Changes in bone mineral density following laparoscopic sleeve gastrectomy: 2-year outcomes |
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| Institution: | 1. Department of Human Metabolism and Nutrition, Braun School of Public Health, Hebrew University, Jerusalem, Israel;2. Department of Nutrition, Hadassah-Hebrew University Medical Center, Jerusalem, Israel;3. Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel;4. Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel;5. Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel;6. Technion School of Medicine and the Department of Pediatrics, Rambam Medical Center, Haifa, Israel;7. Osteoporosis Center, Endocrinology and Metabolism Service, Internal Medicine Ward, Hadassah Medical Organization, Jerusalem, Israel;1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland;2. Departments of Psychiatry and Medicine, Dartmouth-Hitchcock Medical Center, Hanover, Lebanon, New Hampshire;1. Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates;2. Cleveland Clinic, Cleveland, Ohio;1. Division of Bariatric and Gastrointestinal Surgery, Department of Surgery, Virginia Commonwealth University, Richmond, Virginia;2. Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio;3. Department of Surgery, Division of General and Gastrointestinal Surgery, The Ohio state University, Wexner Medical Center, Columbus, Ohio;4. South Florida Transplant Center, Broward Health Medical Center, Fort Lauderdale, Florida;5. Division of Gastroenterology, Hepatology, & Nutrition, Ohio State University Wexner Medical Center, Columbus, Ohio;6. Department of Medicine, University of California, San Francisco, California;7. Department of Surgery, Stanford University School of Medicine, Stanford, California;8. Section of Minimally Invasive & Bariatric Surgery, Stanford University School of Medicine, Stanford, California;9. Department of Surgery, University of Minnesota, Minneapolis, Minnesota;1. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania;2. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania;3. Department of Surgery, Division of GI Metabolic and Bariatric Surgery, Weill Cornell Medicine, New York, New York;4. Department of Surgery, University of Montreal, Montreal, Canada;5. Department of Surgery, East Carolina University, Greenville, North Carolina |
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| Abstract: | BackgroundEmerging evidence suggests that sleeve gastrectomy (SG) leads to significant bone mineral density (BMD) losses, but there is a paucity of studies evaluating skeletal consequences beyond 12-months post-operatively.ObjectivesTo evaluate BMD changes 2 years postoperatively.SettingA university hospital.MethodsThirty-three women (mean age: 34.4 ± 12.3 years) who underwent SG and completed 24 months of follow-up were evaluated prospectively at baseline and at 3 (M3), 6 (M6), 12 (M12), and 24 (M24) months postoperatively. Data collected included BMD at the total hip, femoral neck, and lumbar spine measured by dual-energy x-ray absorptiometry and anthropometrics, biochemical, nutritional, and physical activity parameters.ResultsAt M24, patients achieved a mean body mass index and excess weight loss of 32.4 ± 5.1 kg/m2 and 64.5 ± 21.4%, respectively; however, weight stabilized at M12. Femoral neck BMD decreased significantly from baseline to M24 (.924 ± .124 versus .870 ± .129 g/cm2, P < .001), with no change between M12 and M24 (P = .273). Total hip BMD decreased significantly from baseline to M24 (1.004 ± .105 versus .965 ± .132 g/cm2, P < .001) but increased between M12 and M24 (P = .001). No significant changes were noted in lumbar spine BMD. The percentage of changes in the femoral neck and the total hip BMD from baseline to M24 positively correlated with postoperative excess weight loss (r = .352, P = .045, and r = .416, P = .018, respectively).ConclusionDespite notable weight loss, women who underwent SG experienced significant bone loss at the total hip and femoral neck more than 2 years postoperatively. Future studies should investigate intervention strategies to attenuate skeletal deterioration after SG. |
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| Keywords: | Obesity Bariatric surgery Sleeve Gastrectomy Bone Mineral Density Bone turnover markers |
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