ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 P80 | DOI: 10.1530/endoabs.63.P80

Effects of bariatric surgery on bone health

María Rosa Alhambra Expósito1,2,3, Ana Barrera Martín1,2,3, Concepción Muñoz Jiménez1,2,3, María José Molina Puerta1,2,3 & María Ángeles Gálvez Moreno1,2,3


1Maimonides Institute of Biomedical Research of Cordoba, Córdoba, 14004, Spain; 2Reina Sofia University Hospital (HURS), Córdoba, 14004, Spain; 3Service of Endocrinology and Nutrition, HURS, CÓRDOBA, Spain.


Introduction: Bariatric surgery has important metabolic complications such as bone mass loss.

Goal: To assess bone mineral density (BMD) after Roux-en-Y gastric by-pass (RYGB) in patients under standard calcium and vitamin D supplementation.

Method: In patients with morbid obesity submitted to RYGB, we measured BMD with a dual X-ray densitometer. Using World Health Organization (WHO) criteria’s, values were compared with young controls and same age and sex population, evaluating osteopenia and osteoporosis.

Results: 375 pacients were inclueded, 290 women and 85 men. Positive correlation was observed between BMI and BMD lumbar spine (LS) (Femur (F) 0.104, P 0.001 y LS 0.104, P 0.001) and inverse correlation was observed between BMI postoperative and preoperative BMD lossed (F 0.223, P 0.780; LS 0.189, P 0.022). Inverse correlation was observed between BMD and age (F −0.314, P 0.000 y LS-0.161, P 0.000) as well as with preoperative weight excess (−0.284, P 0.000). Group correlations are maintained when separated by sex. In women we observed a diminished BMD in femur from 1.086±0.150 g/cm2 (T-score 0.558±1.188) to 1.00±.150 g/cm2 (T-score 0.150±1.206) and in LS from 1.206±0.197 g/cm2 (T-score 0.171±1.22) to 1.192±0.155 g/cm2 (P 0.001) (T-score 0.094±1.267) (P 0.000). In femur 8.6% of them were osteopenia, with no cases of osteoporosis, in LS corresponding to 12.9% of osteopenia. Following the follow-up, BMD diminished progressively mainly in left hip, 14.8% osteopenia and 2.1% osteoporosis were found in left hip; 17.2% osteopenia y 2.8% osteoporosis. In men, we observed a BMD F 1.154±0.148 g/cm2 (T-score 0.490±1.083) and in LS 1.108±0.160 g/cm2 (T-score 0.180±1.174). After the follow-up BMD were 1.107±0.160 g/cm2 and 1.247±0.160 g/cm2 respectively (P 0.000 y 0.030) and T-score F 0.274±1.215 and LS 0.245±1.327 (P 0.000). In femur 12% of them were osteopenia, with no cases of osteoporosis, in LS corresponding to 16% osteopenia. Following the follow-up, BMD diminished progressively, 14.1% osteopenia and 1.2% osteoporosis were found in left hip; and 17.6% osteopenia in LS.

Table 1
Women 290Men 85P
Age (years)46.50±11.0344.65±10.500.077
Preoperative weigth (Kg)128.44±21.89155.48±25.700.000
Preoperative BMI (Kg/m2)50.97±8.5152.07±8.770.230
Postoperative BMI (Kg/m2)35.94±7.2435.94±7.220.995
Excess weight lost (%)53.86±22.1855.44±20.820.501
Time (months)83.4±14.2481.27±11.180.541

Conclusion: Patients from both genders and diverse ages after BPYR presented osteopenia and osteoporosis, despite early supplement prescription of calcium and vitamin D (Table 1).

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