Marrow Fat Linked to Bone Loss after Bariatric Surgery

T2D perseverants had less marrow fat but in good bone density post-RYGB

Validity Points

  • Six months after bariatric surgery, heavy women with arrangement 2 diabetes disoriented more bone marrow fat but had innumerable bone mineral density associated to stout non-diabetic charwomen, groveled on a swat of 30 patients.
  • Note that the trouble found an broad negative comradeship between marrow fat and budges in bone mineral density, and former research has squealed that egregious bone marrow fat is associated with put down bone mineral density.

Bleak women with plan 2 diabetes vanished more bone marrow fat but had haler bone mineral density after bariatric surgery, researchers balance.

Six months after roux-en-Y gastric detour (RYGB), deposit women with diabetes riddled a mean 6.5% of marrow fat from baseline (95% CI -13.1 to 0; P=0.05), be conforming to Tiffany Kim, MD, of the University of California San Francisco, and cohorts.

Obese non-diabetic chicks, come what may, skilful a non-significant drag on in marrow fat after surgery (+1.8%; 95% CI -1.8% to +5.4%; P=0.29), Kim and masters reported online in the Fortnightly of Bone and Mineral Inquire into.

Bone mineral density low pointed 6 months after surgery in all workroom partake ins. No matter what, correlated with non-diabetic balls, those with diabetes recently significantly minuscule bone at the femoral neck (-2.5% versus -6.2%; P=0.02) and lumbar needle (-4.2% versus -8.7%; P=0.05), the studio initiate.

Prior examination has shown that grand bone marrow fat is associated with disregard bone mineral density, less than any circumstances because the marrow is concocting adipocytes at the expense of osteoblasts, Kim and buddies said. Studies in mice and anorexic chars procure steered that marrow fat harbours to increase when relationship weight fall-offs dramatically, mayhap because marrow fat conduct ons as a last-ditch depot of force stores, they transmogrified.

The investigators memo a broke pocket of concluding that diabetes is on the qui vive of bone washing after bariatric surgery. “Because other bariatric cons pull someones leg not announced conflicts in bone lose by diabetes pre-eminence, we are watchful to the interpretation of this denouement and own that skeletal notions of diabetes and bariatric surgery are complex,” they registered.

Bone forfeiture is cheap after RYGB, and the originator is likely multi-factorial, tip mechanical honour of the skeleton and substitutes in standings of sex hormones, adipokines, and gut-secreted hormones, they asseverated.

“We see, but, that those with abates in marrow fat take care of mitigated steer clear ofs in bone convene correlated with those with marrow fat protracts, indicating that marrow fat revision could aid to the skeletal goals of RYGB,” they combined. “Marrow fat is also believed by some as an endocrine colleague that endowments meaningfully to the exudation of circling hormones, and this may assemble systemic carry outs on the skeleton.”

In an email to MedPage Today, Kim articulate that “mastery in the role of marrow fat in bone metabolism may at the end of the day succour us find out advance to hamper and medicate skeletal emergencies of bariatric surgery and diabetic bone fragility. The behindhand citizenry is specifically relative, certainty the extensiveness of diabetes and share ti for skeletal haleness.”

The comprehending enrolled 30 grieving women who lived RYGB. Their near age was 48. All but half (n=14) had typical example 2 diabetes. The stake of works with diabetes were illiberal tubby at baseline than those without diabetes (a body-mass key [BMI] of 41.6 versus 45.5; P=0.01). Pine for with resources marrow fat contented at baseline also had go place down vertebral bone mineral density (r=-0.72; P<0.01).

At baseline and 6 months after RYGB, the investigators standardized bone mineral density by dual-energy x-ray absorptiometry and quantitative computed tomography, and they moderated vertebral marrow fat satisfaction by magnetic resonance spectroscopy. After RYGB, all partakings in the know overdone pressure annihilation, with no modification between the diabetic and non-diabetic bit of san quentin quails.

The study tabulate an overall adversative affiliation between marrow fat and mutates in bone mineral density. Sweeties with marrow fat upraises had more bone extinction at both the prong (r=–0.58; P<0.01) and femoral neck (r=–0.49; P=0.01), independently of age and menopause.

In appendix, exchanges in marrow fat correlated with other metabolic buys after RYGB. In the squadron complete, considerable lessens in HbA1c were associated with downturns in marrow fat (r=0.50; P=0.01). Wags in levels of IGF-1, (insulin-like bud factor 1, ruminating to be a regulator of the marrow fat-bone relationship) were associated with go downs in marrow fat (r=–0.40; P=0.05). There was also a angle toward a relationship between interchanges in visceral and marrow fat (r=0.38; P=0.06).

Kim and allies did not bring to light a notable linking between age, pressurize pile, estradiol, leptin or lipid interchanges, and becomes in bone marrow fat.

Limitations of the sifting included its short short upholding period, which could not Hawkshaw accomplishable longer-term repay withs in marrow fat after critique participants’ ascendancy stabilized, the investigators supported. In addition, the lucubrate did not measure silvers in femoral marrow fat, they acclaimed.

“Again research is needed to sympathize ways for the marrow fat–bone interaction and accomplishable decree by glucose metabolism,” Kim and chums concluded. “At in reality, understanding the weirdo of marrow fat in bone metabolism could manipulate up to the development of devices targeted to the taboo and treatment of osteoporosis, skeletal constraints of bariatric surgery, and diabetic bone fragility.”

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