DXA evaluation of bone fragility 2 years after bariatric surgery in patients with obesity
Marine Fauny,
Marion Halin,
Edem Allado,
Laurent Brunaud,
Claire Nomine-Criqui,
Eliane Albuisson,
Isabelle Chary-Valckenaere,
Didier Quilliot,
Damien Loeuille
Affiliations
Marine Fauny
Department of Rheumatology, University Hospital, Nancy, France; Department of Rheumatology, Saint Charles Hospital, Toul, France; Corresponding author at: Department of Rheumatology, University Hospital Nancy, 5 rue du Morvan, 54500 VANDOEUVRE les Nancy, France.
Marion Halin
Department of Rheumatology, University Hospital, Nancy, France
Edem Allado
CHRU-Nancy, University Center of Sports Medicine and Adapted Physical Activity, F-54000 Nancy, France; Université de Lorraine, DevAH, F-54000 Nancy, France
Laurent Brunaud
Unité Multidisciplinaire de la Chirurgie de l'obésité (UMCO), University Hospital, Nancy, France; Inserm UMRS 1256 N-GERE (Nutrition-Genetics-Environmental Risks) - University de Lorraine, Faculty of Medicine, Nancy, France; Department of Gastrointestinal, Visceral, Metabolic, and Cancer Surgery (CVMC), University Hospital, Nancy, France
Claire Nomine-Criqui
Unité Multidisciplinaire de la Chirurgie de l'obésité (UMCO), University Hospital, Nancy, France; Inserm UMRS 1256 N-GERE (Nutrition-Genetics-Environmental Risks) - University de Lorraine, Faculty of Medicine, Nancy, France; Department of Gastrointestinal, Visceral, Metabolic, and Cancer Surgery (CVMC), University Hospital, Nancy, France
Eliane Albuisson
Université de Lorraine, CNRS, IECL, F-54000 Nancy, France; CHRU-Nancy, DRCI, Département MPI, Unité de méthodologie, Data management et statistiques UMDS, F-54000 Nancy, France
Isabelle Chary-Valckenaere
Department of Rheumatology, University Hospital, Nancy, France; Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA). UMR 7365 CNRS –University of Lorraine, France
Didier Quilliot
Inserm UMRS 1256 N-GERE (Nutrition-Genetics-Environmental Risks) - University de Lorraine, Faculty of Medicine, Nancy, France; Department of Endocrinology Diabetology and Nutrition, University Hospital, Nancy, France
Damien Loeuille
Department of Rheumatology, University Hospital, Nancy, France; Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA). UMR 7365 CNRS –University of Lorraine, France
Purpose: 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. Methods: 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. Results: 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). Conclusion: 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.
