Effects of weight loss on bone status after bariatric surgery: association between adipokines and bone markers.
BACKGROUND
The prevalence of overweight and obesity is increasing dramatically worldwide. As a consequence, bariatric surgery for morbid obesity is in constant development. Although bariatric surgery has proven its efficiency at achieving weight loss and correcting comorbidities, it may cause vitamin deficiencies and subsequent complications. The goal of this review is to assess the impact of obesity surgery on bone metabolism and to analyze the underlying mechanisms and relationships with adipokines. Our review focuses on gastric banding, vertical banded gastroplasty, and gastric bypass.


METHODS
The articles were located via PubMed database, using the key words "bariatric surgery," "weight loss," "bone loss," and "bone metabolism" and published until May 2006.


RESULTS
Five main studies were reviewed concerning gastric banding and six concerning Roux-en-Y gastric bypass. An early increase in bone markers (formation and resorption) is constantly found, prevailing on bone resorption, and resulting in early bone loss.


CONCLUSIONS
According to the few studies available, bone loss frequently occurs after bariatric surgery and particularly in a more pronounced way after gastric bypass, but its clinical significance is still under discussion. In addition, the physiopathology of these changes remains unclear, but could implicate adipokines such as leptin and adiponectin.
Wucher
Hélène
H
Department of Nutrition, Hôtel-Dieu Hospital (AP-HP), Paris, France.
Ciangura
Cécile
C
Poitou
Christine
C
Czernichow
Sébastien
S
D054392:Adipokines / Q000032:analysis*; D050110:Bariatric Surgery / Q000009:adverse effects*; D015415:Biomarkers / Q000032:analysis; D001842:Bone and Bones / Q000378:metabolism*; D006801:Humans; D010024:Osteoporosis / Q000209:etiology; D015431:Weight Loss / Q000502:physiology*
D054392:Adipokines; D015415:Biomarkers