Bone marrow adipose tissue composition and glycemic improvements after gastric bypass surgery

Tiffany Y. Kim; Ann V. Schwartz; Xiaojuan Li; Kaipin Xu; Galateia J. Kazakia; Carl Grunfeld; Robert A. Nissenson; Dolores M. Shoback; Anne L. Schafer

Bone Reports (Dec 2022)

Bone marrow adipose tissue composition and glycemic improvements after gastric bypass surgery

Tiffany Y. Kim,
Ann V. Schwartz,
Xiaojuan Li,
Kaipin Xu,
Galateia J. Kazakia,
Carl Grunfeld,
Robert A. Nissenson,
Dolores M. Shoback,
Anne L. Schafer

Affiliations

Tiffany Y. Kim: Department of Medicine, University of California, San Francisco, CA, USA; Medical Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA; Corresponding author at: 4150 Clement St 111F, San Francisco, CA 94121, USA.
Ann V. Schwartz: Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
Xiaojuan Li: Department of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA
Kaipin Xu: Department of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI), Cleveland Clinic, Cleveland, OH, USA
Galateia J. Kazakia: Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
Carl Grunfeld: Department of Medicine, University of California, San Francisco, CA, USA; Medical Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
Robert A. Nissenson: Department of Medicine, University of California, San Francisco, CA, USA; Endocrine Research Unit, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
Dolores M. Shoback: Department of Medicine, University of California, San Francisco, CA, USA; Medical Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
Anne L. Schafer: Department of Medicine, University of California, San Francisco, CA, USA; Medical Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA

Journal volume & issue: Vol. 17
p. 101596

Abstract

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Fracture risk is increased in type 2 diabetes, which may in part be due to altered bone marrow adiposity. Cross sectional studies have reported that people with type 2 diabetes have lower unsaturated BMAT lipid levels than people without diabetes, although there are limited data on longitudinal changes. We hypothesized that Roux-en-Y gastric bypass (RYGB), which dramatically improves glycemic status, would have differential effects on BMAT composition, with increases in the unsaturated lipid index in people with diabetes. Given reports that axial BMAT is responsive to metabolic stimuli while appendicular BMAT is stable, we hypothesized that BMAT changes would occur at the spine but not the tibia. We enrolled 30 obese women, stratified by diabetes status, and used magnetic resonance spectroscopy to measure BMAT at the spine in all participants, and the tibia in a subset (n = 19). At baseline, BMAT parameters were similar between those with and without diabetes, except tibial marrow fat content was lower in women with diabetes (97.4 % ± 1.0 % versus 98.2 % ± 0.4 %, p = 0.04). Six months after surgery, both groups experienced similar weight loss of 27 kg ± 7 kg. At the spine, there was a significant interaction between diabetes status and changes in both marrow fat content and the unsaturated lipid index (p = 0.02, p < 0.01 for differences, respectively). Women with diabetes had a trend towards a decline in marrow fat content (−4.3 % ± 8.2 %, p = 0.09) and increase in the unsaturated lipid index (+1.1 % ± 1.5 %, p = 0.02). In contrast, BMAT parameters did not significantly change in women without diabetes. In all women, changes in the unsaturated lipid index inversely correlated with hemoglobin A1c changes (r = −0.47, p = 0.02). At the tibia, there was little BMAT change by diabetes status. Our results suggest that vertebral BMAT composition is responsive to changes in glycemic control after RYGB.

Published in Bone Reports

ISSN: 2352-1872 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the musculoskeletal system
Website: http://www.journals.elsevier.com/bone-reports/

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