Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Obesity Surgery
Published in: Obesity Surgery 1/2008

01-01-2008 | Research Article

Effects of Weight Loss on Bone Status after Bariatric Surgery: Association Between Adipokines and Bone Markers

Authors: Hélène Wucher, Cécile Ciangura, Christine Poitou, Sébastien Czernichow

Published in: Obesity Surgery | Issue 1/2008

Login to get access

Abstract

Background

The prevalence of overweight and obesity is increasing dramatically worldwide. As a consequence, bariatric surgery for morbid obesity is in constant development. Although bariatric surgery has proven its efficiency at achieving weight loss and correcting comorbidities, it may cause vitamin deficiencies and subsequent complications. The goal of this review is to assess the impact of obesity surgery on bone metabolism and to analyze the underlying mechanisms and relationships with adipokines. Our review focuses on gastric banding, vertical banded gastroplasty, and gastric bypass.

Methods

The articles were located via PubMed database, using the key words “bariatric surgery,” “weight loss,” “bone loss,” and “bone metabolism” and published until May 2006.

Results

Five main studies were reviewed concerning gastric banding and six concerning Roux-en-Y gastric bypass. An early increase in bone markers (formation and resorption) is constantly found, prevailing on bone resorption, and resulting in early bone loss.

Conclusion

According to the few studies available, bone loss frequently occurs after bariatric surgery and particularly in a more pronounced way after gastric bypass, but its clinical significance is still under discussion. In addition, the physiopathology of these changes remains unclear, but could implicate adipokines such as leptin and adiponectin.
Literature
1.
Ogden CL, Carroll MD, Curtin LR, et al. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 2006;295:1549–55.PubMedCrossRef
2.
3.
Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004;351:2683–93.PubMedCrossRef
4.
Craig BM, Tseng DS. Cost-effectiveness of gastric bypass for severe obesity. Am J Med 2002;113:491–8.PubMedCrossRef
5.
Sampalis JS, Liberman M, Auger S, et al. The impact of weight reduction surgery on health-care costs in morbidly obese patients. Obes Surg 2004;14:939–47.PubMedCrossRef
6.
Shah M, Simha V, Garg A. Review: long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. J Clin Endocrinol Metab 2006;91:4223–31.PubMedCrossRef
7.
Ducy P, Amling M, Takeda S, et al. Leptin inhibits bone formation through a hypothalamic relay: a central control of bone mass. Cell 2000;100:197–207.PubMedCrossRef
8.
Elefteriou F, Ducy P. Control of body mass by leptin occurs through the sympathetic nervous system. Med Sci (Paris) 2003;19:391–3.
9.
Lenchik L, Register TC, Hsu FC, et al. Adiponectin as a novel determinant of bone mineral density and visceral fat. Bone 2003;33:646–51.PubMedCrossRef
10.
Chapin BL, LeMar HJ Jr, Knodel DH, et al. Secondary hyperparathyroidism following biliopancreatic diversion. Arch Surg 1996;131:1048–52.PubMed
11.
Compston JE, Horton LW, Laker MF, et al. Bone disease after jejuno-ileal bypass for obesity. Lancet 1978;2:1–4.PubMedCrossRef
12.
Compston JE, Vedi S, Gianetta E, et al. Bone histomorphometry and vitamin D status after biliopancreatic bypass for obesity. Gastroenterology 1984;87:350–6.PubMed
13.
Marceau P, Biron S, Lebel S, et al. Does bone change after biliopancreatic diversion? J Gastrointest Surg 2002;6:690–8.PubMedCrossRef
14.
Newbury L, Dolan K, Hatzifotis M, et al. Calcium and vitamin D depletion and elevated parathyroid hormone following biliopancreatic diversion. Obes Surg 2003;13:893–5.PubMedCrossRef
15.
Shaker JL, Norton AJ, Woods MF, et al. Secondary hyperparathyroidism and osteopenia in women following gastric exclusion surgery for obesity. Osteoporos Int 1991;1:177–81.PubMedCrossRef
