Long-term trajectories of bone metabolism parameters and bone mineral density (BMD) in obese patients treated with metabolic surgery: a real-world, retrospective study

Greco, Carla; Passerini, Francesca; Coluccia, Silvia; Teglio, M; Bondi, Mario; Mecheri, Fouzia; Trapani, Vincenzo; Volpe, A; Toschi, Patrizia; Madeo, Bruno; Simoni, Manuela; Rochira, Vincenzo; Santi, Daniele

doi:10.1007/s40618-023-02066-8

Cited by 4 publications

(2 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This result remains, however, poorly reported. In a study of BS patients at a mean of 16.9 ± 8.1 years follow-up, phosphate levels were stable, with no difference between procedures [ 40 ]. Another approach to explain these differences in BMD and biomarkers with the malabsorptive hypothesis was to investigate loss of alkali related to malabsorption diarrhea.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Differential Effects of Gastric Bypass and Sleeve Gastrectomy on Bone Mineral Density

Cailleaux,

Ostertag,

Haguenauer

et al. 2024

Journal of the Endocrine Society

View full text Add to dashboard Cite

Context The association of obesity with bone fragility fractures is complex and non-linear. Despite good efficacy on weight loss, bariatric surgery (BS) is also associated with bone loss. However, we lack information on risk factors of the long-term deleterious effects of BS on the skeleton. Objective We aimed to assess the factors associated with low bone mineral density (BMD) performed a long time after Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Methods This cross-sectional study involved patients at a long distance from their BS that underwent dual-energy x-ray absorptiometry (DXA) with biological factors (vitamins, micronutrients, bone and inflammation biomarkers). Simple and multiple linear models (stepwise and parsimony approach) were developed. Results A total of 131 patients (91 RYGB, 40 SG) underwent DXA (51.8 ± 11.08 years, 87.8% women). At a mean of 6.8 ± 3.7 years after surgery, the mean weight loss was –28.6 ± 9.6%, and only 6 patients (5.7%) had a T-score less than or equal to 2.5. On univariate analysis, BMD was lower in the RYGB than in the SG group (P < .001) at all sites, despite similar fat and fat-free mass and weight loss. Serum parathyroid hormone and phosphate levels were higher in RYGB than SG patients. A total of 10.1% of patients showed vascular calcifications. On multivariable analysis, BMD remained different between surgery groups after adjustment for age, body mass index, ethnicity, and sex. The model-adjusted R2 values were 0.451 for the total hip; 0.462 the femoral neck, and 0.191 the lumbar spine for the inflammation model; 0.458, 0.462, and 0.254, respectively, for the bone marker model; and 0.372, 0.396, and 0.142 for the vitamin model. Serum zinc, ferritin, and uric acid levels were the markers associated with BMD to a low extent. Conclusion BMD differed depending on the BS procedure. A few biological markers may be associated weakly with BMD well after the surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Long-Term Differential Effects of Gastric Bypass and Sleeve Gastrectomy on Bone Mineral Density

Cailleaux,

Ostertag,

Haguenauer

et al. 2024

Journal of the Endocrine Society

View full text Add to dashboard Cite

show abstract

“…The expected percentage of weight loss after 2 years of RYGB is 74-80% [11]. However, a weight regain (up to 30% of maximum loss) and a post-surgical decrease in micronutrient absorption has been described, even after mineral and vitamin supplementation [12,13]. Thus, those patients who do not reach the desirable body weight after the RYGB or those who exhibit micronutrient deficiencies at any pre-surgical or post-surgical stage could require additional interventions.…”

Section: Introductionmentioning

confidence: 99%

A Program of Life-Style Modification Improved the Body Weight and Micronutrient Status in Obese Patients after Bariatric Surgery

Crespo-Yanguas,

Lumpuy-Castillo,

Espadas

et al. 2023

Nutrients

View full text Add to dashboard Cite

Introduction: Bariatric surgery is an efficient approach to rapidly reduce morbid obesity and associated comorbidities. However, approximately one-fourth of patients experience weight and comorbidity recurrence, and both obesity and bariatric surgery can lead to micronutrient deficiencies. Implementing a structured program of lifestyle modification (PLM) might enhance weight loss and improve micronutrient status. Methodology: A total of 121 severely obese patients underwent Roux-en-Y gastric bypass (RYGB). Among them, 71 adhered to a PLM involving dietary changes (low- and very-low-calorie Mediterranean diets) and physical exercises (aerobic and resistance training) both before and after surgery, while 50 patients followed a conventional protocol. Anthropometric measurements and serological parameter quantifications were conducted throughout the procedures. Results: The obese study population, primarily female (76.9%), with an average age of 47.11 ± 9.68, and a body mass index (BMI) of 44.68 ± 5.08 kg/m2, underwent either RYGB with a PLM or a conventional procedure. Before surgery, the PLM group exhibited significant reductions in body weight (6.3%) and phosphoremia compared to the conventional protocol (0.78%). Post-RYGB, the PLM group demonstrated shortened in-hospital stays and further BMI reductions (−16.12 kg/m2) that persisted for up to 2 years. Furthermore, the PLM group experienced increased plasma vitamin D levels (14.79 ng/mL vs. 1.2 ng/mL) for up to 2 years, as well as elevated folic acid (1.52 vs. −0.29 ng/mL) and phosphorus (0.48 vs. 0.06 mg/dL) levels at 1 month and 1 year after intervention, respectively. Notably, these effects were independent of weight loss. Conclusions: Initiating a structured PLM from the early stages of patients’ preparation for RYGB could enhance and extend the benefits of weight loss and positively impact micronutrient (vitamin D, phosphorus, and folic acid) status in obese patients.

show abstract

Short-term effects of Roux-en-Y gastric bypass or gastric sleeve on bone mineral density and calciotropic hormones: a systematic review and meta-analysis

de Almeida,

Lima,

Avila

et al. 2024

Surgery for Obesity and Related Diseases

View full text Add to dashboard Cite

Long-term trajectories of bone metabolism parameters and bone mineral density (BMD) in obese patients treated with metabolic surgery: a real-world, retrospective study

Cited by 4 publications

References 48 publications

Long-Term Differential Effects of Gastric Bypass and Sleeve Gastrectomy on Bone Mineral Density

Long-Term Differential Effects of Gastric Bypass and Sleeve Gastrectomy on Bone Mineral Density

A Program of Life-Style Modification Improved the Body Weight and Micronutrient Status in Obese Patients after Bariatric Surgery

Short-term effects of Roux-en-Y gastric bypass or gastric sleeve on bone mineral density and calciotropic hormones: a systematic review and meta-analysis

Contact Info

Product

Resources

About