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Bone structural changes after gastric bypass surgery evaluated by HR-pQCT: a two-year longitudinal study

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  • Vikram V Shanbhogue
  • René Klinkby Støving
  • Katrine Hartmund Frederiksen
  • Stine Hanson
  • Kim Brixen
  • Jeppe Gram
  • Niklas Rye Jørgensen
  • Stinus Hansen
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OBJECTIVE, DESIGN AND METHODS: Roux-en-Y gastric bypass (RYGB) has proved successful in attaining sustained weight loss but may lead to metabolic bone disease. To assess impact on bone mass and structure, we measured a real bone mineral density at the hip and spine by dual-energy X-ray absorptiometry, and volumetric BMD (vBMD) and bone microarchitecture at the distal radius and tibia by high-resolution peripheral quantitative CT in 25 morbidly obese subjects (15 females, 10 males) at 0, 12 and 24 months after RYGB. Bone turnover markers (BTMs), calciotropic and gut hormones and adipokines were measured at the same time points.

RESULTS: After a 24.1% mean weight loss from baseline to month 12 (P < 0.001), body weight plateaued from month 12 to 24 (-0.9%, P = 0.50). However, cortical and trabecular vBMD and microarchitecture deteriorated through the 24 months, such that there was a 5 and 7% reduction in estimated bone strength at the radius and tibia respectively (both P < 0.001). The declines observed in the first 12 months were matched or exceeded by declines in the 12- to 24-month period. While a significant increase in BTMs and decrease in leptin and insulin were seen at 24 months, these changes were maximal at month 12 and stabilized from month 12 to 24.

CONCLUSIONS: Despite weight stabilization and maintenance of metabolic parameters, bone loss and deterioration in bone strength continued and were substantial in the second year. The clinical importance of these changes in terms of increased risk of developing osteoporosis and fragility fractures remain an important concern.

Original languageEnglish
JournalEuropean Journal of Endocrinology
Volume176
Issue number6
Pages (from-to)685-693
Number of pages9
ISSN0804-4643
DOIs
Publication statusPublished - Jun 2017

    Research areas

  • Absorptiometry, Photon, Adiponectin, Adult, Bone Density, Bone Diseases, Metabolic, Bone Remodeling, Collagen Type I, Female, Follicle Stimulating Hormone, Gastric Bypass, Hip Joint, Humans, Insulin, Leptin, Longitudinal Studies, Lumbar Vertebrae, Luteinizing Hormone, Male, Middle Aged, Obesity, Morbid, Osteoporosis, Parathyroid Hormone, Peptide Fragments, Peptides, Postoperative Complications, Procollagen, Radius, Tibia, Tomography, X-Ray Computed, Vitamin D, Weight Loss, Journal Article

ID: 52120666