Skeletal Effects of Sleeve Gastrectomy in Adolescents and Young Adults: A 2-Year Longitudinal Study
Authors' conclusion
VSG leads to progressive changes in bone health over 2 years, and may lead to increased skeletal fragility in adolescents and young adults.
Study context
- Population
- Patients aged 13 to 24 years with moderate-to-severe obesity meeting criteria for vertical sleeve gastrectomy (VSG), tertiary care center
- Participants
- 66 patients
- Exposure
- VSG vs nonsurgical management
- VSGn = 30
- Controln = 36reference
- Outcome
- DXA and high-resolution peripheral quantitative computed tomography (HRpQCT) measures of BMD, geometry and microarchitecture
- Follow-up
- 2 years
Methodological detailssingle-centre (tertiary care center), non-randomised; treatment per patient and clinical team decision
- Single-centre (tertiary care center)
- Non-randomised; treatment per patient and clinical team decision
Main finding
As reported in the abstract
Total hip BMD change
VSG
−8.5
± 1.0 · %
Control
0.1
± 1.0 · %
P < 0.001
- Similar results at the femoral neck
- P < 0.001
- Total volumetric BMD (vBMD) decreased at distal radius and tibia following VSG, driven primarily by trabecular vBMD loss
- P < 0.001
- Cortical porosity decreased following VSG at radius and tibia
- P = 0.048 and P < .001
- Cortical thickness increased in controls but not in VSG (between-group, radius and tibia)
- P = 0.022 and P = .002
Observational data: associations, not effects.
Further findings
| Outcome | VSG | Control |
|---|---|---|
| Weight change · 2 years | 25.3 ± 2.0 % weight loss | 4.0 ± 2.0 % weight gain |
- Weight change — VSG weight loss (within-group)
- P < .001
- Weight change — Control weight gain (within-group)
- P = .026
Original publication
Skeletal Effects of Sleeve Gastrectomy in Adolescents and Young Adults: A 2-Year Longitudinal Study. J Clin Endocrinol Metab. Published 31 October 2022. doi:10.
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