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Changes in Bone Mineral Density in Women Following 1-Year Gastric Bypass Surgery

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An Erratum to this article was published on 15 July 2015

Abstract

Background

Roux-en-Y gastric bypass (RYGB) surgery is the gold standard surgical treatment for obesity. However, unintended nutritional deficiencies following this surgery are common, including changes in bone metabolism. We assessed changes in bone mineral density (BMD), nutritional compounds, and bone resorption markers before and 1 year following RYGB surgery.

Methods

Our study included 22 female patients with class II/III obesity. A clinical questionnaire, a 24-h recall, blood and urine samples, and dual-energy X-ray absorptiometry were provided.

Results

Mean age was 37.2 ± 9.6 years; 86 % were Caucasian and 77.2 % were premenopausal. Mean preoperative body mass index was 44.4 ± 5.0 and 27.5 ± 4.5 kg/m2 at 1-year follow-up (p < 0.001). 25-OH-vitamin D-levels were similar in both periods [11.7 (9.7–18.0) vs. 15.7 (10.2–2.7) pg/dL, p = 0.327]. Serum N-telopeptide (16.3 ± 3.4 vs. 38.2 ± 7.0 nM BCE, p < 0.001) and parathyroid hormone (45.4 ± 16.7 vs. 62.7 ± 28.9 pg/mL, p = 0.026) increased after RYGB surgery, reflecting bone resorption. BMD decreased after RYGB surgery in the lumbar spine (1.13 ± 0.11 vs. 1.04 ± 0.09 g/cm2, p = 0.001), femoral neck (1.03 ± 0.15 vs. 0.94 ± 0.16 g/cm2, p = 0.001), and total femur (1.07 ± 0.11 vs. 0.97 ± 0.15 g/cm2, p = 0.003).

Conclusions

Decreased BMD in the lumbar spine, femoral neck, and total femur is detectable in women 1 year after RYGB surgery. Calcium malabsorption, caused by vitamin D deficiency and increased bone resorption, is partially responsible for these outcomes and should be targeted in future clinical trials.

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Acknowledgments

We thank Dr. Melissa Markoski from Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Brazil, for the bone resorption markers' measurements. This work was supported by a grant from the Brazilian Federal Agency for Support and Evaluation of Graduate Education—Capes and PBBEP3-131567 from the Swiss National Science Foundation (MW). The authors have no other potential conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript.

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Authors and Affiliations

  1. Postgraduate Program in Medical Sciences: Endocrinology and Metabolism, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

    Daniela Schaan Casagrande & Beatriz D. Schaan

  2. Obesity and Metabolic Syndrome Center of Hospital São Lucas, Pontificia Universidade Católica do Rio Grande do Sul (COM HSL-PUCRS), Porto Alegre, Brazil

    Daniela Schaan Casagrande & Claudio Corá Mottin

  3. Research on Research Group, Department of Surgery, Duke University Medical Center, Durham, NC, USA

    Daniela Schaan Casagrande, Jatin Shah, Ricardo Pietrobon & Mathias Worni

  4. Faculty of Medicine, Hospital Sao Lucas, Pontificia Universidade Catolica do Rio Grande do Sul, Porto Alegre, Brazil

    Giuseppe Repetto & Claudio Corá Mottin

  5. Endocrine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, prédio 12, No. 4 andar, 90035-003, Porto Alegre, RS, Brazil

    Beatriz D. Schaan

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  1. Daniela Schaan Casagrande
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Correspondence to Beatriz D. Schaan.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s11695-015-1793-5.

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Casagrande, D.S., Repetto, G., Mottin, C.C. et al. Changes in Bone Mineral Density in Women Following 1-Year Gastric Bypass Surgery. OBES SURG 22, 1287–1292 (2012). https://doi.org/10.1007/s11695-012-0687-z

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