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Prevalence of Morphometric Vertebral Fractures After Bariatric Surgery and Its Relationship with Bone Mineral Density and Bone Markers

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Abstract

Background

Bariatric surgery (BS) can lead to bone loss and an increased fracture risk.

Methods

To determine the morphometric vertebral fracture (MVF) prevalence, and its relationship with bone mineral density (BMD), and biomarker’s turnover after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), we analyzed post-surgery X-rays of the spine in 80 patients (88% female, 51% RYGB, age 41.2 [6.8] years) from 117 participants’ retrospective cohort (1–2 years, >2 and <5 years, and >5 years). We still analyzed body composition and BMD by dual-energy X-ray absorptiometry and bone parameters.

Results

MVF prevalence was 17.5% (14/80), with no statistical difference between groups (p = 0.210). RYGB group had a higher prevalence of secondary hyperparathyroidism (SHPT) (PTH ≥ 65 pg/ml; 18.4% vs 7.8%, respectively, p = 0.04), PTH (61.3 vs 49.5 pg/ml, p = 0.001), CTX (0.766 [0.29] ng/ml vs 0.453 [0.30] ng/ml, p = 0.037), and AP (101.3 [62.4] U/L vs 123.9 [60.9] U/L, p = 0.027) than the SG group. Up to 5 years postoperatively, RYGB had a lower total (1.200 [0.087] vs 1.236 [0.100] g/cm2, p = 0.02), femoral neck (1.034 [0.110] vs 1.267 [0.105], p = 0.005), and total femur BMD (1.256 [0.155] vs 1.323 [0.167], p = 0.002) than SG group. We found no statistically significant difference between the MFV (+) and MVF (−) groups regarding age, sex, BMI, surgery time, BMD, or bone and metabolic parameters, including leptin.

Conclusion

We found a high prevalence of MVF after BS with no differences between RYGB and SG.

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Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior–Brasil (CAPES) [Finance Code 001].

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Authors and Affiliations

  1. Department of Endocrinology, Federal University of Paraiba, Joao Pessoa, Brazil

    Narriane Chaves Pereira de Holanda, Tadeu Iury Araujo Rodrigues Silva, Arthur Gomes Cavalcante, Mariana Braga Lacerda, Gabrielly de Oliveira Viena, Carolina Cabral de Carvalho, Kauê Tavares Menezes, Igor Rosemberg Nóbrega de Medeiros & Marília Moreira Sales

  2. Post-Graduation Program in Health Science, University of Pernambuco Medical School, Recife, Brazil

    Narriane Chaves Pereira de Holanda & Francisco Bandeira

  3. Department of Radiology, Federal University of Paraiba, Joao Pessoa, Brazil

    Felipe Reis e Silva de Queiroz & Cecília Gabriela de Arruda Castelo Branco Brito

  4. Division of Endocrinology and Diabetes, Agamenon Magalhães Hospital, University of Pernambuco Medical School, Recife, Brazil

    Francisco Bandeira

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  1. Narriane Chaves Pereira de Holanda
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Corresponding author

Correspondence to Narriane Chaves Pereira de Holanda.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Key points

• There was a high prevalence of MVF after BS (17.5%), with no differences between RYGB and SG.

• High serum CTX concentrations were independently associated with MVF.

• After 5 years, RYGB group had lower BMD and higher serum PTH than SG group.

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de Holanda, N.C.P., Silva, T.I.A.R., Cavalcante, A.G. et al. Prevalence of Morphometric Vertebral Fractures After Bariatric Surgery and Its Relationship with Bone Mineral Density and Bone Markers. OBES SURG 34, 733–740 (2024). https://doi.org/10.1007/s11695-023-07049-5

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