title: Roux-en-Y gastric bypass surgery but not vertical sleeve gastrectomy decreases bone mass in male rats.
abstract: The most effective treatment for obesity is bariatric surgery. However, there is increasing concern that bariatric surgery can cause nutrient deficiencies that translate into metabolic bone disease. Whether this is true for all surgery types is not yet clear. We therefore investigated the effects of 2 commonly applied bariatric surgeries (Roux-en-Y gastric bypass [RYGB] and vertical sleeve gastrectomy) on energy and bone metabolism in rats 60 days after surgery. Both surgeries resulted in similar reductions of body weight, body fat, and food intake. Glucose tolerance was improved to a similar extent after both surgeries and was accompanied by increased postprandial secretion of glucose-dependent insulinotropic peptide. Using microcomputed tomography, we found that, relative to sham-operated rats, bone volume was significantly reduced after RYGB but not vertical sleeve gastrectomy. RYGB rats also had markedly reduced lipid absorption from the intestine and significantly lower serum 25-hydroxyvitamin D and calcium levels. Importantly, dietary supplementation with calcium and vitamin D could not fully rescue the reduced bone volume after RYGB surgery. Both surgeries resulted in a significant increase in stomach pH, which may have worsened the malabsorption in RYGB rats. Our findings suggest that bone loss in RYGB rats is not exclusively driven by calcium and vitamin D malabsorption but also by additional factors that may not be rescuable by dietary supplementation. These data point toward important similarities and differences between bariatric procedures that should be considered in clinical settings as guidance for which procedure will be best for specific patient populations.
authors.affiliation: Institute for Diabetes and Obesity, Helmholtz Centre Munich, 85764 Neuherberg, Germany. Department of Orthopaedic Surgery (T.L.C.), The Johns Hopkins University, Baltimore, Maryland 21287 and the Baltimore Veterans Affairs Medical Center (T.L.C.), Baltimore, Maryland 21201
authors.forename: Kerstin
authors.initials: K
authors.lastname: Stemmer
authors.forename: Maximilian
authors.initials: M
authors.lastname: Bielohuby
authors.forename: Bernadette E
authors.initials: BE
authors.lastname: Grayson
authors.forename: Denovan P
authors.initials: DP
authors.lastname: Begg
authors.forename: Adam P
authors.initials: AP
authors.lastname: Chambers
authors.forename: Christina
authors.initials: C
authors.lastname: Neff
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Woods
authors.forename: Reinhold G
authors.initials: RG
authors.lastname: Erben
authors.forename: Matthias H
authors.initials: MH
authors.lastname: Tschöp
authors.forename: Martin
authors.initials: M
authors.lastname: Bidlingmaier
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Clemens
authors.forename: Randy J
authors.initials: RJ
authors.lastname: Seeley
mesh_terms: D000273:Adipose Tissue; D000818:Animals; D001835:Body Weight; D015519:Bone Density; D002118:Calcium / Q000008:administration & dosage / Q000097:blood; D002136:Calcium, Dietary / Q000008:administration & dosage; D019587:Dietary Supplements; D004435:Eating; D004734:Energy Metabolism; D005269:Femur / Q000378:metabolism; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass / Q000379:methods*; D005749:Gastric Inhibitory Polypeptide / Q000378:metabolism; D041981:Gastrointestinal Tract / Q000378:metabolism; D007408:Intestinal Absorption; D008055:Lipids / Q000493:pharmacokinetics; D008297:Male; D051381:Rats; D020318:Rats, Long-Evans; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000097:blood; D055114:X-Ray Microtomography
chemical_list: D002136:Calcium, Dietary; D008055:Lipids; D014807:Vitamin D; D005749:Gastric Inhibitory Polypeptide; C104450:25-hydroxyvitamin D; D002118:Calcium
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