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Changes in Bone Mineral Density, Body Composition and Adiponectin Levels in Morbidly Obese Patients after Bariatric Surgery

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Abstract

Background

Gastric bypass surgery (GBP) is increasingly used as a treatment option in morbid obesity. Little is known about the effects of this surgery on bone mineral density (BMD) and the underlying mechanisms. To evaluate changes on BMD after GBP and its relation with changes in body composition and serum adiponectin, a longitudinal study in morbid obese subjects was conducted.

Methods

Forty-two women (BMI 45.0 ± 4.3 kg/m2; 37.7 ± 9.6 years) were studied before surgery and 6 and 12 months after GBP. Percentage of body fat (%BF), fat-free mass (FFM), and BMD were measured by dual-energy X-ray absorptiometry and serum adiponectin levels by RIA.

Results

Twelve months after, GBP weight was decreased by 34.4 ± 6.5% and excess weight loss was 68.2 ± 12.8%. Significant reduction (p < 0.001) in total BMD (−3.0 ± 2.1%), spine BMD (−7.4 ± 6.8%) and hip BMD (−10.5 ± 5.6%) were observed. Adiponectin concentration increased from 11.4 ± 0.7 mg/L before surgery to 15.7 ± 0.7 and 19.8 ± 1.0 at the sixth and twelfth month after GBP, respectively (p < 0.001). Thirty-seven percent of the variation in total BMD could be explained by baseline weight, initial BMD, BF reduction, and adiponectin at the twelfth month (r 2 = 0.373; p < 0.001). Adiponectin at the twelfth month had a significant and positive correlation with the reduction of BMD, unrelated to baseline and variation in body composition parameters (adjusted correlation coefficient: r = 0.36).

Conclusion

GBP induces a significant BMD loss related with changes in body composition, although some metabolic mediators, such as adiponectin increase, may have an independent action on BMD which deserves further study.

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Authors and Affiliations

  1. Department of Nutrition, Faculty of Medicine, University of Chile, Independencia 1027, Postal Code 838-0453, Santiago, Chile

    Fernando Carrasco, Manuel Ruz, Pamela Rojas, Annabella Rebolledo, Juana Codoceo, Jorge Inostroza & Karen Basfi-fer

  2. Department of Surgery, Clinical Hospital, University of Chile, Santiago, Chile

    Attila Csendes, Karin Papapietro & Jorge Rojas

  3. Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile

    Fernando Pizarro & Manuel Olivares

Authors
  1. Fernando Carrasco
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  2. Manuel Ruz
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  3. Pamela Rojas
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Correspondence to Fernando Carrasco.

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Carrasco, F., Ruz, M., Rojas, P. et al. Changes in Bone Mineral Density, Body Composition and Adiponectin Levels in Morbidly Obese Patients after Bariatric Surgery. OBES SURG 19, 41–46 (2009). https://doi.org/10.1007/s11695-008-9638-0

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  • DOI: https://doi.org/10.1007/s11695-008-9638-0

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