scholarly journals Low bone mineral density following gastric bypass is not explained by lifestyle and lack of exercise

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katharina Stevens ◽  
Hella Hultin ◽  
Per Hellman ◽  
Magnus Sundbom
Keyword(s):  
Physical Activity ◽  
Bone Mineral Density ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Calcium Intake ◽  
Lifestyle Factors ◽  
Mineral Density ◽  
Study Participants

Abstract Background Bariatric surgery, Roux-en-Y gastric bypass (RYGBP) in particular, is associated with weight loss as well as low bone mineral density. Bone mineral density relies upon multiple factors, some of which are lifestyle factors. The aim of this study was to compare lifestyle factors in order to eliminate them as culprits of the suspected difference in BMD in RYGBP operated and controls. Materials and methods Study participants included 71 RYGBP-operated women (42.3 years, BMI 33.1 kg/m2) and 94 controls (32.4 years, BMI 23.9 kg/m2). Each completed a DEXA scan, as well as survey of lifestyle factors (e.g. physical activity in daily life, corticosteroid use, and calcium intake). All study participants were premenopausal Caucasian women living in the same area. Blood samples were taken in RYGBP-patients. Results BMD was significantly lower in RYGBP, femoral neck 0.98 vs. 1.04 g/cm2 compared to controls, despite higher BMI (present and at 20 years of age) and similar physical activity and calcium intake. In a multivariate analysis, increased time since surgery and age were negatively associated with BMD of the femoral neck and total hip in RYGBP patients. Conclusion Despite similar lifestyle, RYGBP was followed by a lower BMD compared to controls. Thus, the reduced BMD in RYGBP cannot be explained, seemingly nor prevented, by lifestyle factors. As the reduction in BMD was associated with time since surgery, strict follow-up is a lifelong necessity after bariatric surgery, and especially important in younger bariatric patients.

scholarly journals Low Bone Mineral Density Following Gastric Bypass Is Not Explained by Lifestyle and Lack of Exercise

2021 ◽  
Author(s):  
Hella Hultin ◽  
Katharina Stevens ◽  
Magnus Sundbom ◽  
Per Hellman
Keyword(s):  
Physical Activity ◽  
Bone Mineral Density ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Calcium Intake ◽  
Lifestyle Factors ◽  
Mineral Density ◽  
Study Participants

Abstract Background: Bariatric surgery, Roux-en-Y gastric bypass (RYGBP) in particular, is associated with weight loss as well as low bone mineral density. Bone mineral density relies upon multiple factors, some of which are lifestyle factors. The aim of this study was to compare lifestyle factors in order to eliminate them as culprits of the suspected difference in BMD in RYGBP operated and controls. Materials and Methods: Study participants included 71 RYGBP-operated women (42.3 yrs, BMI 33.1) and 94 controls (32.4 years, BMI 23.9). Each completed a DEXA scan, as well as survey of lifestyle factors (e.g. physical activity in daily life, corticosteroid use, and calcium intake). All study participants were premenopausal Caucasian women living in the same area. Blood samples were taken in RYGBP-patients.Results: BMD was significantly lower in RYGBP, femoral neck 0.98 vs. 1.04 g/cm2 compared to controls, despite higher BMI (present and at 20 years of age) and similar physical activity and calcium intake. In a multivariate analysis, increased time since surgery and age were negatively associated with BMD of the femoral neck and total hip in RYGBP patients. Conclusion: Despite similar lifestyle, RYGBP was followed by a lower BMD compared to controls. Thus, the reduced BMD in RYGBP cannot be explained, seemingly nor prevented, by lifestyle factors. As the reduction in BMD was associated with time since surgery, strict follow-up is a lifelong necessity after bariatric surgery, and especially important in younger bariatric patients.

scholarly journals Bone Mineral Density, Parathyroid Hormone, and Vitamin D After Gastric Bypass Surgery: a 10-Year Longitudinal Follow-Up

