Dadson Prince, Rebelos Eleni, Jaakkola Maria K, Monfort-Pires Milena, Ojala Ronja, Honka Henri, Kalliokoski Kari K, Klén Riku, Nuutila Pirjo, Ivaska Kaisa K
Turku PET Centre, University of Turku, Turku, Finland.
Turku PET Centre, Turku University Hospital, Turku, Finland.
Int J Obes (Lond). 2025 Aug 26. doi: 10.1038/s41366-025-01888-1.
Obesity suppresses bone turnover markers (BTMs) in circulation, and weight loss after metabolic and bariatric surgery (MBS) increases BTM levels. However, the relationship between regional fat distribution and BTMs has not been thoroughly investigated. This study aimed to determine which specific fat compartments - namely abdominal and femoral subcutaneous fat (SF), intraperitoneal fat, extraperitoneal fat, and total visceral fat (VF) - have the greatest impact on circulating BTM levels following weight loss induced by MBS.
The study comprised a cohort of individuals with severe obesity (n = 46) studied before and 6 months after MBS, either sleeve gastrectomy (SG, n = 25) or Roux-en-Y gastric bypass (RYGB, n = 21). Healthy individuals without obesity (n = 25) served as controls. Regional fat depots were quantified with magnetic resonance imaging. The BTMs included Tartrate-Resistant Acid Phosphatase 5b, C-terminal Telopeptide of Type I Collagen (CTX), Procollagen Type I N-terminal Propeptide (PINP), and Total (TotalOC), Carboxylated (cOC), and Undercarboxylated (ucOC) osteocalcin.
In the pooled baseline analysis, no significant associations were observed between fat depots and BTMs (all p > 0.05). Postoperatively, distinct patterns emerged between surgical groups. In the SG cohort, femoral SF was inversely associated with cOC levels (p < 0.05) compared to the RYGB group. Following RYGB, extraperitoneal, intraperitoneal, and total VF were significantly associated with TotalOC, while intraperitoneal and total VF were also negatively associated with ucOC (all p < 0.05) compared to SG. All p-values were adjusted for false discovery rate to correct for multiple comparisons.
The findings suggest a specific interaction between intraperitoneal, extraperitoneal, and total visceral compartments and bone metabolism following RYGB. These observed relationships highlight the need for clinicians to consider regional fat distribution when assessing bone health in post-MBS patients.
NCT00793143 and NCT01373892.
肥胖会抑制循环中的骨转换标志物（BTMs），代谢和减重手术后体重减轻会使BTM水平升高。然而，局部脂肪分布与BTMs之间的关系尚未得到充分研究。本研究旨在确定哪些特定的脂肪区域——即腹部和股部皮下脂肪（SF）、腹腔内脂肪、腹膜外脂肪和总内脏脂肪（VF）——在代谢和减重手术（MBS）引起的体重减轻后对循环BTM水平影响最大。
本研究纳入了一组严重肥胖个体（n = 46），在MBS术前及术后6个月进行研究，其中袖状胃切除术（SG，n = 25）或Roux-en-Y胃旁路术（RYGB，n = 21）。无肥胖的健康个体（n = 25）作为对照。用磁共振成像对局部脂肪库进行定量分析。BTMs包括抗酒石酸酸性磷酸酶5b、I型胶原C端肽（CTX）、I型前胶原N端前肽（PINP）以及总骨钙素（TotalOC）、羧化骨钙素（cOC）和未羧化骨钙素（ucOC）。
在汇总的基线分析中，未观察到脂肪库与BTMs之间存在显著关联（所有p > 0.05）。术后，不同手术组呈现出不同模式。在SG组中，与RYGB组相比，股部SF与cOC水平呈负相关（p < 0.05）。RYGB术后，腹膜外、腹腔内和总VF与TotalOC显著相关，而与SG组相比，腹腔内和总VF与ucOC也呈负相关（所有p < 0.05）。所有p值均经错误发现率校正以校正多重比较。
研究结果表明RYGB术后腹腔内、腹膜外和总内脏区域与骨代谢之间存在特定相互作用。这些观察到的关系凸显了临床医生在评估MBS术后患者骨骼健康时考虑局部脂肪分布的必要性。
NCT00793143和NCT01373892。
