Serum markers of bone turnover are increased at six and 18 months after Roux-en-Y bariatric surgery: Correlation with the reduction in leptin

Carolina Bruno, Angie D. Fulford, Jenna R. Potts, Ronald McClintock, RoseMarie Jones, Brenda M. Cacucci, Christine E. Gupta, Munro Peacock, Robert Considine

Research output: Contribution to journalArticle

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Abstract

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 R 2 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.

Original languageEnglish
Pages (from-to)159-166
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Volume95
Issue number1
DOIs
StatePublished - Jan 2010

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Bariatric Surgery
Bone Remodeling
Leptin
Surgery
Bone
Body Mass Index
Vitamin D
Biomarkers
Bone and Bones
Alkaline Phosphatase
Serum
Osteocalcin
Collagen
Caloric Restriction
Gastric Bypass
Collagen Type I
Skeleton
Weight Loss
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

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Serum markers of bone turnover are increased at six and 18 months after Roux-en-Y bariatric surgery : Correlation with the reduction in leptin. / Bruno, Carolina; Fulford, Angie D.; Potts, Jenna R.; McClintock, Ronald; Jones, RoseMarie; Cacucci, Brenda M.; Gupta, Christine E.; Peacock, Munro; Considine, Robert.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 95, No. 1, 01.2010, p. 159-166.

Research output: Contribution to journalArticle

Bruno, Carolina ; Fulford, Angie D. ; Potts, Jenna R. ; McClintock, Ronald ; Jones, RoseMarie ; Cacucci, Brenda M. ; Gupta, Christine E. ; Peacock, Munro ; Considine, Robert. / Serum markers of bone turnover are increased at six and 18 months after Roux-en-Y bariatric surgery : Correlation with the reduction in leptin. In: Journal of Clinical Endocrinology and Metabolism. 2010 ; Vol. 95, No. 1. pp. 159-166.
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title = "Serum markers of bone turnover are increased at six and 18 months after Roux-en-Y bariatric surgery: Correlation with the reduction in leptin",
abstract = "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 R 2 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.",
author = "Carolina Bruno and Fulford, {Angie D.} and Potts, {Jenna R.} and Ronald McClintock and RoseMarie Jones and Cacucci, {Brenda M.} and Gupta, {Christine E.} and Munro Peacock and Robert Considine",
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T1 - Serum markers of bone turnover are increased at six and 18 months after Roux-en-Y bariatric surgery

T2 - Correlation with the reduction in leptin

AU - Bruno, Carolina

AU - Fulford, Angie D.

AU - Potts, Jenna R.

AU - McClintock, Ronald

AU - Jones, RoseMarie

AU - Cacucci, Brenda M.

AU - Gupta, Christine E.

AU - Peacock, Munro

AU - Considine, Robert

PY - 2010/1

Y1 - 2010/1

N2 - 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 R 2 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.

AB - 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 R 2 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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