2020 ◽  
Vol 30 (12) ◽  
pp. 4995-5000
Author(s):  
Mustafa Raoof ◽  
Ingmar Näslund ◽  
Eva Rask ◽  
Eva Szabo
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Gastric Bypass ◽  
Parathyroid Hormone ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Gastric Bypass Surgery ◽  
Serum Levels ◽  
Massive Weight Loss ◽  
Mineral Density

Abstract Background The aim of the present study was to study longitudinal changes in bone mineral density (BMD), vitamin D, and parathyroid hormone (PTH) levels in females over a 10-year period after laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods Twenty-three women, mean age 43.4 ± 8.7 years and mean body mass index (BMI) 44.6 ± 5.17 kg/m2 at baseline, were included. BMD, BMI, S-calcium, S-25(OH)-vitamin D, and fP-PTH were measured preoperatively and 2, 5, and 10 years postoperatively. Results Ten years after surgery, BMD of the spine and femoral neck decreased by 20% and 25%, respectively. Changes in serum levels of vitamin D, PTH, and calcium over the same period were small. Conclusion After LRYGB with subsequent massive weight loss, a large decrease in BMD of the spine and femoral neck was seen over a 10-year postoperative period. The fall in BMD largely occurred over the first 5 years after surgery.

scholarly journals Bone Mineral Density and Turnover After Sleeve Gastrectomy and Gastric Bypass: A Randomized Controlled Trial (Oseberg)

2020 ◽  
Author(s):  
Dag Hofsø ◽  
Thor Olav Widerøe Hillestad ◽  
Erling Halvorsen ◽  
Farhat Fatima ◽  
Line Kristin Johnson ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Turnover ◽  
Bone Mineral ◽  
Bone Turnover Markers ◽  
Mineral Density ◽  
Turnover Markers

Abstract Context Bariatric surgery, particularly Roux-en-Y gastric bypass (RYGB), is associated with an increased risk of osteoporotic fractures. It is unknown whether RYGB or sleeve gastrectomy (SG) have different effects on bone health. Objective To compare changes in bone mineral density and markers of bone turnover 1 year after SG and RYGB. Design, Setting, Patients, and Interventions Randomized, triple-blind, single-center trial at a tertiary care center in Norway. The primary outcome was diabetes remission. Patients with severe obesity and type 2 diabetes were randomized and allocated (1:1) to SG or RYGB. Main Outcome Measures Changes in areal bone mineral density (aBMD) and bone turnover markers. Results Femoral neck, total hip, and lumbar spine aBMD, but not total body aBMD, decreased significantly more after RYGB (n = 44) than after SG (n = 48) (mean [95% confidence interval] between group differences -2.8% [-4.7 to -0.8], -3.0% [-5.0 to -0.9], -4.2% [-6.4 to -2.1], and -0.5% [-1.6 to 0.6], respectively). The increase in procollagen type 1 N-terminal propeptide (P1NP) and C-telopeptide of type I collagen (CTX-1) were approximately 100% higher after RYGB than after SG (between group difference at 1 year, both P < 0.001). The changes in femoral neck, total hip, and lumbar spine aBMDs and the changes in P1NP and CTX-1 were independently associated with the surgical procedure (all P < 0.05) and not weight change. Conclusions Roux-en-Y gastric bypass was associated with a greater reduction in aBMD and a greater increase in bone turnover markers compared with SG. This finding could suggest greater skeletal fragility after RYGB.

scholarly journals The Relationship between Cortisol and Bone Mineral Density in Competitive Male Cyclists

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Shannon L. Mathis ◽  
Richard S. Farley ◽  
Dana K. Fuller ◽  
Amy E. Jetton ◽  
Jennifer L. Caputo
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Calcium Intake ◽  
Weight Training ◽  
Time Trial ◽  
Mineral Density ◽  
Daily Calcium Intake ◽  
Cycling Time Trial

