Veeravich Jaruvongvanich1, Kornpong Vantanasiri2, Sikarin Upala3, Patompong Ungprasert4. 1. Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota. 2. Department of Internal Medicine, University of Minnesota, Minneapolis, Minnesota. 3. Department of Endocrinology, University of Chicago, Chicago, Illinois. 4. Division of Clinical Epidemiology, Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. Electronic address: ungprasert.patompong@mayo.edu.
Abstract
BACKGROUND: Roux-en-Y gastric bypass surgery adversely affects bone health. The evidence is less well-described for sleeve gastrectomy (SG). OBJECTIVES: To better characterize bone metabolism changes after SG. SETTING: Systematic review and meta-analysis. METHODS: MEDLINE and EMBASE were searched through March 2019 for eligible studies assessing adults with obesity aged 18 years or older that underwent SG. Bone mineral density (BMD), serum calcium, serum phosphate, serum 25-hydroxyvitamin D, serum parathyroid hormone, or serum alkaline phosphatase were reported at baseline and after SG; and a follow-up duration was at least 6 months. Preoperative and postoperative mean of each outcome of interest and corresponding standard deviations were extracted from each study and the mean difference (MD) was calculated. Pooled MD was then calculated by combining MDs of each study using random-effects model. RESULTS: A total of 22 studies with 1905 patients with obesity that underwent SG were included. There were significant decreases in total hip BMD (pooled MD of -.06 g/cm2; 95% confidence interval -.09 to -.03; I2 = 0%) and femoral neck BMD (pooled MD of -.05 g/cm2; 95% confidence interval -.09 to -.02; I2 = 0%) after SG. No significant change in lumbar spine BMD was observed. There were significant increases in serum calcium, serum 25-hydroxyvitamin D, and serum phosphate. Serum parathyroid hormone was significantly decreased. Serum alkaline phosphatase was not significantly altered after SG. CONCLUSIONS: The present study found a decreased BMD among patients with obesity after SG.
BACKGROUND: Roux-en-Y gastric bypass surgery adversely affects bone health. The evidence is less well-described for sleeve gastrectomy (SG). OBJECTIVES: To better characterize bone metabolism changes after SG. SETTING: Systematic review and meta-analysis. METHODS: MEDLINE and EMBASE were searched through March 2019 for eligible studies assessing adults with obesity aged 18 years or older that underwent SG. Bone mineral density (BMD), serum calcium, serum phosphate, serum 25-hydroxyvitamin D, serum parathyroid hormone, or serum alkaline phosphatase were reported at baseline and after SG; and a follow-up duration was at least 6 months. Preoperative and postoperative mean of each outcome of interest and corresponding standard deviations were extracted from each study and the mean difference (MD) was calculated. Pooled MD was then calculated by combining MDs of each study using random-effects model. RESULTS: A total of 22 studies with 1905 patients with obesity that underwent SG were included. There were significant decreases in total hip BMD (pooled MD of -.06 g/cm2; 95% confidence interval -.09 to -.03; I2 = 0%) and femoral neck BMD (pooled MD of -.05 g/cm2; 95% confidence interval -.09 to -.02; I2 = 0%) after SG. No significant change in lumbar spine BMD was observed. There were significant increases in serum calcium, serum 25-hydroxyvitamin D, and serum phosphate. Serum parathyroid hormone was significantly decreased. Serum alkaline phosphatase was not significantly altered after SG. CONCLUSIONS: The present study found a decreased BMD among patients with obesity after SG.
Authors: Ashlyn A Swafford; Jamy D Ard; Daniel P Beavers; Peri C Gearren; Adolfo Z Fernandez; Sherri A Ford; Katelyn A Greene; Daniel E Kammire; Beverly A Nesbit; Kylie K Reed; Ashley A Weaver; Kristen M Beavers Journal: JBMR Plus Date: 2020-10-02
Authors: Madhusmita Misra; Vibha Singhal; Brian Carmine; Amita Bose; Megan M Kelsey; Fatima Cody Stanford; Jennifer Bram; Jeremy Aidlen; Thomas Inge; Mary L Bouxsein; Miriam A Bredella Journal: Bone Date: 2020-02-19 Impact factor: 4.398