Long-Term Effects of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy on Bone Mineral Density: a 4-Year Longitudinal Stud
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ORIGINAL CONTRIBUTIONS
Long-Term Effects of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy on Bone Mineral Density: a 4-Year Longitudinal Study O. Cadart 1,6 & O. Degrandi 2 & T. Barnetche 3 & N. Mehsen-Cetre 3 & M. Monsaingeon-Henry 1 & E. Pupier 1 & L. Bosc 1 & D. Collet 2,6 & C. Gronnier 2,6 & F. Tremollieres 4 & Blandine Gatta-Cherifi 1,5,6
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction Bone mineral density (BMD) declines in the initial years after bariatric surgery, but long-term skeletal effects are unclear and comparisons between sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are rare. Design and Methods An observational longitudinal study of obese patients undergoing SG or RYGB was performed. Wholebody (WB) BMD, along with BMD of the total hip (TH), femoral neck (FN), and lumbar spine (LS), was measured by dualenergy X-ray absorptiometry (DXA) before surgery and yearly thereafter for 4 years. Calciotropic hormones were also measured. Results Forty-seven patients undergoing RYGB surgery and 28 patients undergoing SG were included. Four years after RYGB, BMD declined by 2.8 ± 5.8% in LS, 8.6 ± 5% in FN, 10.9 ± 6.3% in TH, and 4.2 ± 6.2% in WB, relative to baseline. For SG, BMD declined by 8.1 ± 5.5% in FN, 7.7 ± 6% in TH, 2.0 ± 7.2% in LS, and 2.5 ± 6.4% in WB after 4 years, relative to baseline. Vitamin D levels increased with supplementation in both groups. Whereas parathyroid hormone levels increased slightly in the RYGB group, they decreased modestly in the SG group (P < 0.05 in both groups). Conclusions Bone loss after 4 years was comparable between the two procedures, although RYGB was associated with a slightly greater decrease at the TH than SG. Bone health should therefore be monitored after both RYGB and SG. Keywords Obesity . Bariatric surgery . Bone density . Long-term effects
Introduction C. Gronnier, F. Tremollieres and Blandine Gatta-Cherifi contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11695-020-04568-3) contains supplementary material, which is available to authorized users. * Blandine Gatta-Cherifi [email protected] 1
Endocrinology, Diabetology & Nutrition Department, University Hospital of Bordeaux, Pessac, France
2
Digestive Surgery Department, University Hospital of Bordeaux, Pessac, France
3
Rheumatology Department, University Hospital of Bordeaux, Bordeaux, France
4
Menopause center, Hôpital Paule de Viguier, University Hospital of Toulouse, Toulouse, France
5
INSERM U1215 Neurocentre Magendie, University of Bordeaux, Bordeaux, France
6
University of Bordeaux, College Santé, 33076 Bordeaux, France
Bariatric surgery is the most effective treatment to achieve major, long-term weight loss [1–4]. Reflective of the obesity epidemic, the number of bariatric surgeries performed worldwide is also increasing. In 2014, the most commonly performed procedure was sleeve gastrectomy (SG), performed in 45.9% of total surgical
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