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Bone Strength Is Preserved Following Bariatric Surgery

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Abstract

Background

There is an increasing concern that bariatric surgery results in excessive bone loss as demonstrated by studies that use areal bone mineral density (aBMD) outcomes by dual energy X-ray absorptiometry (DXA). Thus, we explored the effect of bariatric surgery on bone mechanical strength.

Methods

Bone strength and body composition outcomes were measured in 21 adults (age 45.3 years; BMI 45.7 kg/m2) at baseline (pre-surgery) and 3, 6, and 12 months post-surgery. Bone geometry, density and strength were assessed by peripheral quantitative computed tomography (pQCT) at the distal (4 %) sites of the radius and tibia and at the midshaft sites of the tibia (66 %) and radius (50 %). Participants were divided into tertiles (high, medium, and low) of percentage weight loss at 6 months post-surgery.

Results

Participants in all three tertiles lost significant body weight by 6 months post-surgery (mean loss −5 to −30 %, all p < 0.05). At 6 months, all tertiles lost significant fat mass (−9 to −51 %, all p < 0.05), but only the high tertile lost significant fat-free mass (−8 %, p < 0.05). Despite a slight increase in tibia bone strength (SSIp) at 3 months (+1.1 %, p < 0.05), estimates of bone strength at the radius and tibia sites did not change at later post-surgical time points regardless of weight loss.

Conclusions

Contrary to DXA-based aBMD outcomes in the current literature, these results suggest that bone strength was preserved up to 12 months following bariatric surgery. Future longer-term studies exploring bone strength and geometry are needed to confirm these findings.

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Conflict of Interest

Dr. Scibora and Dr. Petit received grant support from the Minnesota Obesity Consortium. Dr. Buchwald, Dr. Hughes, and Dr. Ikramuddin declare no conflict of interest.

Grant Funding

This project was supported by a grant from the Minnesota Obesity Consortium.

Author information

Authors and Affiliations

  1. School of Kinesiology, University of Minnesota, 1900 University Avenue SE, Minneapolis, MN, USA, 55455

    Lesley M. Scibora

  2. Department of Surgery, University of Minnesota, VCRC, 401 East River Parkway, Minneapolis, MN, USA, 55455

    Henry Buchwald & Sayeed Ikramuddin

  3. Activ8 LLC, 658 Grand Ave S, Suite 204, St. Paul, MN, USA, 55105

    Moira A. Petit

  4. Military Performance Division, United States Army Institute of Environmental Medicine, 15 Kansas Street, BLDG 42, Natick, MA, USA, 01760

    Julie Hughes

  5. Health and Human Performance Department, University of St. Thomas, 2115 Summit Avenue, Mail #4004, St. Paul, MN, 55105, USA

    Lesley M. Scibora

Authors
  1. Lesley M. Scibora
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  2. Henry Buchwald
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  3. Moira A. Petit
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  4. Julie Hughes
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  5. Sayeed Ikramuddin
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Correspondence to Lesley M. Scibora.

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Scibora, L.M., Buchwald, H., Petit, M.A. et al. Bone Strength Is Preserved Following Bariatric Surgery. OBES SURG 25, 263–270 (2015). https://doi.org/10.1007/s11695-014-1341-8

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  • DOI: https://doi.org/10.1007/s11695-014-1341-8

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