Long-Term Effects of Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypass on Body Composition and Bone Mass Density.
Bariatric surgery
Body composition
Bone density
Dual-energy X-ray absorptiometry
Gastric bypass
Sleeve gastrectomy
Journal
Obesity facts
ISSN: 1662-4033
Titre abrégé: Obes Facts
Pays: Switzerland
ID NLM: 101469429
Informations de publication
Date de publication:
2021
2021
Historique:
received:
25
06
2020
accepted:
12
10
2020
pubmed:
18
12
2020
medline:
8
7
2021
entrez:
17
12
2020
Statut:
ppublish
Résumé
Currently, the two most common bariatric procedures are laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). Long-term data comparing the two interventions in terms of their effect on body composition and bone mass density (BMD) are scarce. The aim of this study was to assess body composition and BMD at least 5 years after LSG and LRYGB. Department of Endocrinology and Nutrition, St. Claraspital Basel and St. Clara Research Ltd., Basel, Switzerland. Bariatric patients at least 5 years after surgery (LSG or LRYGB) were recruited, and body composition and BMD were measured by means of dual-energy X-ray absorptiometry. Data from body composition before surgery were included in the analysis. Blood samples were taken for determination of plasma calcium, parathyroid hormone, vitamin D3, alkaline phosphatase, and C-terminal telopeptide, and the individual risk for osteoporotic fracture assessed by the Fracture Risk Assessment Tool score was calculated. After surgery, all patients received multivitamins, vitamin D3, and zinc. In addition, LRYGB patients were prescribed calcium. A total of 142 patients were included, 72 LSG and 70 LRYGB, before surgery: median body mass index 43.1, median age 45.5 years, 62.7% females. Follow-up after a median of 6.7 years. For LRYGB, the percentage total weight loss at follow-up was 26.3% and for LSG 24.1% (p = 0.243). LRYGB led to a slightly lower fat percentage in body composition. At follow-up, 45% of both groups had a T score at the femoral neck below -1, indicating osteopenia. No clinically relevant difference in BMD was found between the groups. At 6.7 years after surgery, no difference in body composition and BMD between LRYGB and LSG was found. Deficiencies and bone loss remain an issue after both interventions and should be monitored.
Sections du résumé
BACKGROUND
Currently, the two most common bariatric procedures are laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). Long-term data comparing the two interventions in terms of their effect on body composition and bone mass density (BMD) are scarce.
OBJECTIVE
The aim of this study was to assess body composition and BMD at least 5 years after LSG and LRYGB.
SETTING
Department of Endocrinology and Nutrition, St. Claraspital Basel and St. Clara Research Ltd., Basel, Switzerland.
METHODS
Bariatric patients at least 5 years after surgery (LSG or LRYGB) were recruited, and body composition and BMD were measured by means of dual-energy X-ray absorptiometry. Data from body composition before surgery were included in the analysis. Blood samples were taken for determination of plasma calcium, parathyroid hormone, vitamin D3, alkaline phosphatase, and C-terminal telopeptide, and the individual risk for osteoporotic fracture assessed by the Fracture Risk Assessment Tool score was calculated. After surgery, all patients received multivitamins, vitamin D3, and zinc. In addition, LRYGB patients were prescribed calcium.
RESULTS
A total of 142 patients were included, 72 LSG and 70 LRYGB, before surgery: median body mass index 43.1, median age 45.5 years, 62.7% females. Follow-up after a median of 6.7 years. For LRYGB, the percentage total weight loss at follow-up was 26.3% and for LSG 24.1% (p = 0.243). LRYGB led to a slightly lower fat percentage in body composition. At follow-up, 45% of both groups had a T score at the femoral neck below -1, indicating osteopenia. No clinically relevant difference in BMD was found between the groups.
CONCLUSIONS
At 6.7 years after surgery, no difference in body composition and BMD between LRYGB and LSG was found. Deficiencies and bone loss remain an issue after both interventions and should be monitored.
Identifiants
pubmed: 33333510
pii: 000512450
doi: 10.1159/000512450
pmc: PMC7983539
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
131-140Informations de copyright
© 2020 The Author(s) Published by S. Karger AG, Basel.
Références
N Engl J Med. 2017 May 18;376(20):1997
pubmed: 28514616
Osteoporos Int. 2011 Feb;22(2):391-420
pubmed: 21184054
Diabetes Care. 2013 Aug;36(8):2175-82
pubmed: 23439632
Curr Gastroenterol Rep. 2010 Dec;12(6):448-57
pubmed: 20882439
PLoS One. 2013 Jul 10;8(7):e68716
pubmed: 23874736
J Bone Miner Res. 2014 Nov;29(11):2520-6
pubmed: 24771492
Osteoporos Int. 2008 Apr;19(4):385-97
pubmed: 18292978
Calcif Tissue Int. 2000 Feb;66(2):100-3
pubmed: 10652955
Osteoporos Int. 2006 Dec;17(12):1726-33
pubmed: 16983459
Surg Obes Relat Dis. 2016 Mar-Apr;12(3):563-570
pubmed: 26656669
JAMA. 2018 Jan 16;319(3):255-265
pubmed: 29340679
Clin Nutr. 2013 Aug;32(4):550-5
pubmed: 23200926
Endocr Pract. 2010 Nov-Dec;16 Suppl 3:1-37
pubmed: 21224201
Surg Obes Relat Dis. 2017 Apr;13(4):568-574
pubmed: 28089434
BMJ. 2016 Jul 27;354:i3794
pubmed: 27814663
JAMA Surg. 2020 May 1;155(5):e200087
pubmed: 32129809
Ann Rheum Dis. 2014 Sep;73(9):1635-45
pubmed: 24692584
Rev Esp Enferm Dig. 2019 May;111(5):371-377
pubmed: 30829531
Obes Surg. 2020 Aug;30(8):3119-3126
pubmed: 32415634
Sports Med. 2006;36(3):239-62
pubmed: 16526835
Obes Surg. 2016 May;26(5):1141-5
pubmed: 26926187
J Gastrointest Surg. 2002 Sep-Oct;6(5):690-8
pubmed: 12399058
Bone. 2006 Feb;38(2 Suppl 1):S4-9
pubmed: 16455317
Diabetes. 1997 Oct;46(10):1579-85
pubmed: 9313753
Obes Surg. 2017 Jul;27(7):1789-1796
pubmed: 28091892
Nat Rev Rheumatol. 2010 Feb;6(2):99-105
pubmed: 20125177
BMC Geriatr. 2016 Sep 02;16:158
pubmed: 27590604
JAMA Surg. 2015 Dec;150(12):1126-33
pubmed: 26422580
Obes Surg. 2017 Dec;27(12):3092-3101
pubmed: 28593484
Circulation. 2007 Jul 3;116(1):39-48
pubmed: 17576866
Obes Surg. 2016 Mar;26(3):479-85
pubmed: 26189734
Obes Surg. 2006 Dec;16(12):1602-8
pubmed: 17217636
Metabolism. 2004 Jul;53(7):918-21
pubmed: 15254887
Ann Surg. 2017 Oct;266(4):650-657
pubmed: 28742680
Obesity (Silver Spring). 2010 Sep;18(9):1718-24
pubmed: 20414197
Obes Surg. 2011 Jan;21(1):61-70
pubmed: 19997987
Obes Surg. 2012 Apr;22(4):597-601
pubmed: 22065342
N Engl J Med. 1995 Mar 9;332(10):621-8
pubmed: 7632212