Risk of osteoporosis in patients undergoing bariatric surgery

Authors

  • Vitória Martins Castro Feitosa
  • Daniele Kelle Lopes de Araújo
  • Milena Nunes Alves de Sousa

DOI:

https://doi.org/10.56083/RCV2N3-021

Keywords:

Obesity, Bariatric surgery, D vitamin, Osteoporosis, Prognosis

Abstract

The objective was to analyze the risks of osteoporosis in patients undergoing bariatric surgery, considering its main techniques and understanding their implications for metabolism and bone mineral density. A systematic review of the literature was carried out based on the PICO question “In obese patients, what is the impact of bariatric surgery when compared to pharmacological treatment on the risk of osteoporosis?”. In the selection of articles, the following databases were searched: Virtual Health Library, Medical Publisher, EBSCO host and CAPES journal portal with the eligibility criteria only randomized clinical trials published in the last 5 years directly related to the research question. The final sample has 9 articles. In most of the articles analyzed, there was a reduction in bone mineral density both in the hip and in the lumbar spine after bariatric surgery. Besides, there was an increased risk of postoperative fractures when compared to patients in the control group. There were indications of a reduction in bone mineral density among patients undergoing bariatric surgery, with an increased risk of fractures by various mechanisms Furthermore, the relationship between different surgical techniques and the increased risk of fractures is still controversial. Finally, effective screening and prophylaxis interventions are sought.

References

AHLIN, S. et al. Fracture risk after three bariatric surgery procedures in Swedish obese subjects: up to 26 years follow⠰up of a controlled intervention study. Journal Of Internal Medicine, v. 287, n. 5, p. 546-557, 3 mar. 2020. http://dx.doi.org/10.1111/joim.13020. DOI: https://doi.org/10.1111/joim.13020

AMORIM, A. B. M. et al. Impactos da cirurgia bariátrica na qualidade de vida do paciente operado. Revista Coopex, v. 7, p. 1-11, 2016.

ALMEIDA, R. R. de et al. Bariatric Surgery: late outcomes in patients who reduced comorbidities at early follow-up. Medicina, v. 57, n. 9, p. 995, 21 set. 2021. http://dx.doi.org/10.3390/medicina57090995 DOI: https://doi.org/10.3390/medicina57090995

BECKETT, Emma. More Than Bone Health: the many roles for vitamin d. Nutrients, [S.L.], v. 12, n. 8, p. 2388, 10 ago. 2020. http://dx.doi.org/10.3390/nu12082388. DOI: https://doi.org/10.3390/nu12082388

BLOM-HØGESTØL, I. K. et al. Bone metabolism, bone mineral density and low-energy fractures 10 years after Roux-en-Y gastric bypass. Bone, v. 127, p. 436-445, out. 2019. http://dx.doi.org/10.1016/j.bone.2019.07.014. DOI: https://doi.org/10.1016/j.bone.2019.07.014

BRASIL. Ministerio da Saúde. Cirurgia Bariátrica. Brasília. 2021. Disponível em: https://bvsms.saude.gov.br/cirurgia-bariatica/. Acesso em: 12 out. 2021.

BRASIL. Ministério da Saúde. Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Ciência e Tecnologia. Diretrizes metodológicas: sistema GRADE – Manual de graduação da qualidade da evidência e força de recomendação para tomada de decisão em saúde. Brasília: Ministério da Saúde, 2014.

BÜHLER, J. et al. Long-Term Effects of Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypass on Body Composition and Bone Mass Density. Obesity Facts, [S.L.], p. 1-10, 17 dez. 2020. http://dx.doi.org/10.1159/000512450. DOI: https://doi.org/10.1159/000512450

CHIN, W. L. et al. Bariatric Surgery Decreases the Risk of Non-traffic Accident–Related Fractures in Patients with Obesity: real-world data from taiwan. Obesity Surgery, v. 31, n. 5, p. 2231-2240, 19 fev. 2021. http://dx.doi.org/10.1007/s11695-021-05262-8. DOI: https://doi.org/10.1007/s11695-021-05262-8

CHOI, K. H.; LEE, J. H.; LEE, D. G. Sex-related differences in bone metabolism in osteoporosis observational study. Medicine, v. 100, n. 21, 28 maio 2021. http://dx.doi.org/10.1097/md.0000000000026153. DOI: https://doi.org/10.1097/MD.0000000000026153

CINTRA, J. F. M. et al. Impacto da cirurgia bariátrica no metabolismo do cálcio. Pubsaúde, v. 4, p. 1-5, 2020. http://dx.doi.org/10.31533/pubsaude4.a070. DOI: https://doi.org/10.31533/pubsaude4.a070

