Long-Term Bone Health After Roux-en-Y Gastric Bypass: A Pilot Study

Cook, Fiona; Khanna, Ila; Giordano, Jennifer; Matarese, Laura E.; Hudson, Suzanne

doi:10.4158/ep171823.or

Cited by 15 publications

(16 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Two prior studies have evaluated area bone density and bone turnover markers at least a decade after RYGB. ( 27,28 ) Neither of these studies had control groups, but they did document a high proportion of negative Z ‐scores after RYGB, indicating lower than expected bone density. However, by relying on DXA Z ‐scores, these studies were unable to fully take into account the effect of body weight on bone outcomes.…”

Section: Discussionmentioning

confidence: 92%

“…Nevertheless, our use of BMI‐matched controls still enabled us to directly evaluate whether reductions in bone density exceeded the physiologic expectation of mechanical unloading. Our sample size was small, which may have limited our ability to detect significant differences, but unlike prior cross‐sectional studies of bariatric procedures, ( 27,28 ) we evaluated matched controls and provided sophisticated HR‐pQCT analyses of bone microarchitecture and trabecular morphology. These data signify the importance of additional, larger studies to assess skeletal changes after bariatric surgery.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Bone Density and Trabecular Morphology at Least 10 Years After Gastric Bypass and Gastric Banding

Lindeman

Rushin

Cheney

et al. 2020

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

Roux-en-Y gastric bypass (RYGB) instigates high-turnover bone loss in the initial 5 years after surgery, whereas skeletal changes after adjustable gastric banding (AGB) are less pronounced. Long-term skeletal data are scarce, and the mechanisms of bone loss remain unclear. We sought to examine bone density and microarchitecture in RYGB and AGB patients a decade after surgery and to determine whether prior published reports of bone loss represent an appropriate adaptation to new postsurgical weight. In this crosssectional study, 25 RYGB and 25 AGB subjects who had bariatric surgery ≥10 years ago were matched 1:1 with nonsurgical controls for age, sex, and current body mass index (BMI). We obtained bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA), volumetric BMD and microarchitecture by high-resolution peripheral quantitative computed tomography (HR-pQCT), trabecular morphology by individual trabecular segmentation, and metabolic bone laboratory results. As compared with BMI-matched controls, RYGB subjects had significantly lower hip BMD, and lower total volumetric BMD at the distal radius and tibia. Substantial deficits in cortical and trabecular microarchitecture were observed in the RYGB group compared to controls, with reduced trabecular plate bone volume fraction and estimated failure load at both the radius and tibia, respectively. Bone turnover markers CTX and P1NP were 99% and 77% higher in the RYGB group than controls, respectively, with no differences in serum calcium, 25-hydroxyvitamin D, or parathyroid hormone. In contrast, the AGB group did not differ from their BMI-matched controls in any measured bone density, microarchitecture, or laboratory parameter. Thus, RYGB, but not AGB, is associated with lower than expected hip and peripheral BMD for the new weight setpoint, as well as deleterious changes in bone microarchitecture. These findings suggest that pathophysiologic processes other than mechanical unloading or secondary hyperparathyroidism contribute to bone loss after RYGB, and have important clinical implications for the long-term care of RYGB patients.

show abstract

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Bone Density and Trabecular Morphology at Least 10 Years After Gastric Bypass and Gastric Banding

Lindeman

Rushin

Cheney

et al. 2020

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that the operation time, postoperative intestinal recovery time, and length of hospital stay were significantly shorter with modified loop cholecystojejunostomy than Roux-en-Y anastomosis. [10][11][12][13][14][15] Ordog et al 16 found that the pacemaker of the jejunum is located in the duodenal bulb. Their research revealed that the integrity of electrical conduction is essential in the small intestine and that discontinuity of the electrical conduction by jejunal transection is likely to cause jejunal motility disorders and thus increase the chance of reflux cholangitis.…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of laparoscopic modified loop cholecystojejunostomy for the treatment of malignant obstructive jaundice

