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Short- and Mid-term Changes in Bone Mineral Density After Laparoscopic Sleeve Gastrectomy

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Abstract

Background

Bariatric surgery is the most effective treatment for achieving a significant weight loss. Morbidities present a significant reduction after bariatric surgery, but it may also result in several health complications, related to nutritional deficiencies, including bone metabolism. Several studies have reported a decrease in bone mineral density (BMD), but most of them referring to malabsorptive procedures. Restrictive procedures do not imply changes in gastrointestinal anatomy, so that one may expect fewer metabolic disturbances.

Methods

We performed a retrospective observational study of all morbidly obese patients undergoing LSG between 2008 and 2011 at our institution. Bone densitometry was performed before surgery and 1 and 2 years after the intervention. Body size measurements, analytical variables and densitometric values in the lumbar spine (BMD, t score and z score) were investigated.

Results

Forty-two patients were included, 39females and 3males. Mean BMI was 51.21 kg/m2. Mean excessive BMI loss was 79.9 % after 1 year and 80.6 % after 2 years. Mean BMD values for spine increased progressively, reaching statistical significance at 1 and at 2 years. Percentage of BMD increase was 5.7 % at 1 year and 7.9 % at 2 years. An inverse correlation was observed between BMD increase and parathyroid hormone (PTH) decrease and a direct correlation between BMD and vitamin D increase.

Conclusion

Bone mineral density showed a progressive increase during the first and second year after sleeve gastrectomy. BMD changes are not associated with weight loss, but showed a direct correlation with vitamin D and an inverse correlation with PTH levels.

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Authors and Affiliations

  1. Department of Surgery, Bariatric Surgery Unit, General University Hospital Elche, University Miguel Hernandez, Elche, Alicante, Spain

    Jaime Ruiz-Tovar, Inmaculada Oller, Antonio Arroyo, Alicia Calero, María Diez, Lorea Zubiaga & Rafael Calpena

  2. Department of Surgery, General Hospital Castellon, Castellon, Spain

    Pablo Priego

Authors
  1. Jaime Ruiz-Tovar
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  2. Inmaculada Oller
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  3. Pablo Priego
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  4. Antonio Arroyo
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  5. Alicia Calero
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  6. María Diez
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  7. Lorea Zubiaga
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  8. Rafael Calpena
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Correspondence to Jaime Ruiz-Tovar.

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Ruiz-Tovar, J., Oller, I., Priego, P. et al. Short- and Mid-term Changes in Bone Mineral Density After Laparoscopic Sleeve Gastrectomy. OBES SURG 23, 861–866 (2013). https://doi.org/10.1007/s11695-013-0866-6

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  • DOI: https://doi.org/10.1007/s11695-013-0866-6

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