Roux-en-Y gastric bypass and gastric sleeve surgery result in long term bone loss.

Brzozowska, MM; Tran, T; Bliuc, D; Jorgensen, J; Talbot, M; Fenton-Lee, D; Chen, W; Hong, A; Viardot, A; White, CP; Nguyen, TV; Pocock, N; Eisman, JA; Baldock, PA; Center, JR

Roux-en-Y gastric bypass and gastric sleeve surgery result in long term bone loss.

Brzozowska, MM Tran, T Bliuc, D Jorgensen, J Talbot, M Fenton-Lee, D Chen, W Hong, A Viardot, A White, CP Nguyen, TV Pocock, N Eisman, JA Baldock, PA Center, JR

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Publisher:: Springer Nature [academic journals on nature.com]
Publication Type:: Journal Article
Citation:: International Journal of Obesity, 2021, 45, (1), pp. 235-246
Issue Date:: 2021-01

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Field	Value	Language
dc.contributor.author	Brzozowska, MM
dc.contributor.author	Tran, T
dc.contributor.author	Bliuc, D
dc.contributor.author	Jorgensen, J
dc.contributor.author	Talbot, M
dc.contributor.author	Fenton-Lee, D
dc.contributor.author	Chen, W
dc.contributor.author	Hong, A
dc.contributor.author	Viardot, A
dc.contributor.author	White, CP
dc.contributor.author	Nguyen, TV
dc.contributor.author	Pocock, N
dc.contributor.author	Eisman, JA
dc.contributor.author	Baldock, PA
dc.contributor.author	Center, JR
dc.date.accessioned	2022-05-25T08:09:39Z
dc.date.available	2020-08-15
dc.date.available	2022-05-25T08:09:39Z
dc.date.issued	2021-01
dc.identifier.citation	International Journal of Obesity, 2021, 45, (1), pp. 235-246
dc.identifier.issn	0307-0565
dc.identifier.issn	1476-5497
dc.identifier.uri	http://hdl.handle.net/10453/157689
dc.description.abstract	<h4>Objectives</h4>Little is known about the long-term skeletal impact of bariatric procedures, particularly the increasingly commonly performed gastric sleeve surgery (GS). We examined bone density (BMD) change following three types of bariatric surgery Roux-en-Y gastric bypass (RYGB), GS and laparoscopic adjustable gastric banding (LAGB), compared with diet, over 36 months.<h4>Methods</h4>Non-randomized, prospective study of participants with severe obesity (n = 52), undergoing weight-loss interventions: RYGB (n = 7), GS (n = 21), LAGB (n = 11) and diet (n = 13). Measurements of calciotropic indices, gut hormones (fasting and post prandial) peptide YY (PYY), glucagon-like peptide 1 (GLP1) and adiponectin together with dual-X-ray absorptiometry and quantitative computed tomography scans were performed thorough the study.<h4>Results</h4>All groups lost weight during the first 12 months. Despite weight stability from 12 to 36 months and supplementation of calcium and vitamin D, there was progressive bone loss at the total hip (TH) over 36 months in RYGB -14% (95% CI: -12, -17) and GS -9% (95% CI: -7, -10). In RYGB forearm BMD also declined over 36 months -9% (95% CI: -6, -12) and LS BMD declined over the first 12 months -7% (95% CI: -3, -12). RYGB and GS groups experienced significantly greater bone loss until 36 months than LAGB and diet groups, which experienced no significant BMD loss. These bone losses remained significant after adjustment for weight loss and age. RYGB and GS procedures resulted in elevated postprandial PYY, adiponectin and bone turnover markers up to 36 months without such changes among LAGB and diet participants.<h4>Conclusions</h4>RYGB and GS but not LAGB resulted in ongoing TH bone loss for three postoperative years. For RYGB, bone loss was also observed at LS and non-weight-bearing forearms. These BMD changes were independent of weight and age differences. We, therefore, recommend close monitoring of bone health following RYGB and GS surgeries.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Springer Nature [academic journals on nature.com]
dc.relation.ispartof	International Journal of Obesity
dc.relation.isbasedon	10.1038/s41366-020-00660-x
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	11 Medical and Health Sciences, 13 Education
dc.subject.classification	Endocrinology & Metabolism
dc.subject.mesh	Adult
dc.subject.mesh	Bone Density
dc.subject.mesh	Female
dc.subject.mesh	Gastric Bypass
dc.subject.mesh	Humans
dc.subject.mesh	Middle Aged
dc.subject.mesh	Obesity, Morbid
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Weight Loss
dc.subject.mesh	Humans
dc.subject.mesh	Obesity, Morbid
dc.subject.mesh	Weight Loss
dc.subject.mesh	Gastric Bypass
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Bone Density
dc.subject.mesh	Adult
dc.subject.mesh	Middle Aged
dc.subject.mesh	Female
dc.title	Roux-en-Y gastric bypass and gastric sleeve surgery result in long term bone loss.
dc.type	Journal Article
utslib.citation.volume	45
utslib.location.activity	England
utslib.for	11 Medical and Health Sciences
utslib.for	13 Education
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
pubs.organisational-group	/University of Technology Sydney/Faculty of Engineering and Information Technology/School of Biomedical Engineering
pubs.organisational-group	/University of Technology Sydney/Centre for Health Technologies (CHT)
utslib.copyright.status	closed_access	*
pubs.consider-herdc	true
dc.date.updated	2022-05-25T08:09:29Z
pubs.issue	1
pubs.publication-status	Published
pubs.volume	45
utslib.citation.issue	1

Abstract:

Objectives

Little is known about the long-term skeletal impact of bariatric procedures, particularly the increasingly commonly performed gastric sleeve surgery (GS). We examined bone density (BMD) change following three types of bariatric surgery Roux-en-Y gastric bypass (RYGB), GS and laparoscopic adjustable gastric banding (LAGB), compared with diet, over 36 months.

Methods

Non-randomized, prospective study of participants with severe obesity (n = 52), undergoing weight-loss interventions: RYGB (n = 7), GS (n = 21), LAGB (n = 11) and diet (n = 13). Measurements of calciotropic indices, gut hormones (fasting and post prandial) peptide YY (PYY), glucagon-like peptide 1 (GLP1) and adiponectin together with dual-X-ray absorptiometry and quantitative computed tomography scans were performed thorough the study.

Results

All groups lost weight during the first 12 months. Despite weight stability from 12 to 36 months and supplementation of calcium and vitamin D, there was progressive bone loss at the total hip (TH) over 36 months in RYGB -14% (95% CI: -12, -17) and GS -9% (95% CI: -7, -10). In RYGB forearm BMD also declined over 36 months -9% (95% CI: -6, -12) and LS BMD declined over the first 12 months -7% (95% CI: -3, -12). RYGB and GS groups experienced significantly greater bone loss until 36 months than LAGB and diet groups, which experienced no significant BMD loss. These bone losses remained significant after adjustment for weight loss and age. RYGB and GS procedures resulted in elevated postprandial PYY, adiponectin and bone turnover markers up to 36 months without such changes among LAGB and diet participants.

Conclusions

RYGB and GS but not LAGB resulted in ongoing TH bone loss for three postoperative years. For RYGB, bone loss was also observed at LS and non-weight-bearing forearms. These BMD changes were independent of weight and age differences. We, therefore, recommend close monitoring of bone health following RYGB and GS surgeries.

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http://hdl.handle.net/10453/157689