Bone mineral density in females after jejunoileal bypass: a 25-year follow-up study.
BACKGROUND
Jejunoileal (JI) bypass was a widely performed operation for morbid obesity in the 1970s. The aim of this study was to investigate the long-term status of bone mineral density (BMD) after weight loss induced by this technique.


METHODS
18 female patients (age 48-79 y, BMI 23-43 kg/m2) had BMD measurements performed 25 years after JI bypass. Dual energy x-ray absorptiometry was used, and measured sites were the lumbar spine L2-L4, left femoral neck and total hip. Vitamin and mineral supplementation had not routinely been prescribed. An assessment was made on age-adjusted BMD values, and as to whether present BMD was related to present demographic and biochemical variables.


RESULTS
No significant reduction of BMD was found beyond that which was expected for age. BMD was inversely and separately related to age and body weight. The serum level of vitamin D was low in 45% of the patients, and inversely correlated to body weight and BMI. Alk phosphatase and parathyroid hormone were the best markers for low BMD.


CONCLUSIONS
These results suggest that JI bypass has not been detrimental to bone density in females. We recommend, however, vitamin D and calcium supplements after malabsorptive procedures for morbid obesity.
Våge
Villy
V
Department of Surgery, Central Hospital Førde, N-6807 Førde, Norway. villy.vage@helse-forde.no
Gjesdal
Clara Gram
CG
Eide
Geir Egil
GE
Halse
Johan I
JI
Viste
Asgaut
A
D015502:Absorptiometry, Photon; D000368:Aged; D015519:Bone Density / Q000502:physiology*; D002136:Calcium, Dietary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007581:Jejunoileal Bypass / Q000009:adverse effects*; D008875:Middle Aged; D013997:Time Factors; D014808:Vitamin D Deficiency / Q000209:etiology; D015431:Weight Loss / Q000502:physiology
D002136:Calcium, Dietary