ECTS2016 Poster Presentations Energy metabolism and bone, fat and bone (11 abstracts)
Effects of roux-en-Y gastric bypass surgery on bone quality: a pilot study
I.K. Høgestøl 1 , E.P. Paschalis 2 , S. Gamsjaeger 2 , N. Hassler 2 , M.G. Shabestari 3 , H.L. Gulseth 1 , T. Mala 4 , K. Klaushofer 2 & E.F. Eriksen 1
1Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital and University of Oslo, Oslo, Norway; 2Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Vienna, Austria; 3Department of Biomaterials, University of Oslo, Oslo, Norway; 4Department of Endocrinology, Morbid Obesity and Preventive Medicine and Department of Gastrointestinal and Pediatric Surgery, Oslo University Hospital, Oslo, Norway.
Roux-en-Y gastric bypass surgery (RYGBP) is one of the leading surgical treatments for morbid obesity and leads to significant long-term weight loss, diabetes remission, decreased cardiovascular events, and reduced mortality. RYGBP is, however, also implicated in increased fracture risk, mainly due to higher bone turnover rates and malabsorption. In the present study we used Raman microspectroscopic analysis to determine bone quality (an important determinant of bone strength) in paired iliac crest biopsies from eight morbidly obese patients before (three of which suffered from type 2 diabetes), and nine morbidly obese patients 1 year after RYGBP (five of which were type 2 diabetics in remission); seven of these cases were paired biopsies. The bone quality indices assessed included mineral/matrix ratio, nanoporosity (a surrogate for tissue water content), as well as glycosaminoglycan (GAG), lipid, and pyridinoline (PYD) content. Results obtained before and after RYGBP were compared using paired t-tests. In the osteoid, GAGs were significantly lower after RYGBP (−10%, P<0.05), consistent with the reported higher bone turnover rates in these patients following surgery. Within mineralized bone matrix, RYGBP resulted in a higher GAG content (possibly indicative of an altered canalicular network; +20%, P<0.05), and significantly lower nanoporosity (−57%, P<0.01) and PYD values (+2%, P<0.05), also consistent with higher bone turnover rates following surgery. The mineral/matrix ratio remained unchanged. Regression analysis of all individual data before and after RYGBP revealed significant alterations in the relationship between GAG and lipid content, potentially due to diabetes remission following RYGBP. In summary the results of the present pilot study indicate that RYGBP results in significant changes in bone quality irrespective whether the patients suffered from diabetes as well, which are consistent with the reported higher bone turnover rates prevalent following surgery.
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Bone Abstracts
ISSN 2052-1219 (online)
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