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Erschienen in:

23.11.2022 | Original Article

CT evaluation of bone fragility 2 years after bariatric surgery: an observational study

verfasst von: Marine Fauny, Marion Halin, Edem Allado, Didier Quilliot, Laurent Brunaud, Eliane Albuisson, Isabelle Chary-Valckenaere, Damien Loeuille

Erschienen in: Journal of Bone and Mineral Metabolism | Ausgabe 1/2023

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Abstract

Introduction

The objectives were to evaluate bone fragility on computed tomography (CT) in patients with obesity before and 2 years after bariatric surgery and to identify risk factors for a decrease in the scanographic bone attenuation coefficient of the first lumbar vertebra (SBAC-L1).

Materials and Methods

Patients with obesity who underwent bariatric surgery and CT before and 2 years (± 6 months) after bariatric surgery were included. SBAC-L1 was measured on CT with a fracture threshold at 145 HU.

Results

78 patients were included, 85.9% women, mean age of 48.5 years (± 11.4); the mean BMI was 46.2 kg/m² (± 7) before surgery and 29.8 kg/m² (± 6.7) 2 years after surgery. There was a significant change in SBAC-L1 2 years after surgery (p = 0.037). In multivariate analysis, the risk factors for having an SBAC-L1 ≤ 145HU 2 years after bariatric surgery in those with an SBAC-L1 > 145HU before surgery were age and sex, with men and older patients having a higher risk (OR 32.6, CI 95% [1.86–568.77], and OR 0.85, CI 95% [0.74–0.98], respectively).

Conclusion

SBAC-L1 was significantly lower two years after bariatric surgery. Men sex and older patients were the risk factors for having an SBAC-L1 below the fracture threshold 2 years after surgery.

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Toledano E, Candelas G, Rosales Z, Martínez Prada C, León L et al (2012) A meta-analysis of mortality in rheumatic diseases. Reumatol Clin 8:334–341CrossRef

Lane JM, Russell L, Khan SN (2000) Osteoporosis. Clin Orthop Relat Res 372:139–150CrossRef

Dimai HP (2017) Use of dual-energy X-ray absorptiometry (DXA) for diagnosis and fracture risk assessment; WHO-criteria, T- and Z-score, and reference databases. Bone 104:39–43CrossRef

Murray TÉ, Williams D, Lee MJ (2017) Osteoporosis, obesity, and sarcopenia on abdominal CT: a review of epidemiology, diagnostic criteria, and management strategies for the reporting radiologist. Abdom Radiol (NY) 42:2376–2386CrossRef

Pickhardt PJ, Pooler BD, Lauder T, del Rio AM, Bruce RJ, Binkley N (2013) Opportunistic screening for osteoporosis using abdominal computed tomography scans obtained for other indications. Ann Intern Med 158:588–595CrossRef

Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894, 1–253.

Borisenko O, Colpan Z, Dillemans B, Funch-Jensen P, Hedenbro J, Ahmed AR (2015) Clinical indications, utilization, and funding of bariatric surgery in Europe. Obes Surg 25:1408–1416CrossRef

Stahl JM, Malhotra S (2021) obesity surgery indications and contraindications. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 [cited 2021 May 7]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK513285/

Lespessailles E, Paccou J, Javier R-M, Thomas T, Cortet B, Obesity G, GRIO Scientific Committee (2019) Bariatric surgery, and fractures. J Clin Endocrinol Metab. 104:4756–4768CrossRef

10.

Gonnelli S, Caffarelli C, Nuti R (2014) Obesity and fracture risk. Clin Cases Miner Bone Metab 11:9–14

11.

Ambrosi TH, Scialdone A, Graja A, Gohlke S, Jank A-M et al (2017) Adipocyte accumulation in the bone marrow during obesity and aging impairs stem cell-based hematopoietic and bone regeneration. Cell Stem Cell 20:771-784.e6CrossRef

12.

Greco EA, Fornari R, Rossi F, Santiemma V, Prossomariti G et al (2010) Is obesity protective for osteoporosis? Evaluation of bone mineral density in individuals with high body mass index. Int J Clin Pract 64:817–820CrossRef

13.

Compston JE, Flahive J, Hosmer DW, Watts NB, Siris ES et al (2014) Relationship of weight, height, and body mass index with fracture risk at different sites in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women (GLOW). J Bone Miner Res 29:487–493CrossRef

14.

