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Relationship Between Bariatric Surgery and Bone Mineral Density: a Meta-analysis

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Abstract

Background

A meta-analysis regarding bone loss after bariatric surgery, designed to compare surgical and nonsurgical groups, has not yet been performed. Therefore, we performed a meta-analysis to compare the differences between bariatric surgical groups and nonoperated controls with regard to bone mineral density.

Methods

In March 2015, we performed a review of the literature using PubMed, EMBASE, and the Cochrane Library. The search focused on retrospective and prospective studies, including but not limited to randomized studies published in English.

Results

Among 1299 studies that were initially screened, ten met the selection criteria. For all types of bariatric surgery, bone density at the femoral neck was lower in the surgical group than in the nonsurgical control group (mean difference [MD] −0.05 g/cm2; 95 % confidence interval [CI], −0.07 to −0.02; p = 0.001); no difference in bone density was found between the two groups at the lumbar spine (MD −0.01 g/cm2; 95 % CI −0.07 to 0.05; p = 0.661). The analysis of Roux-en-Y gastric bypass showed similar results.

Conclusion

Bone density at the femoral neck decreased after bariatric surgery, compared to that in nonsurgical controls, whereas bone density at the lumbar spine did not show a difference between groups. Further larger scale studies with comparative nonsurgical controls are warranted to overcome the heterogeneity among studies in this analysis and to add evidence of possible bone loss subsequent to bariatric surgical procedures.

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Acknowledgments

We would like to acknowledge Dr. Yu and Dr. Keller for providing further data for their studies.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Author notes

    Authors and Affiliations

    1. Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, 100-742, South Korea

      Byung-Joon Ko

    2. Molecular Epidemiological Branch, Research Institute, National Cancer Center, Goyang, 410-769, South Korea

      Seung Kwon Myung

    3. Department of Family Medicine, Hospital, National Cancer Center, Goyang, 410-769, South Korea

      Seung Kwon Myung

    4. Center for Cancer Prevention and Detection, Hospital, National Cancer Center, Goyang, 410-769, South Korea

      Seung Kwon Myung

    5. Department of Family Medicine, College of Medicine, Korea University, Seoul, 136-705, South Korea

      Kyung-Hwan Cho, Do Hoon Kim & Seon Mee Kim

    6. Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, 137-701, South Korea

      Yong Gyu Park

    7. Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, 136-705, South Korea

      Sin Gon Kim

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    1. Byung-Joon Ko
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    Correspondence to Seon Mee Kim.

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    Additional information

    Byung-Joon Ko and Seung Kwon Myung contributed equally to this work.

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    Supplementary Fig 1

    Mean difference in BMI between all types of surgery and controls (n=9, random effects model). (TIFF 555 kb)

    Supplementary Fig 2

    Mean difference in BMI between patients who underwent Roux-en-Y gastric bypass and controls (n=6, random effects model). (TIFF 513 kb)

    Supplementary Fig 3

    Mean difference in femoral neck BMD between patients who underwent Roux-en-Y gastric bypass and controls by time point after surgery (n=6, fixed effects model). (TIFF 649 kb)

    Supplementary Fig 4

    Mean difference in lumbar BMD between patients who underwent Roux-en-Y gastric bypass and controls by time point after surgery (n=7, fixed effects model). (TIFF 688 kb)

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    Ko, BJ., Myung, S.K., Cho, KH. et al. Relationship Between Bariatric Surgery and Bone Mineral Density: a Meta-analysis. OBES SURG 26, 1414–1421 (2016). https://doi.org/10.1007/s11695-015-1928-8

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    • DOI: https://doi.org/10.1007/s11695-015-1928-8

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