Study explores effects on gastric bypass surgery on bone marrow in type 2 diabetes

A link has been found between bone mineral density deterioration and increased bone marrow fat in women who have gastric bypass surgery.
The findings were the same in a cohort of obese women with and without type 2 diabetes, and suggest that glucose metabolism and weight loss could influence marrow fat behavior.
Bone marrow fat is believed to help regulate bone metabolism, with increased marrow fat levels indicative of low bone mass and type 2 diabetes, researchers say.
A team from the University of California wanted to investigate the relationship between bone marrow density and marrow fat content in 30 obese females, 16 of whom had type 2 diabetes, who underwent Roux-en-Y gastric bypass surgery.
The study found the gastric bypass contributed to 27.3 kg in weight loss and 19.3 kg of total body fat reduction. Decreases in HbA1c were greater in participants with diabetes compared to those without.
The findings also suggested blood sugar improvements were associated with lower marrow fat levels, with the diabetes cohort experiencing significantly decreased marrow fat content. Marrow fat content was stable in those without diabetes.
However, participants with type 2 diabetes also had greater declines in bone mineral density, which can increase the risk of conditions such as osteoporosis.
The researchers believe that while regulators of the marrow fat-bone relationship are uncertain, insulin-like growth factor 1 (IGF-1) could play a role.
“Further research is needed to understand the mechanisms for the marrow fat-bone interaction and possible regulation by glucose metabolism,” wrote the authors.
“Ultimately, understanding the role of marrow fat in bone metabolism could lead to the development of strategies targeted to the prevention and treatment of osteoporosis, skeletal complications of bariatric surgery, and diabetic bone fragility.”
The findings published in the Journal of Bone and Mineral Research.