Evaluation of Bone Mineral Density Loss in Morbidly Obese Women After Gastric Bypass: 3-Year Follow-Up

• DOI: 10.1007/s11695-010-0338-1
• Publication Date: 2010-12-28T07:29:32Z
• Authors: Nuria Vilarrasa; Patricia San José; Isabel García; Carmen Gómez-Vaquero; Pilar Medina Miras; Amador G. Ruiz de...; Carles Masdevall; Jordi Pujol; Joan Soler; José Manuel Gómez
• Keywords: Adult; 2. Zero hunger; Gastric Bypass; Middle Aged; Body Mass Index; Cohort Studies; Bone Diseases, Metabolic; 03 medical and health sciences; 0302 clinical medicine; Bone Density; Weight Loss; Humans; Osteoporosis; Female

Studies that evaluate the influence of gastric bypass (RYGP) on bone mass are limited to short-term follow-up. We analysed changes in bone mineral density (BMD) three years after surgery and evaluated the main determinants of the development of bone disease. Prospective study of 59 morbidly obese white women aged 46 ± 8 years. BMD scanning using DEXA and plasma determinations of calcium, parathyroid hormone, 25-hydroxyvitamin D and insulin-like growth factor-I were made prior, at 12 months and 3 years after surgery. In the first postoperative year BMD decreased at femoral neck (FN) 10.2 % and in the lumbar spine (LS) 3.2 %, in the third year it additionally decreased 2.7 % and 3.1 %, respectively. BMD at both sites remained above the values of women of the same age. In the follow-up, 1.7 % developed osteoporosis at FN and 6.8 % at LS. Patients with bone disease were older, the percentage of women with menopause was greater in this group and had lower initial and final values of lean mass. The percentage of BMD loss at FN remained positively associated with the percentage of lean mass loss [β 0.304, p=0.045], and menopause [β 0.337, p=0.025]. Major osteoporotic fracture and hip fracture risk was low even in menopausal patients (3.1 % and 0.40 %, respectively). After RYGP menopausal women and those with greater lean mass loss are at higher risk of BMD loss but progression to osteoporosis is uncommon and the risk of fracture is low.