C Gronnier1,2, F Tremollieres3, Blandine Gatta-Cherifi4,5,6, O Cadart7,2, O Degrandi1, T Barnetche8, N Mehsen-Cetre8, M Monsaingeon-Henry7, E Pupier7, L Bosc7, D Collet1,2. 1. Digestive Surgery Department, University Hospital of Bordeaux, Pessac, France. 2. University of Bordeaux, College Santé, 33076, Bordeaux, France. 3. Menopause center, Hôpital Paule de Viguier, University Hospital of Toulouse, Toulouse, France. 4. Endocrinology, Diabetology & Nutrition Department, University Hospital of Bordeaux, Pessac, France. blandine.gatta-cherifi@chu-bordeaux.fr. 5. INSERM U1215 Neurocentre Magendie, University of Bordeaux, Bordeaux, France. blandine.gatta-cherifi@chu-bordeaux.fr. 6. University of Bordeaux, College Santé, 33076, Bordeaux, France. blandine.gatta-cherifi@chu-bordeaux.fr. 7. Endocrinology, Diabetology & Nutrition Department, University Hospital of Bordeaux, Pessac, France. 8. Rheumatology Department, University Hospital of Bordeaux, Bordeaux, France.
Abstract
INTRODUCTION: Bone mineral density (BMD) declines in the initial years after bariatric surgery, but long-term skeletal effects are unclear and comparisons between sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are rare. DESIGN AND METHODS: An observational longitudinal study of obese patients undergoing SG or RYGB was performed. Whole-body (WB) BMD, along with BMD of the total hip (TH), femoral neck (FN), and lumbar spine (LS), was measured by dual-energy X-ray absorptiometry (DXA) before surgery and yearly thereafter for 4 years. Calciotropic hormones were also measured. RESULTS: Forty-seven patients undergoing RYGB surgery and 28 patients undergoing SG were included. Four years after RYGB, BMD declined by 2.8 ± 5.8% in LS, 8.6 ± 5% in FN, 10.9 ± 6.3% in TH, and 4.2 ± 6.2% in WB, relative to baseline. For SG, BMD declined by 8.1 ± 5.5% in FN, 7.7 ± 6% in TH, 2.0 ± 7.2% in LS, and 2.5 ± 6.4% in WB after 4 years, relative to baseline. Vitamin D levels increased with supplementation in both groups. Whereas parathyroid hormone levels increased slightly in the RYGB group, they decreased modestly in the SG group (P < 0.05 in both groups). CONCLUSIONS: Bone loss after 4 years was comparable between the two procedures, although RYGB was associated with a slightly greater decrease at the TH than SG. Bone health should therefore be monitored after both RYGB and SG.
INTRODUCTION: Bone mineral density (BMD) declines in the initial years after bariatric surgery, but long-term skeletal effects are unclear and comparisons between sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are rare. DESIGN AND METHODS: An observational longitudinal study of obesepatients undergoing SG or RYGB was performed. Whole-body (WB) BMD, along with BMD of the total hip (TH), femoral neck (FN), and lumbar spine (LS), was measured by dual-energy X-ray absorptiometry (DXA) before surgery and yearly thereafter for 4 years. Calciotropic hormones were also measured. RESULTS: Forty-seven patients undergoing RYGB surgery and 28 patients undergoing SG were included. Four years after RYGB, BMD declined by 2.8 ± 5.8% in LS, 8.6 ± 5% in FN, 10.9 ± 6.3% in TH, and 4.2 ± 6.2% in WB, relative to baseline. For SG, BMD declined by 8.1 ± 5.5% in FN, 7.7 ± 6% in TH, 2.0 ± 7.2% in LS, and 2.5 ± 6.4% in WB after 4 years, relative to baseline. Vitamin D levels increased with supplementation in both groups. Whereas parathyroid hormone levels increased slightly in the RYGB group, they decreased modestly in the SG group (P < 0.05 in both groups). CONCLUSIONS: Bone loss after 4 years was comparable between the two procedures, although RYGB was associated with a slightly greater decrease at the TH than SG. Bone health should therefore be monitored after both RYGB and SG.
Entities:
Keywords:
Bariatric surgery; Bone density; Long-term effects; Obesity
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