[Bone mass loss after sleeve gastrectomy: a prospective comparative study with gastric bypass].
BACKGROUND
Bariatric surgery is the most effective option for the treatment of patients with a high risk of complications due to their obesity. However, it brings about a series of changes in calcium and vitamin D metabolism and an increase in resorption which lead to a loss of bone mass.


OBJECTIVE
The objective of this study is to compare sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) as regards loss of bone mass using bone densitometry and bone remodelling markers.


METHODS
Fifteen women with morbid obesity were included, 8 by SG and 7 by RYGB, with a mean age of 47.8+/-9 and mean body mass index 43.3+/-3.4. Bone mass measurements were made on the lumbar spine, femur and distal radius, and the bone remodelling markers N-telopeptide (NTx) and bone alkaline phosphatase (BALP), as well as vitamin D levels before and 12 months after surgery.


RESULTS
A significant bone mass loss was observed was observed with SG and RYGB, in the lumbar spine and hip, whilst no differences were observed in the radial. The percentage bone mass loss was less in the column and femur after SG than with RYGB, although it did not reach statistical significance, 4.6%+/-4.4 (mean+/-SD) and 6.3%+/-5.4 (mean+/-SD), respectively. At 12 months the Ntx increased for both types of surgery, and the BAP was only increased for SG.


CONCLUSIONS
SG causes less, although not significant, bone mass loss compared to RYGB.
Nogués
Xavier
X
Universitat Autónoma de Barcelona, Hospital del Mar, Barcelona, España.
Goday
Albert
A
Peña
Maria Jesus
MJ
Benaiges
David
D
de Ramón
Marta
M
Crous
Xenia
X
Vial
Manuel
M
Pera
Manuel
M
Grande
Luis
L
Díez-Pérez
Adolfo
A
Ramón
Jose Manuel
JM
D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000209:etiology*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods*; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010865:Pilot Projects; D011446:Prospective Studies