Risk of fracture after bariatric surgery in the United Kingdom: population based, retrospective cohort study
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OBJECTIVES: To estimate fracture risk in patients receiving bariatric surgery versus matched controls. DESIGN: Population based, retrospective cohort study. SETTING: Use of records from the United Kingdom General Practice Research Database, now known as the Clinical Practice Research Datalink (from January 1987 to December 2010). PARTICIPANTS: Patients with a body mass index of at least 30, with a record of bariatric surgery (n=2079), and matched controls without a record (n=10,442). Each bariatric surgery patient was matched to up to six controls by age, sex, practice, year, and body mass index. Patients were followed from the date of bariatric surgery for the occurrence of any fracture. We used time dependent Cox regression to calculate relative rates of fracture, adjusted for disease and previous drug treatment, and time-interaction terms to evaluate fracture timing patterns. MAIN OUTCOME MEASURE: Relative rates of any, osteoporotic, and non-osteoporotic fractures. RESULTS: Mean follow-up time was 2.2 years. Overall, there was no significantly increased risk of fracture in patients who underwent bariatric surgery, compared with controls (8.8 v 8.2 per 1000 person years; adjusted relative risk 0.89, 95% confidence interval 0.60 to 1.33). Bariatric surgery also did not affect risk of osteoporotic and non-osteoporotic fractures. However, we saw a trend towards an increased fracture risk after three to five years following surgery, as well as in patients who had a greater decrease in body mass index after surgery, but this was not significant. CONCLUSION: Bariatric surgery does not have a significant effect on the risk of fracture. For the first few years after surgery, these results are reassuring for patients undergoing such operations, but do not exclude a more protracted adverse influence on skeletal health in the longer term.
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The RYGB subgroup lost more weight, had more cortical bone loss than GB or SG, and had declines in cortical load share estimated by finite element analysis.
“The sub-group of RYGB patients lost more weight, had more cortical bone loss than those with GB or SG and had declines in cortical load share estimated by finite element analysis84.”
From Bone loss after bariatric surgery: causes, consequences, and management (2014) · cites this paper as [84]
A UK retrospective cohort study found no significantly increased risk of fracture in 2079 bariatric surgery patients compared to 10442 matched controls.
“A retrospective cohort study from the United Kingdom found no significantly increased risk of fracture in 2079 bariatric surgery patients compared to 10442 matched controls 84.”
From Bone loss after bariatric surgery: causes, consequences, and management (2014) · cites this paper as [84]
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- Authors
- Lalmohamed, A., de Vries, F., Bazelier, M. T., Cooper, A., van Staa, T.-P., Cooper, C., & Harvey, N. C.
- Affiliations
- Utrecht University (NL)
- Crawley Hospital (GB)
- Southampton General Hospital (GB)
- Corresponding author
- Cooper, C.
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2012-08-03
- Volume
- 345
- Issue
- aug03 1
- Pages
- e5085-e5085
- ISSN
- 1756-1833 (ISSN-L)
- PMC
- PMC3413006
- OpenAlex
- W1970277737
- Cited by
- 173
- References
- 50
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 5 · 2023: 4 · 2022: 15 · 2021: 14 · 2020: 11 · 2019: 17 · 2018: 22 · 2017: 15 · 2016: 16 · 2015: 22 · 2014: 12 · 2013: 13 · 2012: 4
- FWCI
- 16.61
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by-nc)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Keywords
- bariatric surgery, fracture risk, osteoporotic fractures, body mass index, obesity, skeletal health, long-term outcomes
- MeSH terms
- Adult, Bone Resorption, Female, United Kingdom, Humans, Male, Obesity, Retrospective Studies, Risk Factors, Weight Loss, Bone Density, Confounding Factors, Epidemiologic, Body Mass Index, Proportional Hazards Models, Case-Control Studies, Treatment Outcome, Bariatric Surgery, Fractures, Bone, Osteoporotic Fractures
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