DXA evaluation of bone fragility 2 years after bariatric surgery in patients with obesity

• Published in: Bone Reports Vol. 22; p. 101782
• Main Authors: Fauny, Marine, Halin, Marion, Allado, Edem, Brunaud, Laurent, Nomine-Criqui, Claire, Albuisson, Eliane, Chary-Valckenaere, Isabelle, Quilliot, Didier, Loeuille, Damien
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2024; Elsevier
• Subjects: Bariatric surgery; Bone mineral density (BMD); Dual X-ray absorptiometry (DXA); Life Sciences; Obesity; Osteoporosis; Obesity; Osteoporosis; Bone mineral density (BMD); Dual X-ray absorptiometry (DXA); Bariatric surgery; Bariatric Surgery; Bone mineral density BMD; dual x-ray absorptiometry DXA; Osteoporisis
• ISSN: 2352-1872; 2352-1872
• DOI: 10.1016/j.bonr.2024.101782

The primary objective was to evaluate bone fragility on dual X-ray absorptiometry (DXA) in patients with obesity before and 2 years after bariatric surgery. The secondary objective was to identify risk factors for the development of a bone mineral density ≤ −2 SD at 2 years.
This descriptive study included patients with obesity who underwent DXA before and 2 years (±6 months) after bariatric surgery. The BMD and the T-score were assessed at the lumbar spine, femoral neck and total hip. Data on body composition on DXA were also collected. The diagnosis of osteoporosis was retained for a T-score ≤ − 2.5 SD at any measured location. Osteopenia, or low bone mass, was defined by −2.5 SD < T-score ≤ −1 SD.
Among the 675 included patients, 77.8 % were women, with a mean age of 49.5 years (±11.1). After bariatric surgery, there were significantly more patients with osteoporosis: 3.6 % vs. 0.9 % (p = 0.0001). Multivariate analysis revealed that the risk factors for developing a bone mineral density ≤ −2 SD 2 years after bariatric surgery in patients with normal BMD before surgery were age and lower lean and fat mass before the surgery (OR = 1.07, 95%CI = [1.03–1.12], OR = 0.83, 95%CI = [0.77–0.91], OR = 1.08, 95%CI = [1.02–1.15], respectively).
There was a significantly higher prevalence of osteoporosis and low bone mass 2 years after bariatric surgery. Older age and lower lean and fat mass at baseline were risk factors for the development of a BMD ≤ -2SD at 2 years.
•Higher prevalence of osteoporosis and low bone mass after bariatric surgery•Bone screening before and after bariatric surgery to diagnose osteoporosis•Especially in older patients with a lower lean and fat mass at baseline