Effect of regional body composition changes on bone density remodeling after sleeve gastrectomy

Di Yang; Rongrong Xu; Yinfang Tu; Yunfeng Xiao; Hongwei Zhang; Weijie Liu; Pin Zhang; Haoyong Yu; Yuqian Bao; Ying Yang; Junfeng Han

doi:10.3389/fendo.2023.1238060

Effect of regional body composition changes on bone density remodeling after sleeve gastrectomy

Front Endocrinol (Lausanne). 2023 Sep 11:14:1238060. doi: 10.3389/fendo.2023.1238060. eCollection 2023.

Authors

Di Yang¹, Rongrong Xu¹, Yinfang Tu¹, Yunfeng Xiao², Hongwei Zhang³, Weijie Liu³, Pin Zhang³, Haoyong Yu¹, Yuqian Bao¹, Ying Yang¹, Junfeng Han⁴

Affiliations

¹ Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
² Department of Radiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
³ Department of General Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁴ Department of Endocrinology and Metabolism, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.

Abstract

Background: Sleeve gastrectomy (SG) results in bone mineral density (BMD) loss and varying body composition parameters. However, the effects of body compositions on bone health are controversial. In order to accurately demonstrate their relationship and provide new insights into the causes of BMD loss after sleeve gastrectomy, this study is aimed to investigate the role of changes in body composition in BMD loss 12 months after SG.

Methods: 41 Chinese individuals with obesity (25 women and 16 men) who underwent SG were prospectively examined for at least 12 months. Measurements of anthropometrics, body composition, BMD and blood samples were collected.

Results: For 12 months, the femoral neck (FN) BMD and total hip (TH) BMD decreased significantly compared with baseline in both sexes but not lumbar spine (LS) BMD. Greater TH BMD loss was observed in men than in women. For the first 6 months post-SG, the FN BMD loss was positively associated with the estimated fat free mass index (eFFMI) reduction in women (adjusted β = 0.77, P = 0.004) and positively associated with reduction of subcutaneous fat area (SFA) in men (r = 0.931, P = 0.007). For 12 months post-SG, the FN BMD loss was negatively associated with visceral fat area (VFA) reduction in women (adjusted β = -0.58, P = 0.027) and men (adjusted β = -0.68, P = 0.032). TH BMD loss was positively associated with waist circumference reduction in women (r = 0.448, P = 0.028).

Conclusion: FN and TH BMD decrease after SG in both women and men. The changes in body compositions are associated with BMD loss at different time points and bone sites. Our data emphasize the limitation of simply taking the total weight loss (% TWL) as an influencing factor of bone mineral density and the necessity of delineating body composition in relevant studies.

Keywords: body composition; bone mineral density; bone turnover markers; obesity; sleeve gastrectomy.

Grants and funding

This work was funded by National Natural Sciences Foundation of China (82170867) to JH, Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support (No. 20191920), Shanghai “Science and technology innovation action plan” science and technology support project in biomedical field (20S31903200).