Undergoing Gastric Bypass Impacts Risk of Fracture
Gastric bypass surgery appears to be associated with an increased risk of fracture, regardless of degree of weight loss or calcium/vitamin D supplementation post-surgery, according to the results of a recent study.
Although gastric bypass has been shown to be associated with bone loss, little information regarding the risk of fracture post-surgery is available.
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To study this further, researchers conducted a retrospective cohort study using obese patients undergoing gastric bypass from Swedish national databases (n= 38,971), 7758 of whom had diabetes and 31,213 who did not. Multivariable 1:1 propensity score matching was used to identify an equal number of healthy controls. The researchers used Cox proportional hazards and flexible parameter models to assess the risk of fracture and fall injury according to weight loss and degree of calcium and vitamin D supplementation 1-year post-surgery.
Over a median follow-up of 3.1 years, the researchers found that gastric bypass was associated with an increased risk of fracture in patients with and without diabetes (hazard ratio [HR] 1.26 and HR 1.32, respectively). Using flexible parameter models, the researchers found that the risk appeared to increase over time. The risk of fall injury without fracture was also increased with time. However, the degree of weight loss and calcium/vitamin D supplementation post-surgery were not associated with increased fracture risk.
“In conclusion, gastric bypass surgery is associated with an increased fracture risk, which appears to be increasing with time and not associated with degree of weight loss or calcium and vitamin D supplementation following surgery. An increased risk of fall injury was seen after surgery, which could contribute to the increased fracture risk.”
—Michael Potts
Reference:
Axelsson KF, Werling M, Eliasson B, et al. Fracture risk after gastric bypass surgery–a retrospective cohort study [published online July 16, 2018]. JBMR. https://doi.org/10.1002/jbmr.3553.