Biagioni Maria Fernanda G, Mendes Adriana L, Nogueira Célia Regina, Leite Celso V, Gollino Loraine, Mazeto Gláucia Mfs
Internal Medicine Department (MFGB, ALM, CRN, LG, GMFSM), Botucatu Medical School, São Paulo State University, FMB-Unesp, Botucatu, Brazil.
Internal Medicine Department, Botucatu Medical School, São Paulo State University, FMB-Unesp, Rubião Júnior District, no number, Botucatu, SP, 18618-970, Brazil.
Obes Surg. 2017 Jul;27(7):1789-1796. doi: 10.1007/s11695-017-2546-4.
Bariatric surgery has been associated with bone remodeling changes. The action of adipokines on the expression of receptor activator of nuclear factor kappa β ligand (RANKL) and osteoprotegerin (OPG) and on an increase in sclerostin could be related to these changes.
This study aimed to assess the repercussions of weight loss, fat mass (FM), and fat-free mass (FFM) loss and biochemical and hormonal changes on bone remodeling markers after Roux-en-Y gastric bypass (RYGB). Anthropometric data, parathyroid hormone (PTH), bone-specific alkaline phosphatase (BSAP), collagen type 1 C-telopeptide (CTX), 25-hydroxy vitamin D (25-OH-VitD), leptin, adiponectin, RANKL, OPG, and sclerostin of 30 menstruating women were measured preoperatively (Pre), and 3, 12, and 24 months (m) after RYGB.
Leptin (34.4 (14.7; 51.9) vs. 22.5 (1.9; 52.7) ng/mL) and OPG (3.6 (1.1; 11.5) vs. 3.4 (1.5; 6) pmol/L) decreased, and adiponectin (7.4 (1.7; 18.4) vs. 13.8 (3.0; 34.6) μg/mL), CTX (0.2 (0.1; 2.2) vs. 0.6 (0.4; 6.0) ng/mL), RANKL (0.1 (0.0; 0.5) vs. 0.3 (0.0; 2.0) pmol/L), and sclerostin (21.7 (3.2; 75.1) vs. 34.8 (6.4; 80.5) pmol/L) increased after 3 m. BSAP increased after 12 m (10.1 (5.4; 18.9) vs. 13.9 (6.9; 30.2) μg/mL) (p < 0.005). CTX correlated positively with adiponectin at 24 m and inversely with leptin Pre; OPG at 3 m; weight, FM, FFM, and leptin at 24 m. RANKL correlated directly with weight at 3 m. Sclerostin correlated inversely with weight Pre and FM at 3 m. BSAP correlated negatively with 25-OH-VitD at 12 m, and positively with PTH at 24 m.
RYGB induced weight loss, and biochemical, hormonal, and body composition changes are associated with higher bone remodeling.
减重手术与骨重塑变化有关。脂肪因子对核因子κβ受体激活剂配体（RANKL）和骨保护素（OPG）表达以及硬化蛋白增加的作用可能与这些变化有关。
本研究旨在评估减重、脂肪量（FM）和去脂体重（FFM）减少以及生化和激素变化对 Roux-en-Y 胃旁路术（RYGB）后骨重塑标志物的影响。测量了 30 名月经周期正常女性术前（Pre）以及 RYGB 术后 3、12 和 24 个月（m）的人体测量数据、甲状旁腺激素（PTH）、骨特异性碱性磷酸酶（BSAP）、Ⅰ型胶原 C 末端肽（CTX）、25-羟基维生素 D（25-OH-VitD）、瘦素、脂联素、RANKL、OPG 和硬化蛋白。
术后 3 个月，瘦素（34.4（14.7；51.9）对 22.5（1.9；52.7）ng/mL）和 OPG（3.6（1.1；11.5）对 3.4（1.5；6）pmol/L）降低，脂联素（7.4（1.7；18.4）对 13.8（3.0；34.6）μg/mL）、CTX（0.2（0.1；2.2）对 0.6（0.4；6.0）ng/mL）、RANKL（0.1（0.0；0.5）对 0.3（0.0；2.0）pmol/L）和硬化蛋白（21.7（3.2；75.1）对 34.8（6.4；80.5）pmol/L）升高。术后 12 个月 BSAP 升高（10.1（5.4；18.9）对 13.9（6.9；30.2）μg/mL）（p < 0.005）。术后 24 个月 CTX 与脂联素呈正相关，术前与瘦素呈负相关；术后 3 个月与 OPG 呈负相关；术后 24 个月与体重、FM、FFM 和瘦素呈负相关。术后 3 个月 RANKL 与体重呈正相关。术后 3 个月硬化蛋白与术前体重和 FM 呈负相关。术后 12 个月 BSAP 与 25-OH-VitD 呈负相关，术后 24 个月与 PTH 呈正相关。
RYGB 导致体重减轻，生化、激素和身体成分变化与更高的骨重塑相关。
