Bone metabolism, bone mineral density and low-energy fractures 10 years after Roux-en-Y gastric bypass

Blom-Høgestøl, Ingvild Kristine; Hewitt, Stephen; Chahal-Kummen, Monica; Brunborg, Cathrine; Gulseth, Hanne Løvdal; Kristinsson, Jon; Eriksen, Erik Fink; Mala, Tom

doi:10.1016/j.bone.2019.07.014

Cited by 39 publications

(39 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results are in agreement with a recent cross-sectional study from Norway [32] of 124 patients 10 years after gastric bypass. There is also a small study from Denmark with longitudinal data over 7 years reporting similar results [33].…”

Section: Discussionsupporting

confidence: 93%

Bone Mineral Density, Parathyroid Hormone, and Vitamin D After Gastric Bypass Surgery: a 10-Year Longitudinal Follow-Up

et al. 2020

View full text Add to dashboard Cite

Background The aim of the present study was to study longitudinal changes in bone mineral density (BMD), vitamin D, and parathyroid hormone (PTH) levels in females over a 10-year period after laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods Twenty-three women, mean age 43.4 ± 8.7 years and mean body mass index (BMI) 44.6 ± 5.17 kg/m 2 at baseline, were included. BMD, BMI, S-calcium, S-25(OH)-vitamin D, and fP-PTH were measured preoperatively and 2, 5, and 10 years postoperatively. Results Ten years after surgery, BMD of the spine and femoral neck decreased by 20% and 25%, respectively. Changes in serum levels of vitamin D, PTH, and calcium over the same period were small. Conclusion After LRYGB with subsequent massive weight loss, a large decrease in BMD of the spine and femoral neck was seen over a 10-year postoperative period. The fall in BMD largely occurred over the first 5 years after surgery.

show abstract

Section: Discussionsupporting

confidence: 93%

Bone Mineral Density, Parathyroid Hormone, and Vitamin D After Gastric Bypass Surgery: a 10-Year Longitudinal Follow-Up

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Importantly, the authors point at a very low compliance of vitamin and mineral supplementation during post-BS follow-up. Indeed, 16% of patients drop out of the RCT [55] and only one third of the patients reported regular calcium and vitamin D intake in retrospective studies [34]. Furthermore, the prevalence of patients undergoing systematic vitamin dosage dropped dramatically at one year post-BS which confirms previous findings of a decreased compliance to follow-up after the first years [57].…”

Section: Effects Of Supplementation On Vitamin Status and Clinical Ousupporting

confidence: 71%

“…5 [33] to 10 years [34]), the prevalence of vitamin D insufficiency or deficiency reaches up to 60% of patients [33,34]. More worryingly, this is present in a large proportion of patients having a bone mineral density (BMD) below the normal range, or even osteopenia and osteoporosis, thus increasing the risk of low-energy bone fractures [34]. This adverse effect represents one of the recent concerns arising in the mid and long term post-BS.…”

Section: Vitamin Deficiency and Need For Supplementation Following Bamentioning

confidence: 99%

A place for vitamin supplementation and functional food in bariatric surgery?

Aron‐Wisnewsky

Clément

2019

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

View full text Add to dashboard Cite

 Purpose of review: This article summarizes the recent literature concerning vitamin deficiency and required supplementation post bariatric surgery (BS), with a focus on vitamin (and associated clinical adverse effect on bone loss) and on the potential implication of the gut microbiota.  Recent findings: BS improves health outcomes in terms of weight loss and metabolic alterations yet with major inter-individual variability. Indeed, although BS is efficient in most patients, some display poor response (i.e. patients with the lowest weight loss at one year or weight regain afterwards, or patients who do not undergo metabolic disease remission). Furthermore, despite systematic vitamin supplementation post-BS, some patients develop vitamin deficiencies leading to poor clinical outcomes. Specifically, a major recently described adverse outcome is vitamin D deficiency associated in part with observed bone mass loss and fractures. Recent mechanistic studies have been performed to better understand the involved physiopathology. Furthermore, different intervention studies tested on top of BS (using vitamin supplementation, diet or nutrients acting as functional food) have evaluated whether they could improve these nutritional adverse outcomes and are summarized herein. Importantly, gut microbiota involved in food digestion and metabolization as well as vitamin synthesis, is largely perturbed during severe obesity and is partially restored post-BS, yet again with large inter-individual variability. Whether differential modification of the gut microbiota could be associated with those vitamin deficiencies is an open question.  Summary: Future clinical research studies will need to evaluate whether add-on intervention to BS using vitamin, diet or specific food items could help prevent nutritional deficiencies and improve clinical response observed post-BS. More importantly, personalizing the add-on intervention after BS upon gut microbiota composition should be tested in predicted poor responders to BS as already performed during diet intervention to further improve metabolic health.

