Thirty percent increase in risk of fracture after gastric bypass

August 13, 2018

A study published in the Journal of Bone and Mineral Research shows that the risk of fractures increases by about 30 percent after a gastric bypass operation. It was also discovered that falls increase after these operations.

"Gastric bypass is a well-established method that has proven effective in reducing obesity, diabetes and mortality, so naturally our findings do not mean that you should stop providing these types of operations," says Mattias Lorentzon, professor of geriatrics at Sahlgrenska Academy, University of Gothenburg, Sweden, and Chief Physician at the University Hospital.

The study is based on the records of 38,971 patients who underwent gastric bypass operations, of which 7,758 had diabetes and 31,213 did not. Those who had had the operation were compared with an equally large group of individuals who had not been operated on and who had the equivalent morbidity and background data.

Regardless of diabetes status, those who had been operated on had about a 30 percent increased risk of fractures. Individuals without diabetes had an increased risk of 32 percent and those with diabetes had an increased risk of 26 percent. The risk increase applies to fractures in general, with the exception of the lower leg. After surgery, fractures of the lower legs occurred less frequently.

The results correspond well with earlier research in the field, but the current study is statistically stronger due to its size. The data is also more equivalent since the researchers focused on the dominant method of obesity surgery, gastric bypass, and exclude other forms.

With gastric bypass operations, most of the stomach and part of the small intestine are removed. Food goes directly into the small intestine instead of passing through the entire stomach, which increases the sense of being full. The person eats less and nutrient uptake decreases leading to weight loss.

The most common hypothesis of the mechanism behind increased fracture after obesity surgery has been weight loss and that the skeleton becomes weaker with the less load. The study did not show a relationship between the fracture rate and the degree of weight loss. An increased risk of falls after surgery, however, was noted, which in itself could contribute to increased risk of fractures. The question of why individuals who have had operations fall more often, with or without fractures as a consequence, has no clear answer yet.

"The fact that the risk of fractures increases and also seems to increase over time means that it will be important to follow patients, evaluate the fracture risk and, when required, institute measures to prevent fractures," says Kristian Axelsson, doctoral student at Sahlgrenska Academy, University of Gothenburg, and resident physician in orthopedics at Skaraborg Hospital Skövde.
-end-
Title: Fracuture risk after gastric bypass surgery - a retrospective cohort study; https://onlinelibrary.wiley.com/doi/10.1002/jbmr.3553

Contact:

Kristian Axelsson, first author, +46 708 19 73 73; kristian.axelsson@gu.se
Mattias Lorentzon, corresponding author, +46 733 38 81 85; mattias.lorentzon@medic.gu.se

University of Gothenburg

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.