Trim the gut, lose the weight — and the bone
Soravis Osataphan, Mary Elizabeth Patti
Soravis Osataphan, Mary Elizabeth Patti
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Commentary

Trim the gut, lose the weight — and the bone

Abstract

Vertical sleeve gastrectomy (VSG) is an effective therapeutic approach for obesity and type 2 diabetes but is associated with osteoporosis. In this issue of the JCI, Li et al. report that VSG rapidly reduces bone mass, as observed in humans, via rapid demineralization and decreased bone formation, independent of weight loss or Ca2+/vitamin D deficiency. VSG also reduces bone marrow adipose tissue, in part via increased granulocyte–colony stimulating factor (G-CSF). The interplay between VSG-mediated effects on systemic metabolism and bone biology remain to be investigated. These findings suggest novel mechanisms and therapeutic targets for bariatric surgery–induced osteoporosis.

Authors

Soravis Osataphan, Mary Elizabeth Patti

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Figure 1

VSG induces bone loss by reducing mineralization and bone formation.

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VSG induces bone loss by reducing mineralization and bone formation. VSG...
VSG-induced bone loss (left). In parallel, G-CSF decreases bone marrow adipose tissue and activates myeloid proliferation (right). The contribution of altered gastrointestinal physiology and systemic metabolism to both bone loss and increased G-CSF remain to be investigated.