16.
Slater GH, Ren CJ, Siegel N, et al. Serum fat-soluble vitamin deficiency and abnormal calcium metabolism after malabsorptive bariatric surgery. J Gastrointest Surg 2004;8:48–55.PubMedCrossRef
17.
Vage V, Solhaug JH, Berstad A, et al. Jejunoileal bypass in the treatment of morbid obesity: a 25-year follow-up study of 36 patients. Obes Surg 2002;12:312–8.PubMedCrossRef
18.
Vage V, Gjesdal CG, Eide GE, et al. Bone mineral density in females after jejunoileal bypass: a 25-year follow-up study. Obes Surg 2004;14:305–12.PubMedCrossRef
19.
Cundy T, Evans MC, Kay RG, et al. Effects of vertical-banded gastroplasty on bone and mineral metabolism in obese patients. Br J Surg 1996;83:1468–72.PubMedCrossRef
20.
Giusti V, Gasteyger C, Suter M, et al. Gastric banding induces negative bone remodelling in the absence of secondary hyperparathyroidism: potential role of serum C telopeptides for follow-up. Int J Obes (Lond) 2005;29:1429–35.CrossRef
21.
Guney E, Kisakol G, Ozgen G, et al. Effect of weight loss on bone metabolism: comparison of vertical banded gastroplasty and medical intervention. Obes Surg 2003;13:383–8.PubMedCrossRef
22.
Pugnale N, Giusti V, Suter M, et al. Bone metabolism and risk of secondary hyperparathyroidism 12 months after gastric banding in obese pre-menopausal women. Int J Obes Relat Metab Disord 2003;27:110–6.PubMedCrossRef
23.
Strauss BJ, Marks SJ, Growcott JP, et al. Body composition changes following laparoscopic gastric banding for morbid obesity. Acta Diabetol 2003;40(Suppl 1):S266–9.PubMedCrossRef
24.
Coates PS, Fernstrom JD, Fernstrom MH, et al. Gastric bypass surgery for morbid obesity leads to an increase in bone turnover and a decrease in bone mass. J Clin Endocrinol Metab 2004;89:1061–5.PubMedCrossRef
25.
Goode LR, Brolin RE, Chowdhury HA, et al. Bone and gastric bypass surgery: effects of dietary calcium and vitamin D. Obes Res 2004;12:40–7.PubMed
26.
Johnson JM, Maher JW, Samuel I, et al. Effects of gastric bypass procedures on bone mineral density, calcium, parathyroid hormone, and vitamin D. J Gastrointest Surg 2005;9:1106–10.PubMedCrossRef
27.
Johnson JM, Maher JW, DeMaria EJ, et al. The long-term effects of gastric bypass on vitamin D metabolism. Ann Surg 2006;243:701–4.PubMedCrossRef
28.
Ott MT, Fanti P, Malluche HH, et al. Biochemical evidence of metabolic bone disease in women following Roux-Y gastric bypass for morbid obesity. Obes Surg 1992;2:341–8.PubMedCrossRef
29.
von Mach MA, Stoeckli R, Bilz S, et al. Changes in bone mineral content after surgical treatment of morbid obesity. Metabolism 2004;53:918–21.CrossRef
30.
De PC, Levine SN. Metabolic bone disease after gastric bypass surgery for obesity. Am J Med Sci 2005;329:57–61.CrossRef
31.
Colquitt J, Clegg A, Sidhu M, et al. Surgery for morbid obesity. Cochrane Database Syst Rev 2003;CD003641.
32.
Sahota O, Mundey MK, San P, et al. The relationship between vitamin D and parathyroid hormone: calcium homeostasis, bone turnover, and bone mineral density in postmenopausal women with established osteoporosis. Bone 2004;35:312–9.PubMedCrossRef
33.
Buchwald H, Buchwald JN. Evolution of operative procedures for the management of morbid obesity 1950–2000. Obes Surg 2002;12:705–17.PubMedCrossRef
34.
Liel Y, Edwards J, Shary J, et al. The effects of race and body habitus on bone mineral density of the radius, hip, and spine in premenopausal women. J Clin Endocrinol Metab 1988;66:1247–50.PubMedCrossRef
35.
Mazess RB, Barden HS, Drinka PJ, et al. Influence of age and body weight on spine and femur bone mineral density in U.S. white men. J Bone Miner Res 1990;5:645–52.PubMedCrossRef
36.
Orozco P, Nolla JM. Associations between body morphology and bone mineral density in premenopausal women. Eur J Epidemiol 1997;13:919–24.PubMedCrossRef
