Effect of Bariatric Surgery on Bone Mineral Density: Comparison of Gastric Bypass and Sleeve Gastrectomy

The aim of our study was to compare bone mineral density (BMD) a year after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in age- and body mass index-matched women. In 33 morbidly obese women undergoing RYGB and 33 undergoing SG, plasma determinations of calcium, parathyroid hormone (PTH), 25-hydroxyvitamin D (25(OH) D-3), and insulin-like growth factor-I (IGF-I) were made prior to and at 12 months after surgery. Dual-energy X-ray absorptiometry was performed in all patients 1 year after surgery. BMD at the femoral neck and the lumbar spine 1 year after surgery was similar in women undergoing RYGB and SG (1.01 +/- 0.116 vs. 1.01 +/- 0.122 g/cm(2), p = 0.993; 1.05 +/- 0.116 vs. 1.08 +/- 0.123 g/cm(2), p = 0.384). The percentage of patients with osteopenia and osteoporosis was not different between groups. In the linear regression analysis, age (beta = -0.628, p = 0.034) and lean mass 12 months after surgery (beta = 0.424, p = 0.021) were found to be the main determinants of femoral neck BMD. Age (beta = -0.765, p = 0.025), menopause (beta = -0.898, p = 0.033), and lean mass (beta = 0.615, p = 0.023) were determinants of BMD at the lumbar spine. No influence was found between low bone mass and type of surgery, plasma PTH, 25(OH) D-3, or IGF-I. The effect of RYGB and SG on BMD was comparable a year after surgery. Menopausal women were at a higher risk of having low bone mass, but the presence of osteoporosis was uncommon.