show abstract

“…SHPT may also lead to reduced BMD, which is observed after weight stabilizes 1-2 years postoperatively [15,19]. We recently found SHPT related with lower BMD 10 years after RYGB [21].…”

Section: Supplementation Shpt and Bone Effectsmentioning

confidence: 96%

“…Relationships of calcium and vitamin D with PTH should be explored further, as PTH may impact bone turnover and bone mineral density (BMD) postoperatively [14][15][16][17][18][19][20][21][22][23][24]. More focus on these are needed during follow-up.…”

Section: Introductionmentioning

confidence: 99%

Relationships Between Vitamin D Status and PTH over 5 Years After Roux-en-Y Gastric Bypass: a Longitudinal Cohort Study

et al. 2020

Self Cite

View full text Add to dashboard Cite

Purpose Secondary hyperparathyroidism (SHPT) after obesity surgery may affect bone health. Optimal vitamin D levels have not been established to prevent SHPT postoperatively. We investigated whether SHPT differed across threshold levels of serum 25-hydroxyvitamin D (S-25(OH)D) from 6 months up to 5 years after Roux-en-Y gastric bypass (RYGB). Materials and Methods We included 554 patients at follow-up 5 years postoperatively. Blood samples were analysed for S-25(OH)D, ionized calcium (iCa) and parathyroid hormone (PTH) during follow-up. Results PTH and prevalence of SHPT increased from 6 months to 5 years postoperatively, while S-25(OH)D and iCa decreased (all P < 0.001). PTH and SHPT development are related with S-25(OH)D, and PTH differed between all subgroups of S-25(OH)D. SHPT occurred less frequently across all subgroups of S-25(OH)D ≥ 50 nmol/l during follow-up: odds ratio (OR) 0.44 (95% CI 0.36-0.54) in patients with S-25(OH)D ≥ 50 nmol/l, OR 0.38 (0.30-0.49) with S-25(OH)D ≥ 75 nmol/l and OR 0.19 (0.12-0.31) with S-25(OH) D ≥ 100 nmol/l, all compared with S-25(OH)D < 50 nmol/l. At 5 years, 208/554 patients (38%) had SHPT; SHPT was found in 94/188 patients (50%) with S-25(OH)D < 50 nmol/l, in 69/222 (31%) with S-25(OH)D 50-74 nmol/l, in 40/117 (34%) with S-25(OH)D 75-99 nmol/l and in 5/27 (19%) with S-25(OH)D ≥ 100 nmol/l. An interaction existed between S-25(OH)D and iCa. Bone alkaline phosphatase remained increased with SHPT. Conclusions A significant relationship existed between S-25(OH)D and development of PTH and SHPT. The prevalence of SHPT was lower with threshold levels 25(OH)D ≥ 50 nmol/l and ≥ 75 nmol/l over the 5 years, and lowest with S-25(OH)D ≥ 100 nmol/l.

show abstract

Bone metabolism, bone mineral density and low-energy fractures 10 years after Roux-en-Y gastric bypass

Cited by 39 publications

References 48 publications

Bone Mineral Density, Parathyroid Hormone, and Vitamin D After Gastric Bypass Surgery: a 10-Year Longitudinal Follow-Up

Bone Mineral Density, Parathyroid Hormone, and Vitamin D After Gastric Bypass Surgery: a 10-Year Longitudinal Follow-Up

A place for vitamin supplementation and functional food in bariatric surgery?

Relationships Between Vitamin D Status and PTH over 5 Years After Roux-en-Y Gastric Bypass: a Longitudinal Cohort Study

Contact Info

Product

Resources

About

Bone metabolism, bone mineral density and low-energy fractures 10 years after Roux-en-Y gastric bypass

Cited by 39 publications

References 48 publications

Bone Mineral Density, Parathyroid Hormone, and Vitamin D After Gastric Bypass Surgery: a 10-Year Longitudinal Follow-Up

Bone Mineral Density, Parathyroid Hormone, and Vitamin D After Gastric Bypass Surgery: a 10-Year Longitudinal Follow-Up

A place for vitamin supplementation and functional food in bariatric surgery?

Relationships Between Vitamin D Status and PTH over 5 Years After Roux-en-Y Gastric Bypass: a Longitudinal Cohort Study

Contact Info

Product

Resources

About

Bone metabolism, bone mineral density and low-energy fractures 10 years after Roux-en-Y gastric bypass