Objective. The purpose of this study was to determine whether race day cortisol was related to bone mineral density (BMD) in competitive male cyclists. A secondary purpose was to determine additional factors associated with BMD in competitive male cyclists.Methods. Measurements of lumbar spine and hip BMD were performed in 35 male competitors in a state championship cycling time trial event. Salivary cortisol was measured 10 minutes prior to the start of the race and 5 minutes after race finished. Participants reported daily calcium intake, age, years of bike training, races per season, and average weekly minutes spent riding a bike, weight training, and running on a survey.Results. Cortisol level increased significantly from pre- to postcompetition but was not significantly associated with BMD. Increased weekly minutes of weight training was associated with higher BMD of the lumbar spine and the hip. The increased number of years of cycling experience was associated with lower BMD of the femoral neck. Increased daily calcium intake was associated with higher BMD of the lumbar spine and femoral neck.Conclusions. Findings indicate that cyclists should participate in weight training and increase calcium intake in order to increase or maintain BMD of the lumbar spine and hip.

scholarly journals Total and femoral neck bone mineral density and physical activity in a sample of men and women

2012 ◽  
Vol 37 (5) ◽  
pp. 947-954 ◽  
Author(s):  
Sarah M. Camhi ◽  
Peter T. Katzmarzyk
Keyword(s):  
Physical Activity ◽  
Bone Mineral Density ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Linear Models ◽  
Menopausal Status ◽  
Whole Body ◽  
Mineral Density ◽  
Men And Women ◽  
Total Body

Physical activity (PA), total body fat (TBF), and lean body mass (LBM) are associated with bone mineral density (BMD). However, the independent influence of PA on BMD, while controlling for body composition is not understood as well and is the purpose of the current study. Whole-body BMD (g·cm–2), femoral neck BMD (g·cm–2), TBF (kg), and LBM (kg) were measured with dual-energy X-ray absorptiometry. PA levels (total, work, sport, non-sport) were estimated using the Baecke questionnaire. General linear models determined the independent effects of PA on BMD (whole-body and femoral neck), with adjustment for age, sex, ethnicity, smoking, menopausal status (as appropriate), LBM, and TBF. These associations were also examined by sex and age group (20–34, 35–49, and 50–64 years). The sample included 802 adults (65% women; 13% African American) from the Pennington Center Longitudinal Study that were 20 to 64 years of age (mean ± SD: 46.9 ± 11.0 years). Higher sports scores were associated with higher femoral neck BMD in the total group, men and women, and in 20- to 34-year-olds and 35- to 49-year-olds, but not significant in those 50–64 years of age. Similar significant associations were found for sports score with total body BMD; however, this relationship was not significant for women or for those 50–64 years of age. Total PA had inconsistent relationships with both femoral neck BMD and total body BMD. Higher levels of sport-related PA are associated with higher femoral neck BMD; however, these relationships vary by PA domain and site of BMD measurement.

Correlates and Determinants of Bone Mineral Density in Prepubertal Girls

2002 ◽  
Vol 14 (4) ◽  
pp. 345-357 ◽  
Author(s):  
Peter N. Wiebe ◽  
Cameron J.R. Blimkie ◽  
Nathalie Farpour-Lambert ◽  
Julie Briody ◽  
Helen Woodhead ◽  
...  
Keyword(s):  
Physical Activity ◽  
Bone Mineral Density ◽  
Bone Mineral ◽  
Fat Mass ◽  
Calcium Intake ◽  
Physical Activity Level ◽  
Linear Regression Analysis ◽  
Activity Level ◽  
Dietary Calcium Intake ◽  
Mineral Density

The correlates and determinants of total body (TB), femoral neck (FN), greater trochanter (GT) and leg areal bone mineral density (aBMD), and FN volumetric (vol) BMD were investigated in 42 healthy 6–10-year-old girls. Predictor variables included age, height, weight, lean tissue mass (LTM), fat mass, percent body fat, physical activity level, calcium intake, isokinetic knee flexion and extension strength and endocrine (E2) status. Bone density and body composition were determined by dual energy-x-ray absorptiometry (DEXA), and pubertal status was self-determined. LTM, weight, age, knee extensor strength and fat mass were significantly correlated (Pearson correlation coefficients; 0.36 £ r ‡ 0.62) with TBaBMD. These same variables with the addition of height and knee flexor strength were significantly correlated (0.33 £ r ‡ 0.77) with leg aBMD. Only LTM correlated significantly with FNaBMD and none of the independent variables correlated with FNvolBMD or GTaBMD. Only LTM entered as a significant predictor in multiple linear regression analysis (R2 = 46.7%) for TBaBMD. In conclusion, estradiol status, dietary calcium intake and physical activity level appeared not to be important predictors of BMD in this population, whereas LTM was consistently correlated with most BMD measures and was the single significant determinant of TBaBMD in this study.

