Changes in bone metabolism and densitometry after metabolic/bariatric surgery: a comparison of pre- and postoperative results in a prospective long-term study
Abstract
Background: Metabolic and bariatric surgery (MBS) is associated with sustained weight loss and metabolic improvement. However, the understanding of its long-term effects on skeletal health remains incomplete, particularly with respect to different surgical procedures.
Objectives: This study aimed to evaluate long-term changes in bone metabolism, bone mineral density (BMD), and fracture risk after sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one-anastomosis gastric bypass (OAGB).
Setting: University hospital.
Methods: In this retrospective cohort with prospective long-term follow-up, 60 patients (20 RYGB, 20 OAGB, and 20 SG) underwent primary MBS. Dual-energy X-ray absorptiometry-derived bone densitometry and bone metabolism markers were assessed preoperatively and after a mean follow-up of 10.1± 2.5 years. Measurements included BMD, T-score, and z score at lumbar spine and femoral neck. Ten-year fracture probability was estimated using the FRAX (Fracture Risk Assessment tool) score.
Results: Bone metabolism markers largely remained within reference ranges throughout follow-up. Serum vitamin D levels increased significantly after all procedures reflecting postoperative supplementation. In contrast, significant reductions in femoral BMD was observed after all three procedures (SG: .99 ± .14 to .49 ± .17 g/cm2, P = .03; RYGB: 1.09 ± .80 to .59 ± .17 g/cm2, P = .02; OAGB: 1.11 ± .18 to .53 ± .13 g/cm2, P = .01), whereas lumbar spine BMD showed no significant…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 60 participants or records.
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