Evaluation effects of sleeve gastrectomy to bone metabolism and bone mineral densitometry in patients over 50 years

Abstract

Background: Despite the improvement in health, function and quality of life of patients with morbid obesity following bariatric surgery, such intervention may result in some potential complications such as metabolic disturbances especially involving bone motabolism. The aim of this study was to evaluate the extent of Bone Mineral Density (BMD) changes in older patients with morbid obesity and its relation with bone metabolism indices. Methods: This study was a single-center cross-sectional study on 50 new morbidly obese patients over 50 years old of age who were candidates for bariatric surgery. Before and 6 months after surgery, the values of BMD, anthropometric indices and metabolic serum biomarkers were assessed. Results: BMD examination before and 6 months after surgery showed decrease in the BMD in hip region from 1.242 ± 0.136 to 1.117 ± 0.112 g/cm2, in the femoral neck from 1.109 ± 0.131 to 0.987 ± 0.127 g/cm2, in the lumbar spine from 1.253 ± 0.146 to 1.190 ± 0.135 g/cm2. The analysis of BMD changes showed significant decrease in the bone density of all site measurement but with variable amounts. The decrement of BMD in the hip and femoral neck was significant but in the spine was not significant. The analysis on bone metabolism markers showed significant increase in 25-Hydroxy vitamin D and Alkaline phosphatase levels but decrease in calcium and parathyroid hormone (PTH) during 6 month follow up. Conclusion: There is significant decrease in BMD at various skeletal areas including femoral neck and hip region. Such changes can be in line with the changes in some serum metabolic and hormonal biomarkers such as calcium, PTH, vitamin D and alkaline phosphatase.