.

Author information

1
Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
2
Department of General and Gastrointestinal Surgery. Bariatric Surgery Unit, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
3
Department of Rheumatology, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
4
Clinical Nutrition Unit, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
5
Department of Endocrinology and Nutrition and Health Sciences Research Institute, University Hospital Germans Trias i Pujol, Badalona, Spain.
6
CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Barcelona, Spain.
7
Instituto de Investigación Biomédica-IDIBELL,, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
8
Diabetes and Metabolic Associated Diseases Research Group, Hospital Joan XXIII, School of Medicine, Rovira i Virgili University, Tarragona, Spain.
9
CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Barcelona, Spain. jvo@comt.es.
10
Diabetes and Metabolic Associated Diseases Research Group, Hospital Joan XXIII, School of Medicine, Rovira i Virgili University, Tarragona, Spain. jvo@comt.es.
11
Department of Endocrinology and Nutrition, Bellvitge University Hospital-IDIBELL, c/ Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain. nuriavilarrasa@yahoo.es.
12
CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Barcelona, Spain. nuriavilarrasa@yahoo.es.

Abstract

BACKGROUND:

To compare changes in bone mineral density (BMD) in patients with morbid obesity and type 2 diabetes (T2D) a year after being randomized to metabolic gastric bypass (mRYGB), sleeve gastrectomy (SG), and greater curvature plication (GCP). We also analyzed the association of gastrointestinal hormones with skeletal metabolism.

METHODS:

Forty-five patients with T2D (mean BMI 39.4 ± 1.9 kg/m2) were randomly assigned to mRYGB, SG, or GCP. Before and 12 months after surgery, anthropometric, body composition, biochemical parameters, fasting plasma glucagon, ghrelin, and PYY as well as GLP-1, GLP-2, and insulin after a standard meal were determined.

RESULTS:

After surgery, the decrease at femoral neck (FN) was similar but at lumbar spine (LS), it was greater in the mRYGB group compared with SG and GCP - 7.29 (4.6) vs. - 0.48 (3.9) vs. - 1.2 (2.7)%, p < 0.001. Osteocalcin and alkaline phosphatase increased more after mRYGB. Bone mineral content (BMC) at the LS after surgery correlated with fasting ghrelin (r = - 0.412, p = 0.01) and AUC for GLP-1 (r = - 0.402, p = 0.017). FN BMD at 12 months correlated with post-surgical fasting glucagon (r = 0.498, p = 0.04) and insulin AUC (r = 0.384, p = 0.030) and at LS with the AUC for GLP-1 in the same time period (r = - 0.335, p = 0.049). However, in the multiple regression analysis after adjusting for age, sex, and BMI, the type of surgery (mRYGB) remained the only factor associated with BMD reduction at LS and FN.

CONCLUSIONS:

mRYGB induces greater deleterious effects on the bone at LS compared with SG and GCP, and gastrointestinal hormones do not play a major role in bone changes.

KEYWORDS:

Bariatric surgery; Bone mineral density; Gastrointestinal hormones

PMID:
31420830
DOI:
10.1007/s11695-019-04127-5

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center