Relationship Between Bariatric Surgery and Bone Mineral Density: a Meta-analysis

Area of Science:

• Metabolic and Bariatric Surgery
• Bone Metabolism and Health
• Comparative Effectiveness Research

Background:

• Bone loss following bariatric surgery is a clinical concern.
• Previous meta-analyses comparing surgical and non-surgical groups for bone loss have not been conducted.
• Understanding the impact of bariatric procedures on bone mineral density is crucial for patient management.

Purpose of the Study:

• To conduct a meta-analysis comparing bone mineral density (BMD) between bariatric surgical groups and non-operated controls.
• To investigate potential differences in bone loss after various bariatric surgical procedures.

Main Methods:

• A comprehensive literature review was performed in March 2015 using PubMed, EMBASE, and the Cochrane Library.
• Retrospective, prospective, and randomized studies published in English were included.
• Ten studies met the selection criteria from an initial screening of 1299 articles.

Main Results:

• A statistically significant decrease in bone density was observed at the femoral neck in the bariatric surgery group compared to controls (MD -0.05 g/cm²; p=0.001).
• No significant difference in bone density was found at the lumbar spine between surgical and non-surgical groups (MD -0.01 g/cm²; p=0.661).
• Analysis specific to Roux-en-Y gastric bypass yielded similar findings regarding bone density.

Conclusions:

• Bariatric surgery is associated with reduced bone density at the femoral neck when compared to non-surgical controls.
• Bone density at the lumbar spine did not differ significantly between the groups post-surgery.
• Further large-scale studies with comparative non-surgical controls are needed to confirm these findings and address study heterogeneity.