Balsa José A, Lafuente Christian, Gómez-Martín Jesús M, Galindo Julio, Peromingo Roberto, García-Moreno Francisca, Rodriguez-Velasco Gloria, Martínez-Botas Javier, Gómez-Coronado Diego, Escobar-Morreale Héctor F, Botella-Carretero José I
Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera de Colmenar Km. 9.1, 28034, Madrid, Spain.
Department of Endocrinology and Nutrition, Hospital Infanta Sofía, Madrid, Spain.
J Bone Miner Metab. 2016 Nov;34(6):655-661. doi: 10.1007/s00774-015-0712-0. Epub 2015 Oct 5.
Metabolic bone disease may appear as a complication of obesity surgery. Because an imbalance in the osteoprotegerin and receptor-activator of nuclear factor-κB ligand system may underlie osteoporosis, we aimed to study this system in humans in the metabolic bone disease occurring after obesity surgery. In this study we included sixty women with a mean age of 47 ± 10 years studied 7 ± 2 years after bariatric surgery. The variables studied were bone mineral density, β-isomer of C-terminal telopeptide of type I collagen cross-links (a bone resorption marker), the bone formation markers osteocalcin and N-terminal propeptide of procollagen 1, serum osteoprotegerin and receptor-activator of nuclear factor-κB ligand. Serum osteoprotegerin inversely correlated with the bone remodeling markers osteocalcin, β-isomer of C-terminal telopeptide of type I collagen cross-links and N-terminal propeptide of procollagen 1. The osteoprotegerin and receptor-activator of nuclear factor-κB ligand ratio also correlated inversely with serum parathormone and osteocalcin. Bone mineral density at the lumbar spine was associated with age (β = -0.235, P = 0.046), percentage of weight loss (β = 0.421, P = 0.001) and osteoprotegerin and receptor-activator of nuclear factor-κB ligand ratio (β = 0.259, P = 0.029) in stepwise multivariate analysis (R = 0.29, F = 7.49, P < 0.001). Bone mineral density at the hip site was associated only with percentage of weight loss (β = 0.464, P < 0.001) in stepwise multivariate regression (R = 0.21, F = 15.1, P < 0.001). These data show that the osteoprotegerin and receptor-activator of nuclear factor-κB ligand system is associated with bone markers and bone mineral density at the lumbar spine after obesity surgery.
代谢性骨病可能表现为肥胖手术的一种并发症。由于骨保护素与核因子κB受体激活剂配体系统失衡可能是骨质疏松的潜在原因，我们旨在研究肥胖手术后发生代谢性骨病的人群中的该系统。在本研究中，我们纳入了60名平均年龄为47±10岁的女性，她们在减肥手术后7±2年接受研究。所研究的变量包括骨密度、I型胶原交联C末端肽β异构体（一种骨吸收标志物）、骨形成标志物骨钙素和前胶原1的N末端前肽、血清骨保护素和核因子κB受体激活剂配体。血清骨保护素与骨重塑标志物骨钙素、I型胶原交联C末端肽β异构体和前胶原1的N末端前肽呈负相关。骨保护素与核因子κB受体激活剂配体比值也与血清甲状旁腺激素和骨钙素呈负相关。在逐步多变量分析中，腰椎骨密度与年龄（β=-0.235，P=0.046）、体重减轻百分比（β=0.421，P=0.001）以及骨保护素与核因子κB受体激活剂配体比值（β=0.259，P=0.029）相关（R=0.29，F=7.49，P<0.001）。在逐步多变量回归中，髋部骨密度仅与体重减轻百分比相关（β=0.464，P<0.001）（R=0.21，F=15.1，P<0.001）。这些数据表明，肥胖手术后，骨保护素与核因子κB受体激活剂配体系统与骨标志物及腰椎骨密度相关。
