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. 2017 Dec 2;9(12):1314.
doi: 10.3390/nu9121314.

Is Trabecular Bone Score Valuable in Bone Microstructure Assessment after Gastric Bypass in Women with Morbid Obesity?

Agustina Pia Marengo  1 , Fernando Guerrero Pérez  2 , Luis San Martín  3 , Rosa Monseny  4 , Anna Casajoana  5 , Rocio Valera  6 , Nuria Virgili  7 , Andreu Simó Servat  8 , Albert Prats  9 , Carmen Gómez-Vaquero  10 , Nuria Vilarrasa  11   12
Affiliations

Is Trabecular Bone Score Valuable in Bone Microstructure Assessment after Gastric Bypass in Women with Morbid Obesity?

Agustina Pia Marengo et al. Nutrients. .

Abstract

Introduction: The effects of bariatric surgery on skeletal health raise many concerns. Trabecular bone score (TBS) is obtained through the analysis of lumbar spine dual X-ray absorptiometry (DXA) images and allows an indirect assessment of skeletal microarchitecture (MA). The aim of our study was to evaluate the changes in bone mineral density (BMD) and alterations in bone microarchitecture assessed by TBS in morbidly obese women undergoing Roux-en-Y gastric bypass (RYGB), over a three-year follow-up.

Material/methods: A prospective study of 38 morbidly obese white women, aged 46.3 ± 8.2 years, undergoing RYGB was conducted. Biochemical analyses and DXA scans with TBS evaluation were performed before and at one year and three years after surgery.

Results: Patients showed normal calcium and phosphorus plasma concentrations throughout the study. However, 25-hydroxyvitamin D (25(OH)D₃) decreased, and 71% of patients had a vitamin D deficiency at three years. BMD at femoral neck and lumbar spine (LSBMD) significantly decreased 13.53 ± 5.42% and 6.03 ± 6.79%, respectively, during the three-year follow-up; however Z-score values remained above those for women of the same age. TBS was within normal ranges at one and three years (1.431 ± 106 and 1.413 ± 85, respectively), and at the end of the study, 73.7% of patients had normal bone MA. TBS at three years correlated inversely with age (r = -0.41, p = 0.010), body fat (r = -0.465, p = 0.004) and greater body fat deposited in trunk (r = -0.48, p = 0.004), and positively with LSBMD (r = 0.433, p = 0.007), fat mass loss (r = 0.438, p = 0.007) and lean mass loss (r = 0.432, p = 0.008). In the regression analysis, TBS remained associated with body fat (β = -0.625, p = 0.031; R² = 0.47). The fracture risk, calculated by FRAX® (University of Sheffield, Sheffield, UK), with and without adjustment by TBS, was low.

Conclusion: Women undergoing RYGB in the mid-term have a preserved bone MA, assessed by TBS.

Keywords: body composition; bone mineral density; osteoporosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Percentage of patients with normal, degraded and partially degraded bone microarchitecture (MA) at baseline, 12 and 36 months after RYGB.
Figure 2
Figure 2
Correlations of TBS at three years after surgery with: (A) Age; (B) Body fat (BF); (C) LSBMD and (D) Body fat distribution trunk/versus lower extremities. Pearson correlation coefficients are included in each graph.
See this image and copyright information in PMC

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