Related Experiment Video
Updated: May 15, 2026
04:19
Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
Published on: November 8, 2024
Bariatric surgery results in cortical bone loss
Emily M Stein1, Angela Carrelli, Polly Young
1Department of Medicine/Endocrinology, Columbia University of Physicians and Surgeons, New York, New York 10032, USA. es2029@columbia.edu
The Journal of Clinical Endocrinology and Metabolism
|January 9, 2013
Summary
Bariatric surgery leads to bone loss, particularly cortical bone deterioration, linked to secondary hyperparathyroidism. This study reveals a new mechanism for bone loss following these procedures.
Area of Science:
- Endocrinology
- Bone Metabolism
- Bariatric Surgery Outcomes
Background:
- Bariatric surgery is associated with bone loss at weight-bearing sites.
- The underlying mechanisms driving this bone loss remain unclear.
Purpose of the Study:
- To investigate the mechanisms of bone loss after bariatric surgery.
- To differentiate bone loss patterns between Roux-en-Y gastric bypass and restrictive procedures.
Main Methods:
- Dual-energy x-ray absorptiometry (DXA) and high-resolution peripheral quantitative computed tomography (HR-pQCT) were used to assess bone density and microstructure.
- Measurements were taken at baseline and 12 months post-surgery in 22 women who underwent bariatric procedures.
- Hormonal markers (PTH, 25-hydroxyvitamin D) and bone turnover markers (C-telopeptide, bone-specific alkaline phosphatase) were monitored.
Main Results:
- Significant weight loss (28 ± 3 kg) was observed post-surgery.
- Areal bone mineral density decreased at the total hip (-5.2%) and femoral neck (-4.5%).
- Cortical bone deteriorated at the tibia (cortical area -2.7%, cortical thickness -2.1%), while trabecular bone remained stable.
- Increased PTH levels predicted cortical bone deterioration, whereas weight loss predicted hip bone loss.
Conclusions:
- Hip bone loss after bariatric surgery is attributed to skeletal unloading.
- Cortical bone loss is linked to secondary hyperparathyroidism, representing a novel mechanism.
- Roux-en-Y gastric bypass was associated with greater weight loss and bone loss compared to restrictive procedures.
Related Concept Videos
01:29Bone Disorders
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:40Bone Remodeling
Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.