Couchot Malory, Schmitt Françoise, Mermet Morgane, Fassot Céline, Mabilleau Guillaume
Univ Angers, Nantes Université, ONIRIS, Inserm, RMeS, UMR 1229, 49000, Angers, France.
Univ Angers, HIFIH, 49000, Angers, France.
Calcif Tissue Int. 2025 Jan 4;116(1):23. doi: 10.1007/s00223-024-01321-1.
Obesity is a major public health issue worldwide. Despite various approaches to weight loss, the most effective technique for reducing obesity, as well as diabetes and associated diseases, is bariatric surgery. Increasingly, young women without children are undergoing bariatric surgery, vertical sleeve gastrectomy (VSG) being the most common procedure nowadays. However, despite several reports suggesting bone loss after VSG, little is known about the potential additive effects of gestation and lactation after VSG to bone health. This study investigated the combined effects of pre-gestational VSG and subsequent gestation/lactation on bone metabolism in a rat model fed a high fat high sugar (HFHS) diet, with a focus on bone biomechanics, mass, microarchitecture and material properties. Furthermore, bone mass and remodelling were followed longitudinally by microCT prior to surgery, 4 weeks post-surgery, after weaning and at sacrifice. Significant alterations in bone mass and microarchitecture, characterized by changes in trabecular thickness and number, as well as changes in bone formation and resorption were influenced by both surgery and reproductive demands. Mechanical testing at sacrifice demonstrated compromised long bone fragility, in rat with HFHS regardless of the surgical procedure (Sham or VSG). Furthermore, analysis of bone material properties highlighted potential disruptions in the pattern of bone mineralization in sham and VSG animals fed a HFHS diet. These findings underscore the complex interplay between pre-gestational VSG and subsequent gestation/lactation in modulating bone metabolism in the investigated rat model. The preclinical rat model may help with optimizing surgical strategies and developing targeted interventions to mitigate potential bone-related complications associated with VSG in reproductive-aged individuals.
肥胖是全球主要的公共卫生问题。尽管有多种减肥方法，但减少肥胖以及糖尿病和相关疾病最有效的技术是减肥手术。越来越多未育的年轻女性正在接受减肥手术，其中垂直袖状胃切除术（VSG）是目前最常见的术式。然而，尽管有几份报告表明VSG术后会出现骨质流失，但关于VSG术后妊娠和哺乳对骨骼健康的潜在叠加影响却知之甚少。本研究在高脂高糖（HFHS）饮食喂养的大鼠模型中，研究了孕前VSG及随后的妊娠/哺乳对骨代谢的综合影响，重点关注骨生物力学、骨量、微观结构和材料特性。此外，在手术前、手术后4周、断奶后和处死时，通过显微CT对骨量和重塑进行纵向跟踪。骨量和微观结构的显著改变，表现为小梁厚度和数量的变化，以及骨形成和吸收的变化，均受手术和生殖需求的影响。处死时的力学测试表明，无论手术方式（假手术或VSG）如何，HFHS饮食喂养的大鼠长骨脆性均受损。此外，对骨材料特性的分析突出了HFHS饮食喂养的假手术和VSG动物骨矿化模式的潜在破坏。这些发现强调了在研究的大鼠模型中，孕前VSG与随后的妊娠/哺乳在调节骨代谢方面的复杂相互作用。临床前大鼠模型可能有助于优化手术策略，并开发有针对性的干预措施，以减轻育龄个体中与VSG相关的潜在骨相关并发症。