37.
Bell NH, Epstein S, Greene A, et al. Evidence for alteration of the vitamin D-endocrine system in obese subjects. J Clin Invest 1985;76:370–3.PubMedCrossRef
38.
Bastounis EA, Karayiannakis AJ, Syrigos K, et al. Sex hormone changes in morbidly obese patients after vertical banded gastroplasty. Eur Surg Res 1998;30:43–7.PubMedCrossRef
39.
Teitelman M, Grotegut CA, Williams NN, et al. The impact of bariatric surgery on menstrual patterns. Obes Surg 2006;16:1457–63.PubMedCrossRef
40.
Karsenty G. Convergence between bone and energy homeostases: leptin regulation of bone mass. Cell Metab 2006;4:341–8.PubMedCrossRef
41.
Elefteriou F, Ahn JD, Takeda S, et al. Leptin regulation of bone resorption by the sympathetic nervous system and CART. Nature 2005;434:514–20.PubMedCrossRef
42.
Ahima RS. Metabolic actions of adipocyte hormones: focus on adiponectin. Obesity (Silver Spring) 2006;14(Suppl 1):9S–15S.
43.
Luo XH, Guo LJ, Yuan LQ, et al. Adiponectin stimulates human osteoblasts proliferation and differentiation via the MAPK signaling pathway. Exp Cell Res 2005;309:99–109.PubMedCrossRef
44.
Luo XH, Guo LJ, Xie H, et al. Adiponectin stimulates RANKL and inhibits OPG expression in human osteoblasts through the MAPK signaling pathway. J Bone Miner Res 2006;21:1648–56.PubMedCrossRef
45.
Van Loan MD, Johnson HL, Barbieri TF. Effect of weight loss on bone mineral content and bone mineral density in obese women. Am J Clin Nutr 1998;67:734–8.PubMed
46.
Tothill P, Hannan WJ, Cowen S, et al. Anomalies in the measurement of changes in total-body bone mineral by dual-energy X-ray absorptiometry during weight change. J Bone Miner Res 1997;12:1908–21.PubMedCrossRef
47.
Tothill P, Laskey MA, Orphanidou CI, et al. Anomalies in dual energy X-ray absorptiometry measurements of total-body bone mineral during weight change using Lunar, Hologic and Norland instruments. Br J Radiol 1999;72:661–69.PubMed
48.
Andersen RE, Wadden TA, Herzog RJ. Changes in bone mineral content in obese dieting women. Metabolism 1997;46:857–61.PubMedCrossRef
49.
Gotfredsen A, Westergren HH, Andersen T. Influence of orlistat on bone turnover and body composition. Int J Obes Relat Metab Disord 2001;25:1154–60.PubMedCrossRef
50.
Ricci TA, Heymsfield SB, Pierson RN Jr, et al. Moderate energy restriction increases bone resorption in obese postmenopausal women. Am J Clin Nutr 2001;73:347–52.PubMed
51.
De Laet C, Kanis JA, Oden A, et al. Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 2005;16:1330–8.PubMedCrossRef
52.
Johnell O, Kanis JA, Oden A, et al. Predictive value of BMD for hip and other fractures. J Bone Miner Res 2005;20:1185–94.PubMedCrossRef
Metadata
Title
Effects of Weight Loss on Bone Status after Bariatric Surgery: Association Between Adipokines and Bone Markers
Authors
Hélène Wucher
Cécile Ciangura
Christine Poitou
Sébastien Czernichow
Publication date
01-01-2008
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 1/2008
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-007-9258-0

Other articles of this Issue 1/2008

Obesity Surgery 1/2008 Go to the issue

Research Article

Incidence of Lower Limbs Deep Vein Thrombosis After Open and Laparoscopic Gastric Bypass: A Prospective Study

OriginalPaper

Influence of Sleeve Gastrectomy on Several Experimental Models of Obesity: Metabolic and Hormonal Implications

Research Article

The Impact of Race on Weight Loss After Roux-en-Y Gastric Bypass Surgery

Research Article

Weight Loss and Body Composition During the First Postoperative Year of a Laparoscopic Roux-En-Y Gastric Bypass

OriginalPaper

Challenges in Pulmonary Risk Assessment and Perioperative Management in Bariatric Surgery Patients

Review

Challenges in Cardiac Risk Assessment in Bariatric Surgery Patients