Predictors of bone mineral density in a convenience sample of young Caucasian adults living in southern Ontario

2012 ◽  
Vol 37 (4) ◽  
pp. 706-714 ◽  
Author(s):  
Laura E. Chouinard ◽  
Janis Randall Simpson ◽  
Andrea C. Buchholz
Keyword(s):  
Physical Activity ◽  
Bone Mineral Density ◽  
Body Mass ◽  
Bone Mineral ◽  
Bone Health ◽  
Calcium Intake ◽  
Health Concern ◽  
Mineral Density ◽  
Southern Ontario ◽  
Men And Women

Osteoporosis is a major public health concern in Canada and worldwide. Although much is known about bone health in older adults, little is known about bone health in young, healthy Canadian men and women. The objectives of this research were to describe bone mineral density (BMD) of young, healthy adults living in southern Ontario, Canada, and to identify predictors of BMD in this population. Two-hundred and fifty-eight Caucasian men and women aged 18–33 years completed health and physical activity questionnaires along with a calcium and vitamin D specific food frequency questionnaire. Height and mass were measured. BMD of the total hip, femoral neck, spine, and total body was measured using dual energy X-ray absorptiometry. Among men, body mass, weight-bearing physical activity, and calcium intake were significant predictors of BMD. Among women, body mass, calcium intake, and family history of osteoporosis significantly predicted log BMD. The predictors of BMD in young Canadian men and women identified in this study may inform the development of longitudinal studies designed to examine the influence of lifestyle factors on BMD in young adults.

scholarly journals Long-term Bone Loss and Deterioration of Microarchitecture After Gastric Bypass in African American and Latina Women

2020 ◽  
Author(s):  
Alexandra Krez ◽  
Sanchita Agarwal ◽  
Mariana Bucovsky ◽  
Donald J McMahon ◽  
Yizhong Hu ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
African American ◽  
Bone Loss ◽  
Bone Mineral ◽  
Quantitative Computed Tomography ◽  
Latina Women ◽  
Mineral Density

Abstract Context The prevalence of obesity is burgeoning among African American and Latina women; however, few studies investigating the skeletal effects of bariatric surgery have focused on these groups. Objective To investigate long-term skeletal changes following Roux-en-Y gastric bypass (RYGB) in African American and Latina women. Design Four-year prospective cohort study. Patients African American and Latina women presenting for RYGB (n = 17, mean age 44, body mass index 44 kg/m2) were followed annually for 4 years postoperatively. Main Outcome Measures Dual-energy x-ray absorptiometry (DXA) measured areal bone mineral density (aBMD) at the spine, hip, and forearm, and body composition. High-resolution peripheral quantitative computed tomography measured volumetric bone mineral density (vBMD) and microarchitecture. Individual trabecula segmentation-based morphological analysis assessed trabecular morphology and connectivity. Results Baseline DXA Z-Scores were normal. Weight decreased ~30% at Year 1, then stabilized. Parathyroid hormone (PTH) increased by 50% and 25-hydroxyvitamin D was stable. By Year 4, aBMD had declined at all sites, most substantially in the hip. There was significant, progressive loss of cortical and trabecular vBMD, deterioration of microarchitecture, and increased cortical porosity at both the radius and tibia over 4 years. There was loss of trabecular plates, loss of axially aligned trabeculae, and decreased trabecular connectivity. Whole bone stiffness and failure load declined. Risk factors for bone loss included greater weight loss, rise in PTH, and older age. Conclusions African American and Latina women had substantial and progressive bone loss, deterioration of microarchitecture, and trabecular morphology following RYGB. Further studies are critical to understand the long-term skeletal consequences of bariatric surgery in this population.

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