An Evaluation of 1) Bone Changes Following Bariatric Surgery and 2) Fat and Muscle Indices Assessed by pQCT: Implications for Osteoporosis and Type-2 Diabetes Risk

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dc.contributor.authorButner, Katrina Lindaueren
dc.contributor.committeechairHerbert, William G.en
dc.contributor.committeememberClark, Susan F.en
dc.contributor.committeememberNickols-Richardson, Sharon M.en
dc.contributor.committeememberRamp, Warren K.en
dc.contributor.departmentHuman Nutrition, Foods, and Exerciseen
dc.date.accessioned2016-09-22T15:14:42Zen
dc.date.adate2010-12-03en
dc.date.available2016-09-22T15:14:42Zen
dc.date.issued2010-10-29en
dc.date.rdate2015-04-22en
dc.date.sdate2010-11-09en
dc.description.abstractSTUDY 1 Aim: To compare the effects of Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB) on changes in bone mineral density (BMD), weight loss and blood biomarkers related to bone turnover, hormonal, and nutrient status. Subjects: Nine bariatric surgery patients. Methods: Patients had a DXA bone scan and fasting blood draw at baseline, three, and six months following surgery. Results: RYGB patients had greater weight loss vs. LAGB at both three (mean loss: 19 vs. 9%) and six months (26 vs. 11%), p<0.01. RYGB patients lost an average of 7% hip BMD at six months. Hip BMD loss at six months was correlated to decreased leptin (r=0.88) and increased adiponectin (r=-0.82), p<0.05. Bone turnover was indicated by elevated serum bone biomarkers after surgery. Conclusions: Research with larger sample sizes is warranted to better evaluate potential implications for late-life osteoporosis risk following bariatric surgery. STUDY 2 Aim: To determine repeatability for IMAT and muscle density, to evaluate the distribution of foreleg muscle and fat indices measured by pQCT and to determine predictors of muscle density and type-2 diabetes risk. Subjects: 82 women with varying BMI and physical activity levels. Methods: Subjects had DXA and pQCT bone scans, a fasting blood draw, and completed a 4-day physical activity record. Results: Fat and muscle distribution in the foreleg was highly correlated to total and central body adiposity. The pQCT device reliably measured muscle density (CV=0.8%), thus justifying use as surrogates for IMAT. Muscle density was positively related to physical activity (r=0.29; p<0.05) and negatively associated with markers of fat distribution and risk for type-2 diabetes [HOMA-IR (r=-0.44, p<0.01)]. Conclusions: Further research is necessary to determine whether specific fat or muscle depots can be targeted through exercise training to help with the prevention and treatment of obesity or type-2 diabetes.en
dc.description.degreePh. D.en
dc.identifier.otheretd-11092010-173306en
dc.identifier.sourceurlhttp://scholar.lib.vt.edu/theses/available/etd-11092010-173306/en
dc.identifier.urihttp://hdl.handle.net/10919/73000en
dc.language.isoen_USen
dc.publisherVirginia Techen
dc.rightsIn Copyrighten
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/en
dc.subjectBone Mineral Densityen
dc.subjectStudy 2: Intermuscular Adipoen
dc.subjectPhysical Activityen
dc.subjectBariatric Surgeryen
dc.subjectType-2 Diabetesen
dc.titleAn Evaluation of 1) Bone Changes Following Bariatric Surgery and 2) Fat and Muscle Indices Assessed by pQCT: Implications for Osteoporosis and Type-2 Diabetes Risken
dc.typeDissertationen
dc.type.dcmitypeTexten
thesis.degree.disciplineHuman Nutrition, Foods, and Exerciseen
thesis.degree.grantorVirginia Polytechnic Institute and State Universityen
thesis.degree.leveldoctoralen
thesis.degree.namePh. D.en

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