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Changes in Bone Mineral Density in Women Following 1-Year Gastric Bypass Surgery
Abstract
Background Roux-en-Y gastric bypass (RYGB) surgery is the gold standard surgical treatment for obesity. However, unintended nutritional deficiencies following this surgery are common, including changes in bone metabolism. We assessed changes in bone mineral density (BMD), nutritional compounds, and bone resorption markers before and 1 year following RYGB surgery.Methods Our study included 22 female patients with class II/III obesity. A clinical questionnaire, a 24-h recall, blood and urine samples, and dual-energy X-ray absorptiometry were provided.Results Mean age was 37.2 ± 9.6 years; 86 % were Caucasian and 77.2 % were premenopausal. Mean preoperative body mass index was 44.4 ± 5.0 and 27.5 ± 4.5 kg/m(2) at 1-year follow-up (p < 0.001). 25-OH-vitamin D-levels were similar in both periods [11.7 (9.7-18.0) vs. 15.7 (10.2-2.7) pg/dL, p = 0.327]. Serum N-telopeptide (16.3 ± 3.4 vs. 38.2 ± 7.0 nM BCE, p < 0.001) and parathyroid hormone (45.4 ± 16.7 vs. 62.7 ± 28.9 pg/mL, p = 0.026) increased after RYGB surgery, reflecting bone resorption. BMD decreased after RYGB surgery in the lumbar spine (1.13 ± 0.11 vs. 1.04 ± 0.09 g/cm(2), p = 0.001), femoral neck (1.03 ± 0.15 vs. 0.94 ± 0.16 g/cm(2), p = 0.001), and total femur (1.07 ± 0.11 vs. 0.97 ± 0.15 g/cm(2), p = 0.003).Conclusions Decreased BMD in the lumbar spine, femoral neck, and total femur is detectable in women 1 year after RYGB surgery. Calcium malabsorption, caused by vitamin D deficiency and increased bone resorption, is partially responsible for these outcomes and should be targeted in future clinical trials.
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“Calcium malabsorption has been documented as early as 3 months after RYGB53, 54 with reduced true fractional absorption of calcium57, and secondary hyperparathyroidism52, 53, 58, 59.”
From Bone loss after bariatric surgery: causes, consequences, and management (2014) · cites this paper as [58]
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Metadata
- Authors
- Casagrande, D. S., Repetto, G., Mottin, C. C., Shah, J., Pietrobon, R., Worni, M., & Schaan, B. D.
- Affiliations
- Universidade Federal do Rio Grande do Sul (BR)
- Pontifícia Universidade Católica do Rio Grande do Sul (BR)
- Duke University (US)
- Corresponding author
- Schaan, Beatriz D.
- Venue
- Obesity Surgery
- Published
- 2012-06-13
- Volume
- 22
- Issue
- 8
- Pages
- 1287-1292
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- OpenAlex
- W1998242188
- Cited by
- 79
- References
- 46
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2022: 3 · 2021: 5 · 2020: 8 · 2019: 4 · 2018: 6 · 2017: 7 · 2016: 10 · 2015: 9 · 2014: 12 · 2013: 11
- FWCI
- 10.42
- Type
- journal article
- Language
- en
- Update notices
- correction (2015-07-15)
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Obesity Surgery (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Keywords
- Roux-en-Y gastric bypass, bariatric surgery
- MeSH terms
- Adult, Bone Resorption, Brazil, Calcium, Dietary, Female, Femur, Follow-Up Studies, Humans, Lumbar Vertebrae, Obesity, Morbid, Prospective Studies, Surveys and Questionnaires, Vitamin D Deficiency, Gastric Bypass, Weight Loss, Absorptiometry, Photon, Bone Density, Body Mass Index, Premenopause
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