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Comment
. 2019 May 6;129(6):2184-2186.
doi: 10.1172/JCI128745.

Trim the gut, lose the weight - and the bone

Soravis Osataphan, Mary Elizabeth Patti
Comment

Trim the gut, lose the weight - and the bone

Soravis Osataphan et al. J Clin Invest. .

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.

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Conflict of interest statement

Conflict of interest: MEP reports investigator-initiated grant support from Janssen Pharmaceuticals and Xeris Pharmaceuticals, and pending patents related to hypoglycemia (PCT/US2017/045061 and patent application US20180353112A1).

Figures

Figure 1
Figure 1. VSG induces bone loss by reducing mineralization and bone formation.
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.
See this image and copyright information in PMC

Comment on

  • G-CSF partially mediates effects of sleeve gastrectomy on the bone marrow niche.
    Li Z, Hardij J, Evers SS, Hutch CR, Choi SM, Shao Y, Learman BS, Lewis KT, Schill RL, Mori H, Bagchi DP, Romanelli SM, Kim KS, Bowers E, Griffin C, Seeley RJ, Singer K, Sandoval DA, Rosen CJ, MacDougald OA. Li Z, et al. J Clin Invest. 2019 May 6;129(6):2404-2416. doi: 10.1172/JCI126173. eCollection 2019 May 6. J Clin Invest. 2019. PMID: 31063988 Free PMC article.

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