Zhuo

Chen

et al. 2019

J Int Med Res

View full text Add to dashboard Cite

Objective This study was performed to summarize our experience and investigate the safety and efficacy of laparoscopic modified loop cholecystojejunostomy for the treatment of malignant obstructive jaundice. Methods Thirteen patients with malignant obstructive jaundice who underwent laparoscopic modified loop cholecystojejunostomy from March 2015 to March 2016 were retrospectively reviewed. The patients’ characteristics, operation time, postoperative intestinal recovery time, length of hospital stay, postoperative bilirubin level, and complications were analyzed. Results The patients were followed up as outpatients for 2 years. Nine patients with pancreatic head carcinoma, one patient with periampullary carcinoma, and three patients with distal bile duct carcinoma successfully underwent laparoscopic modified loop cholecystojejunostomy. The mean operation time was 176 ± 45 minutes, and the mean length of hospital stay was 9.5 ± 2.8 days. The serum total bilirubin concentration and gamma-glutamyl transferase concentration significantly decreased on postoperative day 7. The median follow-up time was 7 months. No patients developed bile leakage or required a reoperation. Conclusions Laparoscopic modified loop cholecystojejunostomy is not only safe and minimally invasive, but it is also feasible for patients with malignant obstructive jaundice.

show abstract

“…In the obese person, bone homeostasis shifts towards resorption, decreasing bone quality (Shapses, Pop, & Wang, 2017). Specific risk factors for osteoporosis associated with bariatric surgery include degree of malabsorption of calcium, vitamin D, and micronutrients, time since surgery, compliance with supplements and health care follow up, and extent of and sustained weight loss (Cook, Khanna, Giordano, Matarese, & Hudson, 2017).…”

Section: Osteoporosismentioning

confidence: 99%

Understanding the Experience of Osteoporosis Risk in Bariatric Surgical Patients

Mori

Sheehan

Graor

et al. 2021

Orthopaedic Nursing

View full text Add to dashboard Cite

Despite what is known about risk factors, preventive treatment, and increased prevalence of fragility fractures in post-bariatric surgical patients, little is known about how patient views of osteoporosis inform their commitment to bone health. The purpose of this research was to examine the lived experience of osteoporosis risk in people who have had bariatric surgery. The specific aims were to understand: 1. What it means to live with the risk of osteoporosis after bariatric surgery 2. The perceptions of osteoporosis risks postoperatively. This study used interpretive phenomenology to explore osteoporosis from the perspective of bariatric surgery patients.Purposive and snowball sampling was used to recruit individuals at risk for osteoporosis and a history of bariatric surgery. Eligibility criteria required participants to be female, over the age of 18 and understand and speak English. The study consisted of in-depth semi-structured interviews with 14 participants. Using open-ended questions, the interviews were audio recorded and transcribed. Study aims were addressed using strategies outlined by Diekelmann, Allen, & Tanner (1989). Findings are described under the relational theme of Looking out for Self, and supported by three subthemes Understanding, Protecting, and Preventing. This research provided an ACKNOWLEDGEMENTS I would like to thank many of the individuals who helped me complete this dissertation study. My dissertation chair, Dr. Denice Sheehan, gave me continuous support, guidance, and encouragement. I'm grateful for her advice and clarity she gave throughout this dissertation. Assistance with edits and analysis were greatly appreciated. I'm thankful for her patience with my never-ending emails. I also want to thank my dissertation committee for all their time and effort they put into helping me complete this project.I could not have gotten through this journey without all my family and friends. I want to thank my dear friend, Heather who was willing to run with very early in the morning. I'm grateful for her friendship, willingness to listen, and loving heart. I am grateful for my CNSs colleagues and friends who provided never ending support and encouragement to keep me pushing forward.To my mom, Carol, who gave me support and helped me with juggling schedules while working on this dissertation. I want to thank my beautiful children, Isaac, Conner, and Nya for always being there to encourage me on. I'm appreciative for their patience while I sat for many hours at my computer. They are compassionate and strong individuals and I'm a better person because of them.Lastly, this endeavor would not have been possible without the never-ending support and encouragement that I received from my husband, Jeff. He gave me unending grace, love, and support through my relentless pursuit to not just finish my PhD but to excel. I was able to complete this work because of his steadfast belief in my capabilities. He is my best friend, love of my life, and has blessed me in countless ways. I feel so blessed to have s...

show abstract

Long-Term Bone Health After Roux-en-Y Gastric Bypass: A Pilot Study

Cited by 15 publications

References 37 publications

Bone Density and Trabecular Morphology at Least 10 Years After Gastric Bypass and Gastric Banding

Bone Density and Trabecular Morphology at Least 10 Years After Gastric Bypass and Gastric Banding

Clinical efficacy of laparoscopic modified loop cholecystojejunostomy for the treatment of malignant obstructive jaundice

Understanding the Experience of Osteoporosis Risk in Bariatric Surgical Patients

Contact Info

Product

Resources

About