Bone mineral density changes after bariatric surgery
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and Other Interventional Techniques
2020 SAGES ORAL
Bone mineral density changes after bariatric surgery Kelly Ieong1 · Jessica Ardila‑Gatas1 · Jie Yang2 · Xiaoyue Zhang2 · Stella To Tsui1 · Konstantinos Spaniolas1 · Aurora D. Pryor1 Received: 19 April 2020 / Accepted: 27 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction Although bariatric surgery is associated with multiple health benefits, decreased bone mass is a known complication of the procedure. Roux-en-Y gastric bypass (RYGB) is associated with significant bone loss and increased fracture risk. However, data on the effect of sleeve gastrectomy (SG) on bone mineral changes are sparse. The impact of vitamin D and calcium levels on bone mineral density (BMD) after SG is also unknown. Methods A retrospective chart review was performed to include patients who underwent RYGB or SG from 2014 to 2016 at a single institution. Patients were included if bone densitometry was performed preoperatively and within 2 years postoperatively. Serum 25-hydroxy vitamin D and calcium levels were collected preoperatively and at time of bone densitometry scan. BMD and T-score changes at the femoral neck, femoral trochanter, total hip, and lumbar spine were compared between RYGB and SG patients. Results A total of 40 patients were included. 24 (60%) of patients underwent RYGB and 16 (40%) patients underwent SG. No statistically significant difference in baseline characteristics was noted between RYGB and SG patients. All measurements, except for serum 25-hydroxy vitamin D, were significantly decreased in RYGB patients, postoperatively. All measurements, except for BMD and T-score at the lumbar spine and serum 25-hydroxy vitamin D, were significantly decreased in SG patients, postoperatively. The extent of decrease in serum 25-hydroxyvitamin D was significantly associated with decreased BMD (p = 0.049) and T-score (p = 0.032) at the lumbar spine. The extent of decrease in serum calcium was significantly associated with decreased BMD (p = 0.046) at the femoral neck. Conclusion All patients were found to have decreased BMD after RYGB and SG. Surgery type was not a significant risk factor in BMD change. Despite vitamin D and calcium supplementation in all patients, a decrease in vitamin D and calcium levels were associated with a decrease in BMD. Close follow-up and treatment of vitamin D and calcium levels are warranted in all bariatric patients.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00464-020-07953-2) contains supplementary material, which is available to authorized users. * Kelly Ieong [email protected] 1
Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Health Sciences Center, T19‑053, Stony Brook Medicine, Stony Brook, NY 11794‑8191, USA
Department of Family, Population and Preventive Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA
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