Changes in bone mineral density after bariatric surgery in patients of different ages or patients with different postoperative periods: a systematic review and meta-analysis

Keypoints What is already known? Bariatric surgery (BS) in obese individuals has become increasingly popular. BS can result in many complications, including osteoporosis. There are many reasons for this, including malabsorption and hormonal disorders. It is necessary to investigate the association between BS and bone density. What does this study add? BS had a certain impact on many parts of the body, such as the femoral neck, lumbar spine and whole body. The impact of metabolic surgery on bone density becomes more significant in participants aged 40 or older. The impact of BS on bone density becomes greater in the patients with a postsurgical time of greater than 12 months. How might your results change the direction of research or the focus of clinical practice? BS had a certain impact on many parts of the body, particularly in patients over 40 years of age and individuals with a postsurgical time of greater than 12 months. These patients should pay attention to bone density screening and osteoporosis prevention. Further research is needed to analyze the variations over a longer period. To assess changes in bone mineral density (BMD) following bariatric surgery (BS) in patients with different bone sites, postoperative periods and ages. Twenty-two studies were included. Femoral neck (FN) BMD decreased after surgery (MD, - 0.05 g/cm(2), CI - 0.10 to - 0.01, P = 0.03). Postoperative BMD decreased more in the FN and lumbar spine (LS) of patients older than 40 (FNBMD, - 0.07 g/cm(2), CI - 0.13 to - 0.00, P = 0.04; LSBMD, - 0.03 g/cm(2), CI - 0.05 to - 0.00, P = 0.02) or patients with a postoperative time of greater than 12 months (FNBMD, - 0.06 g/cm(2), CI - 0.12 to - 0.01, P = 0.03; LSMD, - 0.04 g/cm(2), CI - 0.09 to 0.01, P = 0.12); therefore, post-BS bone loss should be monitored among patients in these groups. Longer follow-ups are needed to determine whether BMD changes or stabilizes.

Automated summary

Bariatric surgery has a certain impact on bone density, especially in patients over 40 years of age and individuals with a postsurgical time of greater than 12 months. It is important for these patients to pay attention to bone density screening and osteoporosis prevention. Further research is needed to analyze longer-term changes.