Impact of vitamin D deficiency on bone health after Roux-en-Y gastric bypass and sleeve gastrectomy: a large propensity-matched cohort study
Abstract
BACKGROUND
Vitamin D deficiency (VDD) affects 30%-70% of patients with obesity, yet its impact on postoperative bone health outcomes after metabolic surgery remains incompletely characterized.
OBJECTIVES
To investigate the differential impact of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) on postoperative bone health outcomes, both in the bariatric population with and without pre-existing VDD.
SETTINGS
Analysis of TriNetX Global Collaborative Network, a deidentified real-world database from multiple institutes.
METHODS
Using the TriNetX, we identified adults with obesity who underwent RYGB or SG from 2008 to 2022, with follow-up extended up to 5 years postsurgery. Propensity score matching (1:1) adjusted for baseline confounders. Primary outcomes included osteopenia, osteoporosis, and fracture-related osteoporosis.
RESULTS
After matching, 35,804 patients with preoperative VDD were compared to 35,804 without. Although absolute risk differences were small, VDD patients had significantly higher odds of developing osteopenia (1.9% vs 1.0%; odds ratio [OR] 2.04, 95% confidence interval [CI] 1.79-2.32, P < .001) and osteoporosis (.7% vs .3%; OR 2.54, 95% CI 2.00-3.23, P < .001). Subgroup analyses showed elevated osteopenia risk among VDD patients undergoing RYGB (OR 1.69, 95% CI 1.41-2.02, P < .001) and SG (OR 2.02, 95% CI 1.68-2.42, P < .001), with higher osteoporosis risk in both RYGB (OR 1.94, 95% CI 1.45-2.59, P < .001) and SG (OR 1.91, 95% CI 1.36-2.67, P =…
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: 35,804 participants or records.
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