Abstract:After LSG, body size and variables related to body composition (except for TB BMC) decreased with an accompanying decrease in FN BMD in the men in this study. Spine BMD increased, and TB BMD did not change.
“…Nevertheless, most studies on SG reported decreased BMD ( Maghrabi et al, 2015 ; Carrasco et al, 2014 ; Vilarrasa et al, 2013 ; Muschitz et al, 2016 ; Hsin et al, 2015 ; Muschitz et al, 2015 ; Pluskiewicz et al, 2012 ; Adamczyk et al, 2015a ), whereas two studies described an opposite trend with increased BMD ( Adamczyk et al, 2015b ; Ruiz-Tovar et al, 2013 ). A possible explanation for this discrepancy is that Adamczyk et al investigated solely men, and this observation might indicate sex-dependent responses ( Adamczyk et al, 2015b ). Fig.…”
Section: Effect Of Bariatric Surgery On Bmd and Fracturesmentioning
confidence: 94%
“…It is, however, important to note that at this moment the studies on SG are still limited, both in terms of duration of follow-up and sample size ( Maghrabi et al, 2015 ; Carrasco et al, 2014 ; Vilarrasa et al, 2013 ; Muschitz et al, 2016 ; Hsin et al, 2015 ; Muschitz et al, 2015 ; Pluskiewicz et al, 2012 ; Adamczyk et al, 2015a ; Adamczyk et al, 2015b ; Ruiz-Tovar et al, 2013 ). Nevertheless, most studies on SG reported decreased BMD ( Maghrabi et al, 2015 ; Carrasco et al, 2014 ; Vilarrasa et al, 2013 ; Muschitz et al, 2016 ; Hsin et al, 2015 ; Muschitz et al, 2015 ; Pluskiewicz et al, 2012 ; Adamczyk et al, 2015a ), whereas two studies described an opposite trend with increased BMD ( Adamczyk et al, 2015b ; Ruiz-Tovar et al, 2013 ). A possible explanation for this discrepancy is that Adamczyk et al investigated solely men, and this observation might indicate sex-dependent responses ( Adamczyk et al, 2015b ).…”
Section: Effect Of Bariatric Surgery On Bmd and Fracturesmentioning
Bariatric surgery has proven to be a valuable treatment option for morbid obesity. However, these procedures can lead to impaired intestinal absorption of calcium and vitamin D, thereby challenging calcium homeostasis and possibly contributing to bone loss leading to an increased fracture risk. Besides calcium and vitamin D malabsorption, hormonal changes occurring after surgery can also be the source of observed bone loss. In this review, first, a case report will be discussed, highlighting the relevance of this topic. Afterwards, changes in bone density and fracture risk, after the two most performed types of bariatric surgery, Sleeve Gastrectomy (SG) and Roux-en-Y Gastric Bypass (RYGB) will be discussed. In addition, we discuss the putative underlying mechanisms leading to bone changes based on both preclinical and clinical observations. Nonetheless, it is clear further research is needed to further elucidate the exact mechanisms of bone loss following bariatric surgery and subsequently identify potential treatment options for bone preservation.
“…Nevertheless, most studies on SG reported decreased BMD ( Maghrabi et al, 2015 ; Carrasco et al, 2014 ; Vilarrasa et al, 2013 ; Muschitz et al, 2016 ; Hsin et al, 2015 ; Muschitz et al, 2015 ; Pluskiewicz et al, 2012 ; Adamczyk et al, 2015a ), whereas two studies described an opposite trend with increased BMD ( Adamczyk et al, 2015b ; Ruiz-Tovar et al, 2013 ). A possible explanation for this discrepancy is that Adamczyk et al investigated solely men, and this observation might indicate sex-dependent responses ( Adamczyk et al, 2015b ). Fig.…”
Section: Effect Of Bariatric Surgery On Bmd and Fracturesmentioning
confidence: 94%
“…It is, however, important to note that at this moment the studies on SG are still limited, both in terms of duration of follow-up and sample size ( Maghrabi et al, 2015 ; Carrasco et al, 2014 ; Vilarrasa et al, 2013 ; Muschitz et al, 2016 ; Hsin et al, 2015 ; Muschitz et al, 2015 ; Pluskiewicz et al, 2012 ; Adamczyk et al, 2015a ; Adamczyk et al, 2015b ; Ruiz-Tovar et al, 2013 ). Nevertheless, most studies on SG reported decreased BMD ( Maghrabi et al, 2015 ; Carrasco et al, 2014 ; Vilarrasa et al, 2013 ; Muschitz et al, 2016 ; Hsin et al, 2015 ; Muschitz et al, 2015 ; Pluskiewicz et al, 2012 ; Adamczyk et al, 2015a ), whereas two studies described an opposite trend with increased BMD ( Adamczyk et al, 2015b ; Ruiz-Tovar et al, 2013 ). A possible explanation for this discrepancy is that Adamczyk et al investigated solely men, and this observation might indicate sex-dependent responses ( Adamczyk et al, 2015b ).…”
Section: Effect Of Bariatric Surgery On Bmd and Fracturesmentioning
Bariatric surgery has proven to be a valuable treatment option for morbid obesity. However, these procedures can lead to impaired intestinal absorption of calcium and vitamin D, thereby challenging calcium homeostasis and possibly contributing to bone loss leading to an increased fracture risk. Besides calcium and vitamin D malabsorption, hormonal changes occurring after surgery can also be the source of observed bone loss. In this review, first, a case report will be discussed, highlighting the relevance of this topic. Afterwards, changes in bone density and fracture risk, after the two most performed types of bariatric surgery, Sleeve Gastrectomy (SG) and Roux-en-Y Gastric Bypass (RYGB) will be discussed. In addition, we discuss the putative underlying mechanisms leading to bone changes based on both preclinical and clinical observations. Nonetheless, it is clear further research is needed to further elucidate the exact mechanisms of bone loss following bariatric surgery and subsequently identify potential treatment options for bone preservation.
