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Title: Long-term effects in bone mineral density after different bariatric procedures in patients with type 2 diabetes: outcomes of a randomized clinical trial
Author: Guerrero Pérez, Fernando
Casajoana, Anna
Gómez Vaquero, Carmen
Virgili, Núria
López Urdiales, Rafael
Hernández Montoliu, Laura
Pujol Gebelli, Jordi
Osorio, Javier
Prats, Anna
Pujol Gebelli, Jordi
Pérez Maraver, Manuel
Fernández Veledo, Sonia
Vendrell, Joan
Vilarrasa, Nuria
Keywords: Densitat mineral òssia
Cirurgia de l'obesitat
Bone density
Obesity surgery
Issue Date: 1-Jun-2020
Publisher: MDPI
Abstract: There is scant evidence of the long-term effects of bariatric surgery on bone mineral density (BMD). We compared BMD changes in patients with severe obesity and type 2 diabetes (T2D) 5 years after randomization to metabolic gastric bypass (mRYGB), sleeve gastrectomy (SG) and greater curvature plication (GCP). We studied the influence of first year gastrointestinal hormone changes on final bone outcomes. Forty-five patients, averaging 49.4 (7.8) years old and body mass index (BMI) 39.4 (1.9) kg/m(2), were included. BMD at lumbar spine (LS) was lower after mRYGB compared to SG and GCP: 0.89 [0.82;0.94] vs. 1.04 [0.91;1.16] vs. 0.99 [0.89;1.12],p= 0.020. A higher percentage of LS osteopenia was present after mRYGB 78.6% vs. 33.3% vs. 50.0%, respectively. BMD reduction was greater in T2D remitters vs. non-remitters. Weight at fifth year predicted BMD changes at the femoral neck (FN) (adjustedR(2): 0.3218;p= 0.002), and type of surgery (mRYGB) and menopause predicted BMD changes at LS (adjustedR(2): 0.2507;p< 0.015). In conclusion, mRYGB produces higher deleterious effects on bone at LS compared to SG and GCP in the long-term. Women in menopause undergoing mRYGB are at highest risk of bone deterioration. Gastrointestinal hormone changes after surgery do not play a major role in BMD outcomes.
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It is part of: Journal of Clinical Medicine, 2020, vol. 9, num. 6
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Appears in Collections:Articles publicats en revistes (Ciències Clíniques)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (Ciències Fisiològiques)

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