title: The role of serum osteoprotegerin and receptor-activator of nuclear factor-κB ligand in metabolic bone disease of women after obesity surgery.
abstract: Metabolic bone disease may appear as a complication of obesity surgery. Because an imbalance in the osteoprotegerin and receptor-activator of nuclear factor-κB ligand system may underlie osteoporosis, we aimed to study this system in humans in the metabolic bone disease occurring after obesity surgery. In this study we included sixty women with a mean age of 47 ± 10 years studied 7 ± 2 years after bariatric surgery. The variables studied were bone mineral density, β-isomer of C-terminal telopeptide of type I collagen cross-links (a bone resorption marker), the bone formation markers osteocalcin and N-terminal propeptide of procollagen 1, serum osteoprotegerin and receptor-activator of nuclear factor-κB ligand. Serum osteoprotegerin inversely correlated with the bone remodeling markers osteocalcin, β-isomer of C-terminal telopeptide of type I collagen cross-links and N-terminal propeptide of procollagen 1. The osteoprotegerin and receptor-activator of nuclear factor-κB ligand ratio also correlated inversely with serum parathormone and osteocalcin. Bone mineral density at the lumbar spine was associated with age (β = -0.235, P = 0.046), percentage of weight loss (β = 0.421, P = 0.001) and osteoprotegerin and receptor-activator of nuclear factor-κB ligand ratio (β = 0.259, P = 0.029) in stepwise multivariate analysis (R2= 0.29, F = 7.49, P < 0.001). Bone mineral density at the hip site was associated only with percentage of weight loss (β = 0.464, P < 0.001) in stepwise multivariate regression (R2= 0.21, F = 15.1, P < 0.001). These data show that the osteoprotegerin and receptor-activator of nuclear factor-κB ligand system is associated with bone markers and bone mineral density at the lumbar spine after obesity surgery.
authors.affiliation: Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera de Colmenar Km. 9.1, 28034, Madrid, Spain.|Department of Endocrinology and Nutrition, Hospital Infanta Sofía, Madrid, Spain.
authors.forename: José A
authors.initials: JA
authors.lastname: Balsa
authors.affiliation: Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera de Colmenar Km. 9.1, 28034, Madrid, Spain.
authors.forename: Christian
authors.initials: C
authors.lastname: Lafuente
authors.affiliation: Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera de Colmenar Km. 9.1, 28034, Madrid, Spain.
authors.forename: Jesús M
authors.initials: JM
authors.lastname: Gómez-Martín
authors.affiliation: Department of Digestive and General Surgery, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Galindo
authors.affiliation: Department of Digestive and General Surgery, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Peromingo
authors.affiliation: Department of Digestive and General Surgery, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
authors.forename: Francisca
authors.initials: F
authors.lastname: García-Moreno
authors.affiliation: Department of Digestive and General Surgery, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
authors.forename: Gloria
authors.initials: G
authors.lastname: Rodriguez-Velasco
authors.affiliation: Department of Biochemistry-Research, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.|Centro de Investigación Biomédica en Red-Fisiopatología de Obesidad y Nutrición (CIBERobn), Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Martínez-Botas
authors.affiliation: Department of Biochemistry-Research, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.|Centro de Investigación Biomédica en Red-Fisiopatología de Obesidad y Nutrición (CIBERobn), Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Gómez-Coronado
authors.affiliation: Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera de Colmenar Km. 9.1, 28034, Madrid, Spain.|Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
authors.forename: Héctor F
authors.initials: HF
authors.lastname: Escobar-Morreale
authors.affiliation: Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Carretera de Colmenar Km. 9.1, 28034, Madrid, Spain. joseignacio.botella@salud.madrid.org.|Centro de Investigación Biomédica en Red-Fisiopatología de Obesidad y Nutrición (CIBERobn), Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain. joseignacio.botella@salud.madrid.org.
authors.forename: José I
authors.initials: JI
authors.lastname: Botella-Carretero
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000601:surgery; D015675:Osteocalcin / Q000097:blood; D053244:Osteoprotegerin / Q000097:blood*; D010281:Parathyroid Hormone / Q000097:blood; D010384:Pelvic Bones / Q000378:metabolism; D011183:Postoperative Complications / Q000097:blood*; D053245:RANK Ligand / Q000097:blood*; D013131:Spine / Q000378:metabolism
chemical_list: D015415:Biomarkers; D053244:Osteoprotegerin; D010281:Parathyroid Hormone; D053245:RANK Ligand; C506030:TNFRSF11B protein, human; C505688:TNFSF11 protein, human; D015675:Osteocalcin
keywords: Metabolic bone disease; Obesity surgery; Osteopenia; Osteoprotegerin; Receptor–activator of nuclear factor-κB ligand