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

Malgorzata M Brzozowska; Thach Tran; Dana Bliuc; John Jorgensen; Michael Talbot; Douglas Fenton-Lee; Weiwen Chen; Angel Hong; Alex Viardot; Chris P White; Tuan V Nguyen; Nicholas Pocock; John A Eisman; Paul A Baldock; Jacqueline R Center

doi:10.1038/s41366-020-00660-x

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

Malgorzata M Brzozowska
, Thach Tran
, Dana Bliuc
, John Jorgensen
, Michael Talbot
, Douglas Fenton-Lee
, Weiwen Chen
, Angel Hong
, Alex Viardot
, Chris P White
, Tuan V Nguyen
, Nicholas Pocock
, John A Eisman
, Paul A Baldock
, Jacqueline R Center

Garvan Institute of Medical Research
St George Private Hospital
University of New South Wales (UNSW) Sydney
St Vincent's Private Hospital
Prince of Wales Hospital

Allbwn ymchwil: Cyfraniad at gyfnodolyn › Erthygl › adolygiad gan gymheiriaid

Crynodeb

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.

Iaith wreiddiol	Saesneg
Tudalennau (o-i)	235-246
Nifer y tudalennau	12
Cyfnodolyn	International journal of obesity (2005)
Cyfrol	45
Dyddiad ar-lein cynnar	26 Awst 2020
Dynodwyr Gwrthrych Digidol (DOIs)	https://doi.org/10.1038/s41366-020-00660-x
Statws	Cyhoeddwyd - 26 Awst 2020
Cyhoeddwyd yn allanol	Ie

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Mae’r allbwn hwn yn cyfrannu at y Nod(au) Datblygu Cynaliadwy canlynol

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Mynediad at Ddogfen

10.1038/s41366-020-00660-x

Dyfynnu hyn

Brzozowska, M. M., Tran, T., Bliuc, D., Jorgensen, J., Talbot, M., Fenton-Lee, D., Chen, W., Hong, A., Viardot, A., White, C. P., Nguyen, T. V., Pocock, N., Eisman, J. A., Baldock, P. A., & Center, J. R. (2020). Roux-en-Y gastric bypass and gastric sleeve surgery result in long term bone loss. International journal of obesity (2005), 45, 235-246. https://doi.org/10.1038/s41366-020-00660-x

@article{5fa79df0ab834e5e82ed2a05570041aa,

title = "Roux-en-Y gastric bypass and gastric sleeve surgery result in long term bone loss",

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.",

keywords = "Adult, Bone Density/physiology, Female, Gastric Bypass/adverse effects, Humans, Middle Aged, Obesity, Morbid/surgery, Prospective Studies, Weight Loss/physiology",

author = "Brzozowska, \{Malgorzata M\} and Thach Tran and Dana Bliuc and John Jorgensen and Michael Talbot and Douglas Fenton-Lee and Weiwen Chen and Angel Hong and Alex Viardot and White, \{Chris P\} and Nguyen, \{Tuan V\} and Nicholas Pocock and Eisman, \{John A\} and Baldock, \{Paul A\} and Center, \{Jacqueline R\}",

year = "2020",

month = aug,

day = "26",

doi = "10.1038/s41366-020-00660-x",

language = "English",

volume = "45",

pages = "235--246",

journal = "International journal of obesity (2005)",

issn = "0307-0565",

publisher = "Springer Nature",

}

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 2020, 'Roux-en-Y gastric bypass and gastric sleeve surgery result in long term bone loss', International journal of obesity (2005), cyfrol. 45, tt. 235-246. https://doi.org/10.1038/s41366-020-00660-x

TY - JOUR

T1 - Roux-en-Y gastric bypass and gastric sleeve surgery result in long term bone loss

AU - Brzozowska, Malgorzata M

AU - Tran, Thach

AU - Bliuc, Dana

AU - Jorgensen, John

AU - Talbot, Michael

AU - Fenton-Lee, Douglas

AU - Chen, Weiwen

AU - Hong, Angel

AU - Viardot, Alex

AU - White, Chris P

AU - Nguyen, Tuan V

AU - Pocock, Nicholas

AU - Eisman, John A

AU - Baldock, Paul A

AU - Center, Jacqueline R

PY - 2020/8/26

Y1 - 2020/8/26

N2 - 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.

AB - 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.

KW - Adult

KW - Bone Density/physiology

KW - Female

KW - Gastric Bypass/adverse effects

KW - Humans

KW - Middle Aged

KW - Obesity, Morbid/surgery

KW - Prospective Studies

KW - Weight Loss/physiology

U2 - 10.1038/s41366-020-00660-x

DO - 10.1038/s41366-020-00660-x

M3 - Article

C2 - 32848203

SN - 0307-0565

VL - 45

SP - 235

EP - 246

JO - International journal of obesity (2005)

JF - International journal of obesity (2005)

ER -

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

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