After bariatric surgery, sclerostin — a regulator of bone formation — and other bone turnover markers increased, which boosted bone metabolism and resulted in bone mineral density (BMD) loss, according to data published in the Journal of Clinical Endocrinology & Metabolism.
The researchers included 52 women who underwent Roux-en-Y gastric bypass (RYGB) and 38 women who underwent sleeve gastrectomy. They evaluated sclerostin and Dickkopf-1 (DKK-1) serum levels after surgery and correlations with bone turnover markers (P1NP, CTX) as well as other measures of bone health over 24 months.
Results showed that, after surgery, sclerostin, CTX and, to a lesser extent, P1NP increased after bariatric surgery and stayed elevated throughout the study period (P<.001). DKK-1 decreased during months 3 through 9 and eventually remained unchanged, but serum phosphopate increased continuously.
The researchers also noted a significant positive correlation between sclerostin increases and increase in CTX and P1NP, and a significant negative correlation between sclerostin increases and BMD loss. Results indicated that increases in sclerostin, CTX, P1NP and phosphate were significant discriminating factors for bone loss.
The findings prompted the researchers to conclude that the ongoing loss of BMD warrants “further clinical and pharmacological investigation.” They also recommend weight-bearing exercises, a well-balanced diet and taking vitamin D supplements to prevent iatrogenic sarcopenia.
Context: The role of sclerostin as a key regulator of bone formation remains unknown after Roux-en-Y gastric bypass (RYGB) or laparoscopic sleeve gastrectomy (SG).
Objectives:Evaluation of sclerostin and Dickkopf-1 (DKK-1) serum levels after surgery and correlations with bone turnover markers (P1NP, CTX), parathyroid hormone (iPTH) and areal bone mineral density (BMD), changes at total body, lumbar spine and total hip.
Design and Setting: A prospective observational single-center two-arm study in premenopausal women with acute adipositas over 24 months.