Bariatric surgery led to twofold increased risk for fracture

The Endocrine Society's 91st Annual Meeting

Patients who underwent bariatric surgery had a twofold increased risk for fractures — an even higher risk for foot and hand fracture — following surgery, according to data presented this week.

"Our data suggest that there is a clinically relevant association between bariatric surgery and fractures. After two years, there was an increased risk for fractures, which was sustained throughout the study period, suggesting a late effect of bariatric surgery," Jackie Clowes, MD, PhD, assistant professor of medicine at the Mayo Clinic, said at a press conference.

Clowes and colleagues examined data from 97 patients (86 women; mean age, 44) who underwent bariatric surgery at the Mayo Clinic during 1985 and 2004. Mean follow-up was 7 years.

Ninety percent of patients underwent bariatric surgery and 10% underwent vertical banded gastroplasty or biliopancreatic diversion. Twenty-one patients experienced 31 fractures following bariatric surgery.

When compared with the rate for fracture expected in an age-and-sex matched cohort, the Standardized Incidence ratio for a first fracture at any site for patients who underwent bariatric surgery was two times higher. The first fracture at hip, wrist, spine or humerus was 1.4 times higher and first fracture for any other site was 2.3 times higher - and these consisted predominantly of fractures of the hand (3.2 times higher) and foot (3.0 times higher).

“It is currently unclear why fractures are more common after bariatric surgery, especially at the hand and foot,” said Clowes. “There are data suggesting that obesity appears to protect against fracture. Given this, it would suggest that it is a complication of the procedure itself that leads to fractures.”

The researchers concluded that further research is needed to identify risk factors and understand mechanisms for increased fracture risk following bariatric surgery. - by Jennifer Southall

For more information:

Clowes J. #OR07-4. Presented at: The Endocrine Society’s 91st Annual Meeting; June 10-13, 2009; Washington D.C.