The Short-Term Impact of Sleeve Gastrectomy on Bone Health.

Objective: To study short-term impact of sleeve gastrectomy (SG) on bone outcomes such as bone metabolism, bone turnover, and bone mineral density (BMD).

Methods: The study included 69 bariatric surgery-eligible patients (37 males and 32 females) ranging in age from 30 to 45 years. Dual-energy x-ray absorptiometry (DXA) scans were used to calculate areal BMD (g/cm2) and T scores in the total hip, femoral neck, and lumbar spine (L1-L4). Serum levels of C-terminal telopeptide (CTX), type 1 collagen propeptide (P1NP), parathyroid hormone (PTH), and 25-hydroxy vitamin D (25(OH)D) were measured. All patients received baseline and 12-month postoperative evaluations.

Results: The study included 69 individuals, 37 (53.62%) male and 32 (46.38%) female, aged 36.86 ± 6.31, with morbid obesity (mean BMI 46.32 ± 4.21 kg/m2) who underwent SG. The mean levels of circulating calcium, 25(OH)D, and PTH did not change significantly after surgery (p > 0.05) and remained within normal ranges twelve months later. Following surgery, bone turnover markers increased significantly (p < 0.05), with CTX showing a higher overall percentage increase than P1NP. The total hip and femoral neck BMD decreased significantly after surgery, but there was no significant difference in lumbar spinal BMD before and after surgery.

Conclusion: This study demonstrates that BMD decreases drastically after SG, and bone loss is more pronounced at the hip and femoral neck sites 12 months after surgery than at the lumber spine. Regular follow-ups, including BMD measurements, are recommended after bariatric surgery, at least once a year.