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Bariatric surgery linked to increased fracture risk
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Patients who undergo gastric bypass or other bariatric weight-loss surgeries have a higher risk of fracture than previously reported, according to a recently presented study.
Kelly Nakamura, a medical student at the Mayo Clinic College of Medicine in Rochester, Minn., presented her group’s findings at the 93rd Annual Meeting of The Endocrine Society in Boston, Mass.
The findings are a final analysis of research originally presented 2 years ago in a small subset of the 258 patients presented in the current study. The full analysis, Nakamura reported, reveals that patients who undergo bariatric surgery are 2.3 times more likely than the general population to sustain fracture. The research from 2 years ago reported a 1.8-fold increase.
“A negative effect on bone health that may increase the risk of fractures is an important consideration for people considering bariatric surgery and those who have undergone bariatric surgery,” Nakamura stated in an Endocrine Society press release.
Study methods
Nakamura’s team used the Rochester Epidemiology Project to perform a retrospective study of fracture incidence for 277 patients who underwent their first bariatric surgery at the Mayo Clinic in Rochester between 1985 and 2004. Fracture data were collected, and the team compared the number of observed fractures to the number that would be expected — a figure obtained through the application of age- and gender-specific incidence rates from the local population. Regression models were used to determine hazard ratios and evaluate potential risk factors.
Likelihood of fracture
During a mean follow-up of 9 years, 82 patients sustained 138 fractures, with a mean time to first fracture of 5.9 years. The reported standardized incidence ratio for first fracture at the hip, wrist, spine or humerus was 1.9, and 2.3 at all other sites. Nakamura noted in the release that fractures of the foot, leg and hand were more likely.
Patients who were more physically active before their surgery were less likely to sustain fracture, the authors added, noting that patients who sustained fractures did not necessarily develop osteoporosis.
References:
- Nakamura KM, Haglind EGC, Clowes JA, et al. Fracture risk after bariatric surgery. Paper OR44-5. Presented at the 93rd Annual Meeting of The Endocrine Society. June 4-7, 2011. Boston, MA.
- www.endo-society.org
- Disclosure: The authors have no relevant financial disclosures.
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