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) criterias, 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.
|Women 290||Men 85||P|
|Preoperative weigth (Kg)||128.44±21.89||155.48±25.70||0.000|
|Preoperative BMI (Kg/m2)||50.97±8.51||52.07±8.77||0.230|
|Postoperative BMI (Kg/m2)||35.94±7.24||35.94±7.22||0.995|
|Excess weight lost (%)||53.86±22.18||55.44±20.82||0.501|
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).
18 May 2019 - 21 May 2019