학술논문
Impact of Bariatric Surgery on Bone Mineral Density: Observational Study of 110 Patients Followed up in a Specialized Center for the Treatment of Obesity in France.
Document Type
Academic Journal
Author
Geoffroy M; CHU Reims, Service de Rhumatologie, Hôpital Maison Blanche, F-51092, Reims, France. mgeoffroy@chu-reims.fr.; Service de Rhumatologie, Centre Hospitalier Universitaire de Reims, 45 rue Cognacq-Jay, 51092, Reims cedex, France. mgeoffroy@chu-reims.fr.; Charlot-Lambrecht I; CHU Reims, Service de Rhumatologie, Hôpital Maison Blanche, F-51092, Reims, France.; Chrusciel J; CHU Reims, Service de Recherche Clinique, Hôpital Robert Debré, F-51092, Reims, France.; Gaubil-Kaladjian I; CHU Reims, Service d'Endocrinologie et nutrition, Hôpital Robert Debré, F-51092, Reims, France.; Diaz-Cives A; CHU Reims, Service de chirurgie digestive, Hôpital Robert Debré, F-51092, Reims, France.; Eschard JP; CHU Reims, Service de Rhumatologie, Hôpital Maison Blanche, F-51092, Reims, France.; Salmon JH; CHU Reims, Service de Rhumatologie, Hôpital Maison Blanche, F-51092, Reims, France.; Faculté de Médecine, Université de Reims Champagne Ardenne, EA 3797, F-51095, Reims, France.
Source
Publisher: Springer Science + Business Media Country of Publication: United States NLM ID: 9106714 Publication Model: Print Cited Medium: Internet ISSN: 1708-0428 (Electronic) Linking ISSN: 09608923 NLM ISO Abbreviation: Obes Surg Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: Bariatric surgery is used to treat severe obesity. We aimed to investigate the incidence of clinically significant bone mineral density (BMD) loss at 6 and 12 months after bariatric surgery.
Methods: Observational study performed in a specialized center for the treatment of obesity at the University Hospital of Reims, France. Surface BMD was measured by dual x-ray absorptiometry (DEXA). A reduction of > 0.03 g/cm2 was considered clinically significant.
Results: A total of 110 patients were included. A clinically significant reduction in BMD was observed in 62.1% of patients at 6 months, and in 71.6% at 12 months after surgery. No case of osteoporosis was observed. There were four cases of osteopenia and one fracture post-surgery. BMD loss was related by univariate analysis to the reduction in body mass index (BMI) (p < 0.01), weight loss (p < 0.01), fat mass (p < 0.01), and lean mass (p < 0.01). Multivariable analysis found a significant association between the reduction in BMD and the excess weight loss percentage (odds ratio 1.11, 95% confidence interval (1.05-1.18), p < 0.001).
Conclusion: There was a clinically significant reduction in BMD at 6 months after surgery in over 60% of patients undergoing bariatric surgery. BMD loss is persistent over time and predominantly situated at the femoral level, and strongly associated with weight loss. Systematic vitamin and calcium supplementation, as well as follow-up by DEXA scan seems appropriate. Systematic DEXA scan pre- and post-surgery, and annually thereafter until weight has stabilized seems appropriate.
Methods: Observational study performed in a specialized center for the treatment of obesity at the University Hospital of Reims, France. Surface BMD was measured by dual x-ray absorptiometry (DEXA). A reduction of > 0.03 g/cm
Results: A total of 110 patients were included. A clinically significant reduction in BMD was observed in 62.1% of patients at 6 months, and in 71.6% at 12 months after surgery. No case of osteoporosis was observed. There were four cases of osteopenia and one fracture post-surgery. BMD loss was related by univariate analysis to the reduction in body mass index (BMI) (p < 0.01), weight loss (p < 0.01), fat mass (p < 0.01), and lean mass (p < 0.01). Multivariable analysis found a significant association between the reduction in BMD and the excess weight loss percentage (odds ratio 1.11, 95% confidence interval (1.05-1.18), p < 0.001).
Conclusion: There was a clinically significant reduction in BMD at 6 months after surgery in over 60% of patients undergoing bariatric surgery. BMD loss is persistent over time and predominantly situated at the femoral level, and strongly associated with weight loss. Systematic vitamin and calcium supplementation, as well as follow-up by DEXA scan seems appropriate. Systematic DEXA scan pre- and post-surgery, and annually thereafter until weight has stabilized seems appropriate.