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Rigshospitalet - a part of Copenhagen University Hospital
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Bone Structural Changes and Estimated Strength After Gastric Bypass Surgery Evaluated by HR-pQCT

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  1. Multiple Fractures and Impaired Bone Fracture Healing in a Patient with Pycnodysostosis and Hypophosphatasia

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  2. Bone Mass Development in Childhood and Its Association with Physical Activity and Vitamin D Levels. The CHAMPS-Study DK

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Multiple Fractures and Impaired Bone Fracture Healing in a Patient with Pycnodysostosis and Hypophosphatasia

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Bone turnover markers in children and adolescents with type 1 diabetes-A systematic review

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  3. Role of the purinergic P2X receptors in osteoclast pathophysiology

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  • Katrine Diemer Frederiksen
  • Stine Hanson
  • Stinus Hansen
  • Kim Brixen
  • Jeppe Gram
  • Niklas Rye Jørgensen
  • René Klinkby Støving
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Roux-en-Y gastric bypass surgery (RYGB) is an effective treatment of morbid obesity, with positive effects on obesity-related complications. The treatment is associated with bone loss, which in turn might increase fracture risk. The aim of this study was to evaluate changes in bone mineral density (BMD) and bone architecture assessed using dual-energy X-ray absorptiometry (DXA) and high-resolution peripheral quantitative computed tomography (HR-pQCT), 6 and 12 months after RYGB, and correlate them to changes in selected biochemical markers. A prospective cohort study included 25 morbidly obese patients (10 males, 15 females). Patients were examined with DXA of the hip and spine, HR-pQCT of radius and tibia, and blood sampling before and 6 and 12 months after RYGB. Patients lost in average 33.5 ± 12.1 kg (25.8 ± 8.5 %) in 12 months. In tibia, we found significant loss of total, cortical and trabecular volumetric BMD after 12 months (all p < 0.001). Microarchitectural changes involved lower trabecular number, increased trabecular separation, and network inhomogeneity along with thinning of the cortex. Estimated bone failure load was decreased after 12 months (p = 0.005). We found only minor changes in radius. Results demonstrate significant alterations of bone microarchitecture suggesting an accelerated endosteal resorption along with disintegration of the trabecular structure which resulted in a loss of estimated bone strength in tibia. Such changes may underlie the recently reported increased risk of fracture in bariatric patients after surgery. We only observed bone structural changes in the weight-bearing bone, which indicates that mechanical un-loading is the primary mediator.

Original languageEnglish
JournalCalcified Tissue International
Volume98
Issue number3
Pages (from-to)253-62
Number of pages10
ISSN0171-967X
DOIs
Publication statusPublished - Mar 2016

    Research areas

  • Absorptiometry, Photon, Adult, Anastomosis, Roux-en-Y, Bone Density, Bone and Bones, Female, Fractures, Bone, Gastric Bypass, Humans, Linear Models, Male, Middle Aged, Obesity, Morbid, Prospective Studies, Radius, Regression Analysis, Risk, Stress, Mechanical, Tibia, Tomography, X-Ray Computed, Weight-Bearing, Journal Article, Research Support, Non-U.S. Gov't

ID: 49458229