Sclerostin Levels and Changes in Bone Metabolism After Bariatric Surgery
- 1 March 2015
- journal article
- research article
- Published by The Endocrine Society in Journal of Clinical Endocrinology & Metabolism
- Vol. 100 (3), 891-901
- https://doi.org/10.1210/jc.2014-3367
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.Keywords
This publication has 41 references indexed in Scilit:
- Bone Metabolism After Bariatric SurgeryJournal of Bone and Mineral Research, 2014
- Early Impact of Bariatric Surgery on Type II Diabetes, Hypertension, and Hyperlipidemia: A Systematic Review, Meta-Analysis and Meta-Regression on 6,587 PatientsObesity Surgery, 2013
- Roux-en-Y gastric bypass surgery reduces bone mineral density and induces metabolic acidosis in ratsAmerican Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 2013
- Vitamin D Status 10 Years After Primary Gastric Bypass: Gravely High Prevalence of Hypovitaminosis D and Raised PTH LevelsObesity Surgery, 2013
- Bone and mineral metabolism in patients undergoing Roux-en-Y gastric bypassOsteoporosis International, 2013
- Roux-en-Y Gastric Bypass Surgery But Not Vertical Sleeve Gastrectomy Decreases Bone Mass in Male RatsEndocrinology, 2013
- Metabolic/Bariatric Surgery Worldwide 2011Obesity Surgery, 2013
- The Deleterious Effect of Bariatric Surgery on Cortical and Trabecular Bone Density in the Femurs of Non-obese, Type 2 Diabetic Goto-Kakizaki RatsObesity Surgery, 2012
- National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9·1 million participantsThe Lancet, 2011
- Changes in bone mineral content after surgical treatment of morbid obesityMetabolism, 2004