ECE2014 Poster Presentations Obesity (53 abstracts)
Bariatric surgery and bone loss: novel mechanisms and comparison of different modalities
Malgorzata Brzozowska 1, , Dana Bliuc 1 , Angel Hong 3 , John Jorgensen 4 , Michael Talbot 4 , Georgia Rigas 4 , Weiwen Chen 1, , Nicholas Pocock 2, , John Eisman 1, , Christopher White 3 , Paul Baldock 1, & Jacqueline Center 1,
1Garvan Institute of Medical Research, Darlinghurst, Sydney, Australia; 2St Vincent’s Hospital, Darlinghurst, Sydney, Australia; 3Prince of Wales Hospital, Randwick, Sydney, Australia; 4St George Private Hospital, Kogarah, Sydney, Australia; 5University of Notre Dame, Sydney, Australia; 6University of New South Wales, Kensington, Sydney, Australia.
Although bariatric surgery is the most effective weight loss therapy, its skeletal consequences are unclear. The aim of this study was to assess the impact of weight loss, gut hormones, adiponectin on bone loss in people undergoing Dieting (Diet), Gastric Banding (GB) and Gastric Sleeve (GS) over 24 months post-intervention.
There were 15 Diet, 8 GB and 20 GS subjects with mean (±S.D.) age 53 (12) years and BMI 39 (6). At 12 months mean (±S.D.) % weight change was Diet – 4.5 (5), GB – 12 (6), and GS – 26 (8), P<0.0001. Bone loss (total hip (TH), %) was −0.86 (1.6) in Diet and −1.6 (1.5) in GB. For GS maximal weight loss occurred in the first 6 months but bone loss continued: 3.5 (2) % at 6 months, 6.1 (3) % at 12 months, P<0.0001. The mean postprandial PYY % (+90 min) response differed between groups: Diet 58 (102), GB 70 (74), GS 150 (106), P<0.0008. Adiponectin change (%) varied between groups: Diet 4 (22), GB 21 (19), GS 75 (62), P=0.0022 without significant GLP-1 change. Bone turnover markers increased only in GS with osteocalcin by 110 (89)% and uNTX by 89(83) %, P<0.001. Calcium intake, vitamin D and PTH were normal throughout.
For all study patients at 12 months their BMD loss correlated significantly with weight loss, postprandial PYY and adiponectin. In the multivariate analysis weight loss and PYY response explained 56% of TH BMD loss (P<0.0001).
GS patients with 24 months data (n=12) had ongoing 9 (3) % TH BMD loss, P<0.001 despite no further weight loss.
GS was the most efficient weight loss modality. However, there was evidence of ongoing bone loss in GS not explained by weight loss alone and associated with postprandial PYY and adiponectin changes. These findings have significant implications for people undergoing bariatric surgery and longer term studies of bone health are needed.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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