“… 13 The results on the changes in BMD after LSG are inconsistent. 14 – 18 It has been shown that femoral neck BMD decreases, spine BMD increases, and total body BMD remains unchanged in men with obesity after LSG, 14 while another study has shown that BMD increases during the first and second years after LSG. 15 In addition, researchers have found that BMD decreases after LSG, 16 – 18 and the effect of LSG on BMD differs between genders, decreasing significantly in females while remaining unchanged in males.…”
Objective
Laparoscopic sleeve gastrectomy (LSG) is one of the most effective therapies to treat obesity. Due to a lack of longitudinal research, we explored the changes in BMD and bone metabolism in Chinese patients with obesity before and after LSG.
Materials and Methods
A total of 49 obese Chinese patients with obesity were recruited from the Second Xiangya Hospital of Central South University. All patients underwent LSG, and the metabolic indicators were evaluated, including the serum osteocalcin (OC), total-terminal propeptide of type I procollagen (TPINP) and carboxy terminal telopeptide of collagen type I (CTX) levels at baseline and 2, 6 and 12 months postoperatively. Dual energy X-ray absorptiometry (DEXA) was used to measure body composition and BMD before and 12 months after LSG.
Results
The body mass index (BMI) significantly decreased at 12 months postoperatively, and no patients developed osteoporosis. The BMD of femoral neck and total hip significantly decreased from the baseline to 12 months postoperatively, while the BMD of lumbar spine did not change significantly. The OC, TPINP and CTX levels significantly increased at 12 months postoperatively. The excess BMI loss (EBMIL) was positively related while the reduction in visceral adipose tissue (VAT) mass was negatively related to the decreases in BMD of the femoral neck and total hip at 12 months postoperatively. The increase in OC was negatively correlated with the decrease in BMD of the femoral neck, while the increase in TPINP was positively correlated with the decrease in BMD of total hip.
Conclusion
Based on the 12-month follow-up results, the BMD of the femoral neck and total hip was decreased in Chinese patients with obesity after LSG, while bone remodelling was active. This finding suggested that weight loss, a decrease in the VAT mass and an increase in bone remodelling may be correlated with a reduction in BMD.
“…B/M surgery represents the most effective therapeutic tool for morbid obesity and a promising approach towards obesity-related comorbidities, because, unlike conservative treatment, it assures significant, quick and relatively sustainable weight loss [19,[22][23][24]. Although this effect is predominantly based on the desirable fat mass reduction, it may also be associated with a decrease of other body components, such as muscles and bones [10,19,20]. Both obesity and sarcopenia increase health-related risks, especially when they co-exist.…”
Section: Discussionmentioning
confidence: 99%
“…DEXA measurements were performed before and 24 months after the B/M procedure using the Hologic Discovery A densitometer (Mississauga, Ontario, Canada), calibrated according to the manufacturer's recommendations. The precision error and coefficient of variation were established, which allowed the value of the minimal significant change to be calculated as described in previous studies [18][19][20]. Recorded measurements included fat mass index (FMI) -a measure of relative fat content, independent of fat free mass, estimated visceral adipose tissue (Est VAT) -estimated amount of visceral fat, lean mass index (LMI) -a measure of relative lean content, independent of fat mass, appendage lean mass index (ALMI) -a measure of relative lean mass in arm and legs, bone mineral content (BMC), Z score -for patients aged under 50 and T score -for those above 50 as measures of osteoporosis.…”
Introduction: Bariatric procedures lead to changes in body composition. Desired fat loss may be accompanied by decrease of muscle mass, thus raising the risk of sarcopenia. Aim: To detect the risk of sarcopenia in patients 24 months after different bariatric/metabolic (B/M) procedures by DEXA. Material and methods: Consecutive patients scheduled for a B/M procedure underwent DEXA scan and anthropometric assessment before and 24 months after surgery in a prospective manner. Obtained data were tested for significant differences (p < 0.05) to detect body composition changes and occurrence of sarcopenia. The International Physical Activity Questionnaire (IPAQ) was answered at 24 months to assess physical activity. Results: Nineteen patients were enrolled, with no drop-off at follow-up. Body mass index dropped from 42.4 ±6.3 to 30.3 ±4.9 kg/m 2 , with excess weight loss of 72 ±25% and substantial improvement of all relevant anthropometric measurements (p < 0.001). Significant changes in DEXA parameters were observed: fat mass index (19.5 ±4.7 vs. 12.1 ±3.7 kg/m 2), estimated visceral adipose area (235.8 ±70.0 vs. 126.5 ±50.4 cm 2), lean mass index (22.1 ±2.4 vs. 18.1 ±2.3 kg/m 2), appendage lean mass index (9.7 ±1.3 vs. 7.7 ±1.1 kg/m 2), bone mineral content (1.22 ±0.1 vs. 1.12 ±0.1 kg), Z score (2.32 vs. 0.96) and T score (0.58 vs.-0.58). A low level of physical activity was recorded at 24 months. Conclusions: B/M procedures lead to significant changes in body composition at 24 months after surgery. DEXA detects these changes effectively. Desired fat loss is associated with significant reduction of skeletal muscle and bone mineral mass. As such, patients after B/M surgery are at risk of sarcopenia. A low level of physical activity may also play a negative role.
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