Madhusmita Misra1, Abisayo Animashaun2, Amita Bose3, Vibha Singhal3, Fatima Cody Stanford3, Brian Carmine4, Miriam A Bredella5. 1. Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Division of Pediatric Endocrinology, Mass General Hospital for Children and Harvard Medical School, Boston, Massachusetts. Electronic address: mmisra@mgh.harvard.edu. 2. Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. 3. Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Division of Pediatric Endocrinology, Mass General Hospital for Children and Harvard Medical School, Boston, Massachusetts; MGH Weight Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts. 4. Department of Surgery, Boston Medical Center, Boston, Massachusetts. 5. Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Abstract
BACKGROUND: Sleeve gastrectomy (SG), the most commonly performed metabolic and bariatric surgery, is associated with reductions in areal bone mineral density at multiple sites, and changes in bone structure at the distal radius and tibia without reductions in strength estimates at these peripheral sites. Data are lacking regarding effects on hip strength estimates. OBJECTIVE: To evaluate effects of SG on measures of hip structural analysis in adolescents and young adults over 12 months using dual-energy x-ray absorptiometry. SETTINGS: Translational and Clinical Research Center. METHODS: We enrolled 48 youth 14- to 22-years old with moderate-to-severe obesity; 24 underwent SG and 24 controls were followed without surgery (18 females, 6 males in each group). Hip structure was assessed using dual-energy x-ray absorptiometry at baseline and 12 months. Analyses are adjusted for age, sex, race, and the baseline bone measure. RESULTS: The SG group lost 25.9% weight versus .3% in controls. Compared with controls, SG had reductions in narrow neck, intertrochanteric and femoral shaft bone mineral density Z-scores (P ≤ .012). Furthermore, SG had greater reductions in narrow neck and intertrochanteric region (but not femoral shaft) cross-sectional area, cortical thickness, cross-sectional moment of inertia and section modulus, and increases in buckling ratio (P ≤ .039). Differences were attenuated after adjusting for 12-month body mass index change. At 12 months, differences were minimal after adjusting for age, sex, race, and weight. CONCLUSIONS: Over 12 months, SG had negative effects at the narrow neck and intertrochanteric regions of the hip, but not the femoral shaft. Reduced body mass index may compensate for these deleterious effects on bone.
BACKGROUND: Sleeve gastrectomy (SG), the most commonly performed metabolic and bariatric surgery, is associated with reductions in areal bone mineral density at multiple sites, and changes in bone structure at the distal radius and tibia without reductions in strength estimates at these peripheral sites. Data are lacking regarding effects on hip strength estimates. OBJECTIVE: To evaluate effects of SG on measures of hip structural analysis in adolescents and young adults over 12 months using dual-energy x-ray absorptiometry. SETTINGS: Translational and Clinical Research Center. METHODS: We enrolled 48 youth 14- to 22-years old with moderate-to-severe obesity; 24 underwent SG and 24 controls were followed without surgery (18 females, 6 males in each group). Hip structure was assessed using dual-energy x-ray absorptiometry at baseline and 12 months. Analyses are adjusted for age, sex, race, and the baseline bone measure. RESULTS: The SG group lost 25.9% weight versus .3% in controls. Compared with controls, SG had reductions in narrow neck, intertrochanteric and femoral shaft bone mineral density Z-scores (P ≤ .012). Furthermore, SG had greater reductions in narrow neck and intertrochanteric region (but not femoral shaft) cross-sectional area, cortical thickness, cross-sectional moment of inertia and section modulus, and increases in buckling ratio (P ≤ .039). Differences were attenuated after adjusting for 12-month body mass index change. At 12 months, differences were minimal after adjusting for age, sex, race, and weight. CONCLUSIONS: Over 12 months, SG had negative effects at the narrow neck and intertrochanteric regions of the hip, but not the femoral shaft. Reduced body mass index may compensate for these deleterious effects on bone.
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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
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