Christian Muschitz1, Roland Kocijan, Christina Marterer, Arastoo Rahbar Nia, Gabriela Katharina Muschitz, Heinrich Resch, Peter Pietschmann. 1. St Vincent Hospital, Medical Department II (C.M., R.K., C.M., A.R.N., H.R.), Academic Teaching Hospital of Medical University of Vienna, Stumpergasse 13, Vienna, Austria; Division of Plastic and Reconstructive Surgery, Department of Surgery (G.K.M.), Medical University of Vienna, Vienna, Austria; Department of Pathophysiology and Allergy Research (P.P.), Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna. Vienna, Austria.
Abstract
CONTEXT: The role of sclerostin as a key regulator of bone formation remains unknown after Roux-en-Y gastric bypass (RYGB) or laparoscopic sleeve gastrectomy (SG). OBJECTIVES: The study objectives were evaluation of sclerostin and Dickkopf-1 (DKK-1) serum levels after surgery and correlations with bone turnover markers (P1NP, CTX), parathyroid hormone (iPTH) and areal bone mineral density (BMD), changes at total body, lumbar spine and total hip. DESIGN AND SETTING: This was a prospective observational single-center two-arm study in premenopausal women with acute adipositas over 24 months. PARTICIPANTS: Participants were 52 premenopausal women (40 ± 8 years, BMI 43.4) after RYGB and 38 premenopausal women (41 ± 7 years, BMI 45.7) after SG. MAIN OUTCOME MEASURES: Prior to surgery and 1, 3, 6, 9, 12, 18, and 24 months after surgery sclerostin, DKK-1, CTX, P1NP levels and BMD were measured. RESULTS: Sclerostin, CTX and (to a lesser extent) P1NP increased after surgery and remained elevated during the entire study period (P < 0.001). DKK-1 declined during months 3-9 (P < 0.005) and then remained unchanged, serum phosphate continuously increased (P < 0.001), iPTH remained within the upper normal limit. Sclerostin increases were significantly positively correlated with CTX and P1NP increases and negatively correlated with BMD loss. BMD independently declined regardless of RYGB and SG. Elevations of sclerostin, CTX, P1NP, and phosphate, but not DKK-1 and iPTH, were significant discriminating factors for BMD loss (AUC 0.920). CONCLUSION: Rapid and sustained increases of sclerostin, CTX, and to a lesser extent, P1NP cause an increase in bone metabolism and result in BMD loss at all skeletal sites.
CONTEXT: The role of sclerostin as a key regulator of bone formation remains unknown after Roux-en-Y gastric bypass (RYGB) or laparoscopic sleeve gastrectomy (SG). OBJECTIVES: The study objectives were evaluation of sclerostin and Dickkopf-1 (DKK-1) serum levels after surgery and correlations with bone turnover markers (P1NP, CTX), parathyroid hormone (iPTH) and areal bone mineral density (BMD), changes at total body, lumbar spine and total hip. DESIGN AND SETTING: This was a prospective observational single-center two-arm study in premenopausal women with acute adipositas over 24 months. PARTICIPANTS: Participants were 52 premenopausal women (40 ± 8 years, BMI 43.4) after RYGB and 38 premenopausal women (41 ± 7 years, BMI 45.7) after SG. MAIN OUTCOME MEASURES: Prior to surgery and 1, 3, 6, 9, 12, 18, and 24 months after surgery sclerostin, DKK-1, CTX, P1NP levels and BMD were measured. RESULTS:Sclerostin, CTX and (to a lesser extent) P1NP increased after surgery and remained elevated during the entire study period (P < 0.001). DKK-1 declined during months 3-9 (P < 0.005) and then remained unchanged, serum phosphate continuously increased (P < 0.001), iPTH remained within the upper normal limit. Sclerostin increases were significantly positively correlated with CTX and P1NP increases and negatively correlated with BMD loss. BMD independently declined regardless of RYGB and SG. Elevations of sclerostin, CTX, P1NP, and phosphate, but not DKK-1 and iPTH, were significant discriminating factors for BMD loss (AUC 0.920). CONCLUSION: Rapid and sustained increases of sclerostin, CTX, and to a lesser extent, P1NP cause an increase in bone metabolism and result in BMD loss at all skeletal sites.
Authors: Fernando Guerrero-Pérez; Anna Casajoana; Carmen Gómez-Vaquero; Nuria Virgili; Rafael López-Urdiales; Laura Hernández-Montoliu; Jordi Pujol-Gebelli; Javier Osorio; Carolina Alves; Manuel Perez-Maraver; Silvia Pellitero; Anna Vidal-Alabró; Sonia Fernández-Veledo; Joan Vendrell; Nuria Vilarrasa Journal: Obes Surg Date: 2020-01 Impact factor: 4.129
Authors: Laurel L Tangalakis; Lawrence Tabone; Anna Spagnoli; Mike Muehlbauer; Philip Omotosho; Alfonso Torquati Journal: Obes Surg Date: 2020-01 Impact factor: 4.129
Authors: Anne L Schafer; Galateia J Kazakia; Eric Vittinghoff; Lygia Stewart; Stanley J Rogers; Tiffany Y Kim; Jonathan T Carter; Andrew M Posselt; Courtney Pasco; Dolores M Shoback; Dennis M Black Journal: J Bone Miner Res Date: 2018-02-05 Impact factor: 6.741