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Continuous decline in bone mineral density and deterioration of bone microarchitecture 7 years after Roux-en-Y gastric bypass surgery

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@article{50fa2b8c89b349958343cc1c95debce3,
title = "Continuous decline in bone mineral density and deterioration of bone microarchitecture 7 years after Roux-en-Y gastric bypass surgery",
abstract = "Objective: Roux-en-Y-gastric bypass (RYGB) surgery is an effective treatment for morbid obesity. A possible overlooked side effect is negative bone metabolic consequences.Design: A seven-year prospective study following ten women and seven men after RYGB (baseline mean age 43 ± 8 years, BMI 42 ± 6 kg/m2).Methods: Lumbar spine and total hip bone mineral density (BMD) using dual energy x-ray absorptiometry, distal radius and tibia bone geometry, volumetric BMD, microarchitecture and finite element estimated bone strength using high-resolution peripheral quantitative CT and biochemical markers of bone remodelling were assessed at baseline, 2 and 7 years.Results: Compared to baseline, body weight was 24 ± 10{\%} lower after 2 years and 21 ± 11{\%} after 7 years. During the 7 years of follow-up, radius and tibia vBMD had declined 13 ± 8{\%} and 8 ± 7{\%} from baseline to 2 years and further 10 ± 7{\%} and 7 ± 8{\%} from 2 to 7 years (all P < 0.001). At both radius and tibia, cortical thickness declined and cortical porosity increased. From baseline to 7 years, there were clear indications of deteriorations of the trabecular network with fewer, more widely spaced and more in-homogeneously distributed trabeculae in both radius and tibia. Overall, declines in estimated bone strength of 16 ± 9{\%} in radius and 16 ± 7{\%} in tibia were observed (both P < 0.001).Conclusion: Seven years after RYGB, evidence of continuous declines in BMD and ongoing deterioration of bone microarchitecture and reduced estimated bone strength compared to baseline and 2 years post-surgery results were found. These findings emphasize the need for regular assessment of bone health in patients with prior RYGB.",
keywords = "Absorptiometry, Photon, Adult, Anastomosis, Roux-en-Y/adverse effects, Bone Density, Bone Remodeling, Bone and Bones/pathology, Cohort Studies, Female, Follow-Up Studies, Hip/pathology, Humans, Longitudinal Studies, Male, Middle Aged, Obesity, Morbid/surgery, Postoperative Complications/pathology, Prospective Studies, Spine/pathology",
author = "Stinus Hansen and J{\o}rgensen, {Niklas Rye} and Hermann, {Anne Pernille} and St{\o}ving, {Rene Klinkby}",
year = "2020",
month = "3",
doi = "10.1530/EJE-19-0741",
language = "English",
volume = "182",
pages = "303--311",
journal = "European Journal of Endocrinology",
issn = "0804-4643",
publisher = "BioScientifica Ltd.",
number = "3",

}

RIS

TY - JOUR

T1 - Continuous decline in bone mineral density and deterioration of bone microarchitecture 7 years after Roux-en-Y gastric bypass surgery

AU - Hansen, Stinus

AU - Jørgensen, Niklas Rye

AU - Hermann, Anne Pernille

AU - Støving, Rene Klinkby

PY - 2020/3

Y1 - 2020/3

N2 - Objective: Roux-en-Y-gastric bypass (RYGB) surgery is an effective treatment for morbid obesity. A possible overlooked side effect is negative bone metabolic consequences.Design: A seven-year prospective study following ten women and seven men after RYGB (baseline mean age 43 ± 8 years, BMI 42 ± 6 kg/m2).Methods: Lumbar spine and total hip bone mineral density (BMD) using dual energy x-ray absorptiometry, distal radius and tibia bone geometry, volumetric BMD, microarchitecture and finite element estimated bone strength using high-resolution peripheral quantitative CT and biochemical markers of bone remodelling were assessed at baseline, 2 and 7 years.Results: Compared to baseline, body weight was 24 ± 10% lower after 2 years and 21 ± 11% after 7 years. During the 7 years of follow-up, radius and tibia vBMD had declined 13 ± 8% and 8 ± 7% from baseline to 2 years and further 10 ± 7% and 7 ± 8% from 2 to 7 years (all P < 0.001). At both radius and tibia, cortical thickness declined and cortical porosity increased. From baseline to 7 years, there were clear indications of deteriorations of the trabecular network with fewer, more widely spaced and more in-homogeneously distributed trabeculae in both radius and tibia. Overall, declines in estimated bone strength of 16 ± 9% in radius and 16 ± 7% in tibia were observed (both P < 0.001).Conclusion: Seven years after RYGB, evidence of continuous declines in BMD and ongoing deterioration of bone microarchitecture and reduced estimated bone strength compared to baseline and 2 years post-surgery results were found. These findings emphasize the need for regular assessment of bone health in patients with prior RYGB.

AB - Objective: Roux-en-Y-gastric bypass (RYGB) surgery is an effective treatment for morbid obesity. A possible overlooked side effect is negative bone metabolic consequences.Design: A seven-year prospective study following ten women and seven men after RYGB (baseline mean age 43 ± 8 years, BMI 42 ± 6 kg/m2).Methods: Lumbar spine and total hip bone mineral density (BMD) using dual energy x-ray absorptiometry, distal radius and tibia bone geometry, volumetric BMD, microarchitecture and finite element estimated bone strength using high-resolution peripheral quantitative CT and biochemical markers of bone remodelling were assessed at baseline, 2 and 7 years.Results: Compared to baseline, body weight was 24 ± 10% lower after 2 years and 21 ± 11% after 7 years. During the 7 years of follow-up, radius and tibia vBMD had declined 13 ± 8% and 8 ± 7% from baseline to 2 years and further 10 ± 7% and 7 ± 8% from 2 to 7 years (all P < 0.001). At both radius and tibia, cortical thickness declined and cortical porosity increased. From baseline to 7 years, there were clear indications of deteriorations of the trabecular network with fewer, more widely spaced and more in-homogeneously distributed trabeculae in both radius and tibia. Overall, declines in estimated bone strength of 16 ± 9% in radius and 16 ± 7% in tibia were observed (both P < 0.001).Conclusion: Seven years after RYGB, evidence of continuous declines in BMD and ongoing deterioration of bone microarchitecture and reduced estimated bone strength compared to baseline and 2 years post-surgery results were found. These findings emphasize the need for regular assessment of bone health in patients with prior RYGB.

KW - Absorptiometry, Photon

KW - Adult

KW - Anastomosis, Roux-en-Y/adverse effects

KW - Bone Density

KW - Bone Remodeling

KW - Bone and Bones/pathology

KW - Cohort Studies

KW - Female

KW - Follow-Up Studies

KW - Hip/pathology

KW - Humans

KW - Longitudinal Studies

KW - Male

KW - Middle Aged

KW - Obesity, Morbid/surgery

KW - Postoperative Complications/pathology

KW - Prospective Studies

KW - Spine/pathology

U2 - 10.1530/EJE-19-0741

DO - 10.1530/EJE-19-0741

M3 - Journal article

VL - 182

SP - 303

EP - 311

JO - European Journal of Endocrinology

JF - European Journal of Endocrinology

SN - 0804-4643

IS - 3

ER -

ID: 59910660