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Sleeve gastrectomy in adolescents decreased strength and volumetric BMD of the lumbar spine

Sleeve gastrectomy (SG) decreases strength and bone mineral density of the lumbar spine in adolescents, according to the outcomes from a 12-month prospective non-randomised study by researchers from the Massachusetts General Hospital.

"Weight loss surgery is very effective in treating obesity and obesity-associated comorbidities in adolescents and young adults with obesity; however, it can cause loss of bone density and strength,” said corresponding author of the study, Dr Miriam A Bredella of Massachusetts General Hospital. “We hope that our study raises awareness of the importance of bone health after weight loss surgery, so physicians can make sure that children eat a healthy diet with enough calcium and vitamin D and engage in weight-bearing activity to build up muscle mass, which is good for bones.”

In the study, 29 adolescents/young adults with obesity underwent SG and 30 were followed without surgery. At baseline and 12 months, participants underwent computed tomography of the lumbar spine for bone assessments and magnetic resonance imaging of the abdomen and thigh for body composition assessments.

Participants in the SG group lost an average of 34.3 kg (75.6lbs) 12 months after surgery, whereas weight was unchanged in controls (p<0.001). There were also significant reductions in abdominal fat tissue and thigh muscle in the SG group compared with controls (p<0.001). In addition, bone strength, bending stiffness and average and trabecular volumetric BMD decreased in the SG group compared with controls (p<0.001). The reductions in bone strength and bone mineral density were associated with reductions in body mass index, abdominal fat tissue and muscle (p≤0.03).

The findings were ported in the paper, ‘Biomechanical CT to Assess Bone After Sleeve Gastrectomy in Adolescents With Obesity: A Prospective Longitudinal Study’, published in the Journal of Bone and Mineral Research.


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