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  • Bariatric and Metabolic Surgery Review
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Bariatric surgery and bone disease: from clinical perspective to molecular insights

International Journal of Obesity volume 36, pages 1373–1379 (2012)Cite this article

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Abstract

The use of bariatric surgery for the treatment of morbid obesity has increased annually for the last decade. Although many studies have demonstrated the efficacy and durability of bariatric surgery for weight loss, there are limited data regarding long-term side effects of these procedures. Recently, there has been an increased focus on the impact of bariatric surgery on bone metabolism. Bariatric surgery utilizes one or more of three mechanisms of action resulting in sustained weight loss. These include restriction (gastric banding, vertical banded gastroplasty and sleeve gastrectomy), malabsorption surgery with or without associated restriction (Roux en Y gastric bypass, duodenal switch, biliopancreatic diversion and jejunoileal bypass) and changes in gut-derived hormones that control energy metabolism also referred to as neuro-hormonal control of energy metabolism (Roux en Y gastric bypass, duodenal switch, biliopancreatic diversion, jejunoileal bypass, surgical procedures as above and gastric sleeve). Weight reduction has been associated with increased bone resorption but the mechanisms behind this have not yet been fully elucidated. Each of the mechanisms of action of bariatric surgery (restriction, malabsorption, neuro-hormonal control of energy metabolism) may uniquely affect bone resorption. In this paper we will review the current state of knowledge regarding the relationship between bariatric surgery and bone metabolism with emphasis on possible mechanisms of action such as malnutrition, hormonal interactions and mechanical unloading of the skeleton. Further, we suggest a future research agenda.

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Acknowledgements

We gratefully acknowledge support from CTSA grant (8UL1TR000149).

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Authors and Affiliations

  1. Department of Medicine, Division of Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    F Folli

  2. Department of Medicine, Endocrinology Division, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    B N Sabowitz

  3. Department of Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    W Schwesinger

  4. Department of Medicine, Division of Nephrology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

    P Fanti

  5. Department of Medicine and Nutrition, University of Guanajato, Leon, Mexico

    R Guardado-Mendoza

  6. Division of Endocrinology, Catholic University, Rome, Italy

    G Muscogiuri

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  3. W Schwesinger
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  4. P Fanti
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  5. R Guardado-Mendoza
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  6. G Muscogiuri
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Correspondence to F Folli, W Schwesinger or G Muscogiuri.

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Folli, F., Sabowitz, B., Schwesinger, W. et al. Bariatric surgery and bone disease: from clinical perspective to molecular insights. Int J Obes 36, 1373–1379 (2012). https://doi.org/10.1038/ijo.2012.115

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  • DOI: https://doi.org/10.1038/ijo.2012.115

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