Ko B-J, Myung SK, Cho K-H, Park YG, Kim SG et al (2016) Relationship between bariatric surgery and bone mineral density: a meta-analysis. Obes Surg 26:1414–1421CrossRef

15.

Paccou J, Martignène N, Lespessailles E, Babykina E, Pattou F et al (2020) Gastric bypass but not sleeve gastrectomy increases risk of major osteoporotic fracture: French population-based cohort study. J Bone Miner Res 35:1415–1423CrossRef

16.

Lu C-W, Chang Y-K, Chang H-H, Kuo C-S, Huang C-T et al (2015) Fracture risk after bariatric surgery: a 12-year nationwide cohort study. Medicine (Baltimore) 94:e2087CrossRef

17.

Fauny M, Bauer E, Albuisson E, Perrier-Cornet J, Deibener J et al (2018) Vertebral fracture prevalence and measurement of the scanographic bone attenuation coefficient on CT-scan in patients with systemic sclerosis. Rheumatol Int 38:1901–1910CrossRef

18.

Genant HK, Wu CY, van Kuijk C, Nevitt MC (1993) Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res 8:48

19.

Kanter R, Caballero B (2012) Global gender disparities in obesity: a review. Adv Nutr 3:491–498CrossRef

20.

Hales CM, Carroll MD, Fryar CD, Ogden CL (2020) Prevalence of obesity and severe obesity among adults: US, 2017–2018. In: NCHS Data Brief, no 360. Hyattsville, MD: National Center for Health Statistics

21.

Barnes AS (2011) The epidemic of obesity and diabetes: trends and treatments. Tex Heart Inst J 38:142–144

22.

Pereira-Santos M, Costa PR, Assis AM, Santos CA, Santos DB (2015) Obesity and vitamin D deficiency: a systematic review and meta-analysis. Obes Rev 16:341–349CrossRef

23.

Jammah AA (2015) Endocrine and metabolic complications after bariatric surgery. Saudi J Gastroenterol. 21:269–277CrossRef

24.

Silva LB, Oliveira BMPM, Correia F (2019) Evolution of body composition of obese patients undergoing bariatric surgery. Clin Nutr ESPEN 31:95–99CrossRef

25.

JunqueraBañares S, Ramírez Real L, Camuñas Segovia J, Martín García-Almenta M, Llanos Egüez K, Álvarez HJ (2021) Evaluation of quality of life, weight loss and evolution of comorbidities at 6 years after bariatric surgery. Endocrinol Diabetes Nutr 68:501–508

26.

Jang S, Graffy PM, Ziemlewicz TJ, Lee SJ, Summers RM, Pickhardt PJ (2019) Opportunistic osteoporosis screening at routine abdominal and thoracic CT: normative L1 trabecular attenuation values in more than 20 000 adults. Radiology 291:360–367CrossRef

27.

Paccou J, Caiazzo R, Lespessailles E, Cortet B (2021) Bariatric surgery and osteoporosis. Calcif Tissue Int.

28.

Kelsey JL (1989) Risk factors for osteoporosis and associated fractures. Public Health Rep 104:14–20

29.

Kurra S, Fink DA, Siris ES (2014) Osteoporosis-associated fracture and diabetes. Endocrinol Metab Clin North Am 43:233–243CrossRef

30.

Paschou SA, Vryonidou A (2019) Diabetes mellitus and osteoporosis. Minerva Endocrinol 44:333–335

31.

Uppot RN, Sahani DV, Hahn PF, Gervais D (2007) Impact of obesity on medical imaging and image-guided intervention. AJR Am J Roentgenol 188:433–440CrossRef

32.

Law W-Y, Huang G-L, Yang C-C (2022) Effect of body mass index in coronary CT angiography performed on a 256-slice multi-detector CT scanner. Diagnostics (Basel) 12:319CrossRef

Titel: CT evaluation of bone fragility 2 years after bariatric surgery: an observational study
verfasst von: Marine Fauny
Marion Halin
Edem Allado
Didier Quilliot
Laurent Brunaud
Eliane Albuisson
Isabelle Chary-Valckenaere
Damien Loeuille
Publikationsdatum: 23.11.2022
Verlag: Springer Nature Singapore
Erschienen in: Journal of Bone and Mineral Metabolism / Ausgabe 1/2023
Print ISSN: 0914-8779
Elektronische ISSN: 1435-5604
DOI: https://doi.org/10.1007/s00774-022-01386-8

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CT evaluation of bone fragility 2 years after bariatric surgery: an observational study