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Evaluation of Bone Mineral Density Loss in Morbidly Obese Women After Gastric Bypass: 3-Year Follow-Up

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Abstract

Studies that evaluate the influence of gastric bypass (RYGP) on bone mass are limited to short-term follow-up. We analysed changes in bone mineral density (BMD) three years after surgery and evaluated the main determinants of the development of bone disease. Prospective study of 59 morbidly obese white women aged 46 ± 8 years. BMD scanning using DEXA and plasma determinations of calcium, parathyroid hormone, 25-hydroxyvitamin D and insulin-like growth factor-I were made prior, at 12 months and 3 years after surgery. In the first postoperative year BMD decreased at femoral neck (FN) 10.2 % and in the lumbar spine (LS) 3.2 %, in the third year it additionally decreased 2.7 % and 3.1 %, respectively. BMD at both sites remained above the values of women of the same age. In the follow-up, 1.7 % developed osteoporosis at FN and 6.8 % at LS. Patients with bone disease were older, the percentage of women with menopause was greater in this group and had lower initial and final values of lean mass. The percentage of BMD loss at FN remained positively associated with the percentage of lean mass loss [β 0.304, p = 0.045], and menopause [β 0.337, p = 0.025]. Major osteoporotic fracture and hip fracture risk was low even in menopausal patients (3.1 % and 0.40 %, respectively). After RYGP menopausal women and those with greater lean mass loss are at higher risk of BMD loss but progression to osteoporosis is uncommon and the risk of fracture is low.

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Acknowledgments

This study was supported by the CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), a project of Instituto de Salud Carlos III, ISCIII.

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Authors and Affiliations

  1. CIBERDEM. Endocrinology Service, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, C/Rambla Just Oliveras, N° 64, 3° 2a escalera A, 08901, Barcelona, Spain

    Nuria Vilarrasa, Patricia San José, Isabel García, Joan Soler & José Manuel Gómez

  2. Department of Bariatric Surgery, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

    Amador G. Ruiz de Gordejuela, Carles Masdevall & Jordi Pujol

  3. Rheumatology Service, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

    Carmen Gómez-Vaquero & Pilar Medina Miras

Authors
  1. Nuria Vilarrasa
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  2. Patricia San José
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  3. Isabel García
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  4. Carmen Gómez-Vaquero
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  10. José Manuel Gómez
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Correspondence to Nuria Vilarrasa.

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Vilarrasa, N., San José, P., García, I. et al. Evaluation of Bone Mineral Density Loss in Morbidly Obese Women After Gastric Bypass: 3-Year Follow-Up. OBES SURG 21, 465–472 (2011). https://doi.org/10.1007/s11695-010-0338-1

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  • DOI: https://doi.org/10.1007/s11695-010-0338-1

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