This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Obesity is a risk factor for the development of cardiovascular disease, diabetes, and cancer. Weight loss has been demonstrated to improve insulin sensitivity and reduce risk factors for cardiovascular disease. The Roux-en-Y gastric bypass procedure produces losses of up to 70% of excess body weight and long-term weight loss with this procedure extends out 10-14 yr. Because of the limited success of medical management of obesity, and reduced complications with laparoscopic Roux-en-Y gastric bypass (LRGB), more patients are opting to undergo this surgery. Recent studies have noted an increase in markers of bone resorption and bone loss in subjects following Roux-en-Y or adjustable silicone gastric banding for weight loss. These studies suggest that bone loss occurs following bariatric surgical procedures, although limitations such as cross sectional design and duration of study, restrict the usefulness of the observations. In this study we will test the hypothesis that bone loss occurs following bariatric surgery and that the extent of bone loss is dependent on gender, age and menopause at the time of surgery. Subjects will be recruited from a large bariatric surgical practice at St. Vincent's Hospital in Carmel. Bone density, serum and urine markers of bone metabolism will be evaluated every 3 months following surgery for 1 year, and then every 6 months in the second year. The demonstration of significant bone loss following bariatric surgery will ultimately lead to interventions to prevent bone disease in this population.
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