Roux-en-Y Gastric Bypass

 

There is not a significant change in BMD (using short-term precision values for the facility) approximately one year after a roux-en-y gastric bypass. There is degenerative change in the lumbar spine which may confound the determination of change.

There is a significant loss in bone mineral density (using short-term precision values for the facility) at the left hip approximately 1 year after a roux-en-y gastric bypass.

This figure shows the loss in fat mass that occured after the roux-en-y gastric bypass.

Case Description:

This is a 68 year old postmenopausal Caucasian female who had roux-en-y gastric bypass. The baseline scan was on 4/17/18 and then the patient has a roux-en-y gastric bypass with followup scanning on 7/5/19. Using the 95% CI from the DXA facility, there was not a significant change in bone mineral density at the lumbar spine, but there was a significant loss at the total hip. The compartmental trending shows a loss of fat mass after the bariatric procedure. Loss of bone mineral density is seen more frequently after malabsorptive weight reduction surgery such as a roux-en-y gastric bypass, as opposed to a restrictive procedure like a gastric sleeve.

Credit:

Sarah L Morgan, MD, RD, CCD and Jayleen Grams, MD, The University of Alabama at Birmingham

References:

• Blom-Høgestøl, I.K., et al., Bone metabolism, bone mineral density and low-energy fractures 10 years after Roux-en-Y gastric bypass. Bone, 2019. 127: p. 436-445.
• Casimiro, I., S. Sam, and M.J. Brady, Endocrine implications of bariatric surgery: a review on the intersection between incretins, bone, and sex hormones. Physiol Rep, 2019. 7(10): p. e14111.
• Corbeels, K., et al., Thin bones: Vitamin D and calcium handling after bariatric surgery. Bone Rep, 2018. 8: p. 57-63.
• Ivaska, K.K., et al., Changes in bone metabolism after bariatric surgery by gastric bypass or sleeve gastrectomy. Bone, 2017. 95: p. 47-54.
• Jaruvongvanich, V., et al., Changes in bone mineral density and bone metabolism after sleeve gastrectomy: a systematic review and meta-analysis. Surg Obes Relat Dis, 2019. 15(8): p. 1252-1260.
• Lespessailles, E., et al., Obesity, Bariatric Surgery, and Fractures. J Clin Endocrinol Metab, 2019. 104(10): p. 4756-4768.