ELKHOLY, H. M. et al. Effect of Aerobic Exercises in Prevention of Bone Mass Loss Post Bariatric Surgeries. The Egyptian Journal Of Hospital Medicine, Cairo, v. 82, n. 4, p. 632-636, jan. 2021. DOI: https://doi.org/10.21608/ejhm.2021.150417

FREDERIKSEN, K. D. et al. Bone Structural Changes and Estimated Strength After Gastric Bypass Surgery Evaluated by HR-pQCT. Calcified Tissue International, v. 98, n. 3, p. 253-262, 12 dez. 2015. http://dx.doi.org/10.1007/s00223-015-0091-5. DOI: https://doi.org/10.1007/s00223-015-0091-5

HUANG, T. W. et al. Alterations of bone markers in obese patients with type 2 diabetes after bariatric surgery. Medicine, v. 100, n. 20, 21 maio 2021. http://dx.doi.org/10.1097/md.0000000000026061. DOI: https://doi.org/10.1097/MD.0000000000026061

JAMIL, L. C. Parâmetros nutricionais pré-operatórios para pacientes após cirurgia bariátrica. 2019. 159 f. Dissertação (Mestrado) - Curso de Mestrado Profissional em Ciência, Tecnologia e Gestão Aplicadas À Regeneração Tecidual, Universidade Federal de São Paulo, São Paulo, 2019.

KALANI, A. et al. The effect of bariatric surgery on serum 25-OH vitamin D levels: a systematic review and meta-analysis. Obesity Science & Practice, v. 3, n. 3, p. 319-332, 27 jun. 2017. http://dx.doi.org/10.1002/osp4.113. DOI: https://doi.org/10.1002/osp4.113

LUHRS, A. R. et al. Determining changes in bone metabolism after bariatric surgery in postmenopausal women. Surgical Endoscopy, [v. 34, n. 4, p. 1754-1760, 2020. http://dx.doi.org/10.1007/s00464-019-06922-8. DOI: https://doi.org/10.1007/s00464-019-06922-8

PACHECO, J. P. S.; SCHWARTZ, G. M. Políticas Públicas e Espaços de Esporte e Lazer nos Estudos Acadêmicos. Licere - Revista do Programa de Pós-Graduação Interdisciplinar em Estudos do Lazer, v. 24, n. 2, p. 341-376, 30 jun. 2021. Universidade Federal de Minas Gerais - Pro-Reitoria de Pesquisa. http://dx.doi.org/10.35699/2447-6218.2021.34948. DOI: https://doi.org/10.35699/2447-6218.2021.34948

PEREIRA, J. M. A. et al. Fitoterápicos No Tratamento E Controle Da Obesidade: Uma Revisão Sistemática. RECIMA21 - Revista Científica Multidisciplinar, v. 3, p. e311066, 2022. DOI: https://doi.org/10.47820/recima21.v3i1.1066

PETERSON, L. A. et al. Vitamin D status and supplementation before and after bariatric surgery: a comprehensive literature review. Surgery For Obesity And Related Diseases, v. 12, n. 3, p. 693-702, mar. 2016. http://dx.doi.org/10.1016/j.soard.2016.01.001. DOI: https://doi.org/10.1016/j.soard.2016.01.001

SANCHEZ, A. Efectos óseos de la cirurgía bariátrica. Actualizaciones En Osteologia, Rosario, v. 12, n. 3, p. 215-220, nov. 2016.

SOCIEDADE BRASILEIRA DE REUMATOLOGIA. Osteoporose. São Paulo, 2019. Disponível em: https://www.reumatologia.org.br/doencas-reumaticas/osteoporose/. Acesso em: 12 out. 2021.

SOUSA, M. N. A. et al. Qualidade de vida em adultos jovens com sobrepeso/obesidade. Revista Temas em Saúde, v. 1, p. 1278-1296, 2016.

ZHANG, Q. et al. Comparative risk of fracture for bariatric procedures in patients with obesity: a systematic review and bayesian network meta-analysis. International Journal Of Surgery, v. 75, p. 13-23, mar. 2020. http://dx.doi.org/10.1016/j.ijsu.2020.01.018. DOI: https://doi.org/10.1016/j.ijsu.2020.01.018

ZIEMINSKA, M.; SIEKLUCKA, B.; PAWLAK, K. Vitamin K and D Supplementation and Bone Health in Chronic Kidney Disease—Apart or Together? Nutrients, v. 13, n. 3, p. 809, 1 mar. 2021. http://dx.doi.org/10.3390/nu13030809. DOI: https://doi.org/10.3390/nu13030809

Published

2022-05-30

How to Cite

Feitosa, V. M. C., Araújo, D. K. L. de, & Sousa, M. N. A. de. (2022). Risk of osteoporosis in patients undergoing bariatric surgery. Revista Contemporânea, 2(3), 446–468. https://doi.org/10.56083/RCV2N3-021

Issue

Section

Articles