Effects of laparoscopic Roux-en-Y gastric bypass on bone mineral density and markers of bone turnover |
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| Institution: | 1. Minimally Invasive Bariatric Surgery and Advanced Laparoscopy Fellowship, Gundersen Health System, La Crosse, Wisconsin;2. Department of Surgery, Essentia Health, Duluth, Minnesota;3. Department of Research, Gundersen Medical Foundation, La Crosse, Wisconsin;4. Department of Radiology, Gundersen Health System, La Crosse, Wisconsin;5. Department of General and Vascular Surgery, Gundersen Health System, La Crosse, Wisconsin;1. Hospital de Clínicas Caracas, Caracas 1010, Venezuela;2. Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts;1. Department of Surgery, Bariatric Clinic, Beilinson Medical Center, Petach-Tikva, Israel, affiliated to Tel-Aviv University, Tel-Aviv, Israel;2. Department of Nephrology, Beilinson Medical Center, Petach-Tikva, Israel, affiliated to Tel-Aviv University, Tel-Aviv, Israel;1. Past-President, American Society for Metabolic and Bariatric Surgery;2. Past-President, International Federation for the Surgery of Obesity and Metabolic Disorders;3. Professor of Surgery and Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota;1. Obstetrics & Gynecology Unit, Nice University Hospital, Nice, France;2. University of Nice Sophia-Antipolis, F-06107, Nice, France;3. Digestive Surgery Unit, Nice University Hospital, Nice France;4. Digestive Unit, Archet 2 Hospital, Nice University Hospital, Nice, France;5. Inserm, U1065, Team 8 “Hepatic complications of obesity”, Nice, France;1. Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania;2. Departments of Dermatology and Pathology, Geisinger Medical Center, Danville, Pennsylvania |
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| Abstract: | BackgroundDespite multiple beneficial effects of weight loss after laparoscopic Roux-en-Y gastric bypass (LRYGB), the influence on bone mineral density (BMD) remains largely unknown. Our objective was to evaluate the changes in BMD and serum/urine bone markers after LRYGB.MethodsThirty-four women undergoing LRYGB were prospectively enrolled and underwent bone densitometry and serum/urine analysis preoperatively and 1 year postoperative. Changes≥.025 g/cm2 in hip, femoral neck, and spine BMD and decreases>2% in total BMD were considered significant. Statistical analysis included paired t tests and McNemar’s test.ResultsMean age was 44.6 years. Body mass index at the preoperative and 1-year postoperative intervals were 46.7 and 29.6 kg/m2, respectively. Mean hip, femoral neck, and spine (L1–L4) BMD was 1.191 versus 1.087 g/cm2 (P< .001), 1.105 versus 1.032 g/cm2 (P< .001), and 1.323 versus 1.277 g/cm2 (P< .001) at the preoperative and 1 year postoperative intervals, respectively. Mean total BMD decreased from 1.328 preoperatively to 1.251 g/cm2 at 1 year postoperative (P<.001). The decreases in BMD were 5.8%, 6.5%, 3.5%, and 8.8% for hip, femoral neck, spine (L1–L4) and total BMD from preoperative to 1 year postoperative. The proportion of patients with low vitamin D levels decreased from 55% preoperatively to 21% at 1 year postoperative (P = .004). Elevated osteocalcin and bone alkaline phosphatase was observed in 4% and 63% (P<.001), and 14% and 41% (P = .011) of patients preoperatively and at 1 year postoperative, respectively.ConclusionBMD and bone markers changed significantly after LRYGB. Current recommendations for supplementation in post-LRYGB women may need to be reevaluated. |
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| Keywords: | Gastric bypass Bone density Vitamin D Calcium Osteocalcin Bone resorption |
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