Bariatric Surgery and Osteoporosis

Paccou, Julien; Caïazzo, Robert; Lespessailles, Éric; Cortet, Bernard

doi:10.1007/s00223-020-00798-w

Cited by 46 publications

(28 citation statements)

References 100 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although incompletely understood, factors such as nutritional malabsorption, energy deficits, and changes in adipose and gastrointestinal hormones could be the main contributors to RYGB-induced bone loss. [57][58][59] A relevant finding of the present study indicates that vBMD reductions observed following RYGB seem to worsen for higher follow-up times, suggesting a cumulative deleterious effect throughout the years after surgery. Our meta-regression analysis estimated that, on average, the annual vBMD losses at the LS, radius, and tibia are 5.0%, 2.8%, and 2.7%, respectively.…”

Section: Low Certaintysupporting

confidence: 52%

Changes in volumetric bone mineral density and bone quality after Roux‐en‐Y gastric bypass: A meta‐analysis with meta‐regression

et al. 2022

View full text Add to dashboard Cite

Summary This meta‐analysis aimed to assess the effect of Roux‐en‐Y gastric bypass (RYGB) on three‐dimensionally assessed volumetric bone mineral density (vBMD) with the effect of time on these changes, on bone quality, and the agreement of dual‐energy X‐ray absorptiometry (DXA) with quantitative computed tomography (QCT) or high‐resolution peripheral QCT (HR‐pQCT) estimates of bone loss. We searched PubMed, Web of Science, Cochrane, Scopus, and EBSCO. Longitudinal studies on adults undergoing RYGB in which vBMD was assessed by QCT or HR‐pQCT with ≥6 months follow‐up were included. Total hip (TH) changes were reported in four studies, lumbar spine (LS) in eight, radius in eight, and tibia in seven. Significant post‐RYGB vBMD reductions occurred at all skeletal sites analyzed. Meta‐regression revealed that time post‐RYGB was significantly associated with vBMD deterioration in all skeletal sites except at the TH. RYGB also led to significant deterioration on bone quality. DXA underestimated LS and overestimated TH bone losses post‐RYGB. In conclusion, RYGB was associated with significant vBMD loss, which makes screening of bone mass progression by three‐dimensional technology a crucial clinical issue to prevent fracture risk and osteoporosis.

show abstract

Section: Low Certaintysupporting

confidence: 52%

Changes in volumetric bone mineral density and bone quality after Roux‐en‐Y gastric bypass: A meta‐analysis with meta‐regression

et al. 2022

View full text Add to dashboard Cite

show abstract

“…These factors dramatically increase from the first 3-10 days, peak after 6-24 months, and remain elevated until 7 years following bariatric surgery (116)(117)(118). Both SG and RYGB promote increases in bone turnover markers, with the latter eliciting the strongest effects and leading to an increase in CTX by 50%-300% (37,49,119).…”

Section: Bone Turnover Markers After Bariatric Surgerymentioning

confidence: 99%

Bone Response to Weight Loss Following Bariatric Surgery

et al. 2022

View full text Add to dashboard Cite

Obesity is a global health challenge that warrants effective treatments to avoid its multiple comorbidities. Bariatric surgery, a cornerstone treatment to control bodyweight excess and relieve the health-related burdens of obesity, can promote accelerated bone loss and affect skeletal strength, particularly after malabsorptive and mixed surgical procedures, and probably after restrictive surgeries. The increase in bone resorption markers occurs early and persist for up to 12 months or longer after bariatric surgery, while bone formation markers increase but to a lesser extent, suggesting a potential uncoupling process between resorption and formation. The skeletal response to bariatric surgery, as investigated by dual-energy X-ray absorptiometry (DXA), has shown significant loss in bone mineral density (BMD) at the hip with less consistent results for the lumbar spine. Supporting DXA studies, analyses by high-resolution peripheral quantitative computed tomography (HR-pQCT) showed lower cortical density and thickness, higher cortical porosity, and lower trabecular density and number for up to 5 years after bariatric surgery. These alterations translate into an increased risk of fall injury, which contributes to increase the fracture risk in patients who have been subjected to bariatric surgery procedures. As bone deterioration continues for years following bariatric surgery, the fracture risk does not seem to be dependent on acute weight loss but, rather, is a chronic condition with an increasing impact over time. Among the post-bariatric surgery mechanisms that have been claimed to act globally on bone health, there is evidence that micro- and macro-nutrient malabsorptive factors, mechanical unloading and changes in molecules partaking in the crosstalk between adipose tissue, bone and muscle may play a determining role. Given these circumstances, it is conceivable that bone health should be adequately investigated in candidates to bariatric surgery through bone-specific work-up and dedicated postsurgical follow-up. Specific protocols of nutrients supplementation, motor activity, structured rehabilitative programs and, when needed, targeted therapeutic strategies should be deemed as an integral part of post-bariatric surgery clinical support.

show abstract

“…The nutritional aspect of bone health is affected by decreased levels of calcium and vitamin D parallel to increased levels of PTH; therefore, it is important to measure their levels before and in long-term post-surgical follow-up as a predictor of bone damage. From these follow-ups, treatment options may arise by appropriate supplementation and thus prevention of bone damage [27,28].…”

Section: Discussionmentioning

confidence: 99%

Nutritional Outcomes One Year after One Anastomosis Gastric Bypass Compared to Sleeve Gastrectomy

et al. 2022

View full text Add to dashboard Cite

One Anastomosis Gastric Bypass (OAGB) and Sleeve Gastrectomy (SG) are the most common bariatric procedures performed worldwide. SG is a restrictive procedure whereas OAGB involves malabsorption as well, supposing a risk of deficiency development post OAGB. The aim of the study was to compare nutritional deficiencies and metabolic markers one year after the procedures, while adhering to the current protocols. Retrospective analysis was performed for data on 60 adults undergoing primary OAGB, compared to 60 undergoing primary SG. Mean pre-surgery BMI for SG was 42.7 kg/m2 and 43.3 kg/m2 for OAGB. A multidisciplinary team followed up with the patients at least 3 times during the first year. Mean weight loss was 39.0 kg for SG and 44.1 kg for OAGB. The OAGB group presented a significantly sharper decline in T.Chol and a trend for sharper LDL decrease; a higher increase in folate and a trend for a greater decrease in albumin and hemoglobin were observed in OAGB. For vitamin B12, D, iron and ferritin, no difference was observed between the treatment groups, although there were some in-group differences. Nutritional recommendations and adopted supplement plans minimize the risk of deficiencies and result in improvement in metabolic biomarkers one year after OAGB, which was comparable to SG.

show abstract

Bariatric Surgery and Osteoporosis

Cited by 46 publications

References 100 publications

Changes in volumetric bone mineral density and bone quality after Roux‐en‐Y gastric bypass: A meta‐analysis with meta‐regression

Changes in volumetric bone mineral density and bone quality after Roux‐en‐Y gastric bypass: A meta‐analysis with meta‐regression

Bone Response to Weight Loss Following Bariatric Surgery

Nutritional Outcomes One Year after One Anastomosis Gastric Bypass Compared to Sleeve Gastrectomy

Contact Info

Product

Resources

About