title: Evaluation of bone mineral density loss in morbidly obese women after gastric bypass: 3-year follow-up.
abstract: Studies that evaluate the influence of gastric bypass (RYGP) on bone mass are limited to short-term follow-up. We analysed changes in bone mineral density (BMD) three years after surgery and evaluated the main determinants of the development of bone disease. Prospective study of 59 morbidly obese white women aged 46 ± 8 years. BMD scanning using DEXA and plasma determinations of calcium, parathyroid hormone, 25-hydroxyvitamin D and insulin-like growth factor-I were made prior, at 12 months and 3 years after surgery. In the first postoperative year BMD decreased at femoral neck (FN) 10.2 % and in the lumbar spine (LS) 3.2 %, in the third year it additionally decreased 2.7 % and 3.1 %, respectively. BMD at both sites remained above the values of women of the same age. In the follow-up, 1.7 % developed osteoporosis at FN and 6.8 % at LS. Patients with bone disease were older, the percentage of women with menopause was greater in this group and had lower initial and final values of lean mass. The percentage of BMD loss at FN remained positively associated with the percentage of lean mass loss [β 0.304, p=0.045], and menopause [β 0.337, p=0.025]. Major osteoporotic fracture and hip fracture risk was low even in menopausal patients (3.1 % and 0.40 %, respectively). After RYGP menopausal women and those with greater lean mass loss are at higher risk of BMD loss but progression to osteoporosis is uncommon and the risk of fracture is low.
authors.affiliation: CIBERDEM, Endocrinology Service, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, C/Rambla Just Oliveras, N° 64, 3° 2a escalera A, 08901, Barcelona, Spain. nuriavilarrasa@yahoo.es
authors.forename: Nuria
authors.initials: N
authors.lastname: Vilarrasa
authors.forename: Patricia
authors.initials: P
authors.lastname: San José
authors.forename: Isabel
authors.initials: I
authors.lastname: García
authors.forename: Carmen
authors.initials: C
authors.lastname: Gómez-Vaquero
authors.forename: Pilar Medina
authors.initials: PM
authors.lastname: Miras
authors.forename: Amador G Ruiz
authors.initials: AG
authors.lastname: de Gordejuela
authors.forename: Carles
authors.initials: C
authors.lastname: Masdevall
authors.forename: Jordi
authors.initials: J
authors.lastname: Pujol
authors.forename: Joan
authors.initials: J
authors.lastname: Soler
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Gómez
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D015431:Weight Loss