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Bariatric surgery, bone loss, obesity and possible mechanisms

Abstract

Bariatric surgery remains the most effective treatment for severely obese patients. However, the potential long-term effects of bariatric surgical procedures on health, including bone health, are only partially understood. The goal of this review was to present data on the impact of bariatric surgery on bone metabolism and to analyse possible reasons for the loss of bone mass that frequently occurs after bariatric surgery. Such factors include nutritional deficiencies, rapid weight loss per se, effects of fat-derived adipokines and gut-derived appetite-regulatory hormones. However, the relative roles of these factors in skeletal regulation and the mechanisms by which they work are not yet fully defined. Our review was focussed on the complex relationship between body weight, fat mass and bone mass, as well as peripheral and central mediators potentially involved in the dual regulation of both energy and bone homeostasis. We also review the data on the inverse relationship between central obesity, bone marrow fat and osteoporosis. As the number of bariatric operations increases, it is imperative to recognize mechanisms responsible for bariatric surgery-induced bone loss, with careful monitoring of bone health including long-term fracture incidence in patients undergoing these procedures. Obes Rev. 2012 Oct 25. doi: 10.1111/j.1467-789X.2012.01050.x.

Type Journal
ISBN 1467-789X (Electronic) 1467-7881 (Linking)
Authors Brzozowska, M. M.; Sainsbury, A.; Eisman, J. A.; Baldock, P. A.; Center, J. R.;
Responsible Garvan Author Prof Jacqueline Center
Publisher Name Obesity Reviews
Published Date 2013-01-15 00:00:00
Published Volume 14
Published Issue 1
Published Pages 52-67
Status Published in-print
URL link to publisher's version http://www.ncbi.nlm.nih.gov/pubmed/23094966
OpenAccess link to author's accepted manuscript version https://publications.gimr.garvan.org.au/open-access/11545