Long-Term Effects of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy on Bone Mineral Density: a 4-Year Longitudinal Study

Cadart, Olivier; Degrandi, Olivier; Barnetche, Thomas; Mehsen‐Cetre, Nadia; Monsaingeon-Henry, Maud; Pupier, E.; Bosc, Laurène; Collet, Denis; Gronnier, Caroline; Trémollières, Florence; Gatta-Chérifi, Blandine

doi:10.1007/s11695-020-04568-3

Cited by 20 publications

(9 citation statements)

References 40 publications

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“…Full‐text review of 355 studies resulted in the exclusion of 273 studies (Figure 1). Among the 82 included studies, 15 were of vitamin B 1 , 18–32 28 of folate, 18–45 42 of vitamin B 12 , 18–59 13 of vitamin A, 18,19,23,25,26,28–30,36,39,55,60,61 11 of vitamin E, 18,19,23,25,26,28,29,61–64 57 of vitamin D, 18,19,21–33,37–39,41,42,45,47,51,52,55,59,61,65–94 42 of calcium,…”

Section: Resultsmentioning

confidence: 99%

“…Only five studies 18,45,75,82,93 (12.5% and 7.3% of the included studies performing RYGB and SG, respectively) administered vitamin D supplementation per guidelines postoperatively. Vitamin D levels significantly increased at 6–11 months after RYGB (WMD, 22.71 ng/ml; 95% CI, 15.87–29.56) and 12–23 months after SG (WMD, 6.03 ng/ml; 95% CI, 4.18–7.89) (Table 3).…”

Section: Resultsmentioning

confidence: 99%

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Micronutrient status in bariatric surgery patients receiving postoperative supplementation per guidelines: Insights from a systematic review and meta‐analysis of longitudinal studies

Kwon

et al. 2021

Obesity Reviews

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Summary The micronutrient status and optimal monitoring schedule after bariatric surgery have not been sufficiently assessed. This systematic review and meta‐analysis investigated the longitudinal changes in micronutrient status after bariatric surgery. PubMed, EMBASE, and Cochrane Library were searched for articles that measured preoperative and postoperative serum micronutrient levels in patients undergoing Roux‐en‐Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Among guideline‐adherent studies, the longitudinal changes in micronutrient status were investigated using weighted mean difference (WMD) using a random‐effects model. Among the 82 included studies, the guideline adherence rates for micronutrient supplementation after bariatric surgery did not exceed 20%. In patients supplemented per guidelines, vitamin A significantly decreased after RYGB by −7.54 (95% confidence interval [CI], −10.16 to −4.92) μg/dl at 12–23 months, vitamin E decreased after RYGB by −2.35 (95% CI, −3.65 to −1.05) μg/dl at ≥24 months, and ferritin by −54.93 (95% CI, −77.19 to −32.67] μg/L at ≥24 months after SG, compared with baseline, with moderate level of evidence. Significant decreases in micronutrient levels at certain follow‐up intervals in studies with supplementation per guidelines need to be considered to establish a post‐bariatric micronutrient monitoring schedule for timely detection and management of micronutrient deficiencies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Micronutrient status in bariatric surgery patients receiving postoperative supplementation per guidelines: Insights from a systematic review and meta‐analysis of longitudinal studies

Kwon

et al. 2021

Obesity Reviews

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“…We have chosen to include both RYGB and SG since both procedures induce similar reductions in bone mass in the short- [ 44 – 46 ] and intermediate-term [ 46 ] although some studies have shown some skeletal site-specific difference between the procedures [ 44 ]. Stratifying an equal number of subjects having RYGB or SG into each study arm will take account for such site-specific differences.…”

Section: Discussionmentioning

confidence: 99%

Zoledronic Acid for prevention of bone and muscle loss after BAriatric Surgery (ZABAS)-a study protocol for a randomized controlled trial

Gam

Gram

Juhl

et al. 2022

Trials

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Background Bariatric surgery has adverse effects on the muscular-skeletal system with loss of bone mass and muscle mass and an increase in the risk of fracture. Zoledronic acid is widely used in osteoporosis and prevents bone loss and fracture. Bisphosphonates may also have positive effects on skeletal muscle. The aim of this study is to investigate the effects of zoledronic acid for the prevention of bone and muscle loss after bariatric surgery. Methods/design This is a randomized double-blind placebo-controlled study. Sixty women and men with obesity aged 35 years or older will complete baseline assessments before randomization to either zoledronic acid (5 mg in 100 ml isotonic saline) or placebo (100 ml isotonic saline only) 3 weeks before surgery with Roux-en-Y-gastric bypass (RYGB) or sleeve gastrectomy (SG). Follow-up assessments are performed 12 and 24 months after surgery. The primary outcome is changes in lumbar spine volumetric bone mineral density (vBMD) assessed by quantitative computed tomography (QCT). Secondary bone outcomes are changes in proximal femur vBMD assessed by QCT. Changes in cortical and trabecular bone microarchitecture and estimated bone strength will be assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT). Cortical material bone strength at the mid-tibia diaphysis will be assessed using microindentation and fasting blood samples will be obtained to assess biochemical markers of bone turnover and calcium metabolism. Secondary muscle outcomes include whole body lean mass assessed using dual-energy X-ray absorptiometry. Dynamometers will be used to assess handgrip, shoulder, ankle, and knee muscle strength. Short Physical Performance Battery, 7.6-m walking tests, 2-min walking test, and a stair climb test will be assessed as biomarkers of physical function. Self-reported physical activity level is assessed using International Physical Activity Questionnaire (IPAQ). Discussion Results from this study will be instrumental for the evidence-based care of patients undergoing bariatric surgery. Trial registration ClinicalTrials.gov NCT04742010. Registered on 5 February 2021.

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“…At year 4, the rates of bone loss were: 8.1 ± 5.5 % for the femur neck, 2.0 ± 7.2 % for the lumbar spine; 7.7 ± 6.4 % for the total hip, and 2.4 ± 5.5 % in for whole body BMI. This study, which also followed 47 individuals submitted to RYGB, concluded that bone loss at four years was comparable between procedures, although SG was associated with less bone deterioration for total hip BMD [51]. Another meta-analysis published in 2020 compared the changes in bone metabolism between SG and RYGB.…”

Section: Reviewmentioning

confidence: 96%

The Impact of Bariatric Surgery on Bone Health: State of the Art and New Recognized Links

et al. 2022

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Bariatric surgery (BS) is the most effective therapy for severe obesity, which improves several comorbidities (such as diabetes, hypertension, dyslipidemia, among others) and results in marked weight loss. Despite these consensual beneficial effects, sleeve gastrectomy and Roux-en-Y gastric bypass (the two main bariatric techniques) have also been associated with changes in bone metabolism and progressive bone loss. The objective of this literature review is to examine the impact of bariatric surgery on bone and its main metabolic links, and to analyze the latest findings regarding the risk of fracture among patients submitted to bariatric surgery.

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Long-Term Effects of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy on Bone Mineral Density: a 4-Year Longitudinal Study

Cited by 20 publications

References 40 publications

Micronutrient status in bariatric surgery patients receiving postoperative supplementation per guidelines: Insights from a systematic review and meta‐analysis of longitudinal studies

Micronutrient status in bariatric surgery patients receiving postoperative supplementation per guidelines: Insights from a systematic review and meta‐analysis of longitudinal studies

Zoledronic Acid for prevention of bone and muscle loss after BAriatric Surgery (ZABAS)-a study protocol for a randomized controlled trial

The Impact of Bariatric Surgery on Bone Health: State of the Art and New Recognized Links

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