Serum markers of bone turnover are increased at six and 18 months after Roux-en-Y bariatric surgery: correlation with the reduction in leptin
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Objective: The aim of the study was to examine serum markers of bone turnover at 6 and 18 months after Roux-en-Y gastric bypass surgery. Participants: Ten women and 10 men [body mass index (BMI), 50.2 ± 8.4 kg/m2] were studied at 6 months; 10 women and nine men (BMI, 47.2 ± 6.6 kg/m2) were studied at 18 months after surgery. Main Outcome Measures: Serum osteocalcin, bone specific alkaline phosphatase (BAP), N-telopeptide of type 1 collagen (NTX), PTH, 25-hydroxy vitamin D, and leptin were measured. Results: BMI was reduced 32.7 ± 6.2% at 6 months after surgery. Serum osteocalcin (6.9 ± 2.4 to 10.9 ± 2.6 ng/ml; P < 0.0001), BAP (14.2 ± 3.7 to 16.4 ± 4.5 ng/ml; P = 0.04), and NTX (10.9 ± 1.7 to 19.6 ± 5.3 nm bone collagen equivalents; P < 0.0001) were increased. Calcium, phosphate, and PTH were unchanged, but 25-hydroxy vitamin D increased (16.0 ± 8.9 vs. 26.9 ± 10.6 ng/ml; P <0.0001). The increase in NTX correlated with reduction in serum leptin (r = 0.58; P = 0.007). BMI was reduced 40.9 ± 7.5% at 18 months after surgery. Serum BAP (17.6 ± 5.3 to 22.2 ± 7.8 ng/ml; P = 0.0017) and NTX (10.8 ± 2.7 to 16.9 ± 5.5 nm bone collagen equivalents; P < 0.0001) were increased. Calcium, phosphate, and PTH were unchanged, but 25-hydroxy vitamin D increased (17.7 ± 7.6 to 25.6 ± 6.8 ng/ml; P < 0.0001). The increase in NTX correlated with reduction in BMI (r = 0.58; P = 0.009) and leptin (r = 0.45; P = 0.04) and the increase in serum 25-hydroxy vitamin D (r = 0.43; P = 0.05). In multiple regression (adjusted model R2 0.263; P = 0.013), reduction in leptin was a significant predictor of increase in NTX (P = 0.016), but changes in BMI and 25-hydroxy vitamin D were not. Conclusions: Weight loss after bariatric surgery is associated with long-term increase in serum markers of bone turnover. The increase in NTX is related to the decrease in leptin, which may signal caloric restriction to the skeleton.
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Resorption markers increase steadily by up to 200% over the first 12-18 months after RYGB.
“Resorption markers increase steadily by up to 200% over the first 12-18 months 52, 63, 64.”
From Bone loss after bariatric surgery: causes, consequences, and management (2014) · cites this paper as [64]
One study found the decrease in leptin after RYGB correlated with an increase in bone resorption measured by NTX.
“One study found the decrease in leptin after RYGB correlated with an increase in bone resorption measured by NTX 64.”
From Bone loss after bariatric surgery: causes, consequences, and management (2014) · cites this paper as [64]
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References 35 · Cited by 121
Research works printed but not linked: 1
- [2]2. BuchwaldH,AvidorY,BraunwaldE,JensenMD,PoriesW,Fahrbach K, Schoelles K 2004 Bariatric surgery: a systematic review and metaanalysis. JAMA 292:1724-1737
- Authors
- Bruno, C., Fulford, A. D., Potts, J. R., McClintock, R., Jones, R., Cacucci, B. M., Gupta, C. E., Peacock, M., & Considine, R. V.
- Affiliations
- Indiana University Indianapolis (US)
- St. Vincent Carmel Hospital (US)
- Corresponding author
- Considine, Robert V.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2010-01-01
- Volume
- 95
- Issue
- 1
- Pages
- 159-166
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC2805478
- OpenAlex
- W1975779753
- Cited by
- 121
- References
- 35
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 6 · 2021: 6 · 2020: 6 · 2019: 3 · 2018: 12 · 2017: 10 · 2016: 6 · 2015: 6 · 2014: 13 · 2013: 13 · 2012: 12
- FWCI
- 11.15
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Diabetes Association
- Purdue University
- National Center for Research Resources (M01RR000750)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Keywords
- Roux-en-Y gastric bypass, bariatric surgery, bone turnover markers, leptin, osteocalcin, bone-specific alkaline phosphatase, 25-hydroxyvitamin D, parathyroid hormone, obesity, weight loss, bone metabolism, vitamin D supplementation, calcium supplementation, osteoporosis risk, bone mineral density
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Obesity, Parathyroid Hormone, Peptides, Postoperative Period, Time Factors, Vitamin D, Gastric Bypass, Biomarkers, Weight Loss, Body Mass Index, Bone Remodeling, Leptin, Collagen Type I, Bariatric Surgery, Young Adult
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