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Nutrients 2017, 9(12), 1314; doi:10.3390/nu9121314

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

1
Department of Endocrinology and Nutrition, Hospital Universitari de Bellvitge-IDIBELL, c/ FeixaLlarga s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
2
Clinical Nutrition Unit, Hospital Universitari de Bellvitge-IDIBELL, c/ FeixaLlarga s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
3
Bariatric Surgery Unit, Hospital Universitari de Bellvitge-IDIBELL, c/ Feixa Llarga s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
4
Department of Rheumatology, Hospital Universitari de Bellvitge-IDIBELL, c/ FeixaLlarga s/n, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
5
CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
*
Authors to whom correspondence should be addressed.
Received: 4 October 2017 / Revised: 22 November 2017 / Accepted: 28 November 2017 / Published: 2 December 2017
(This article belongs to the Special Issue Nutrition and Bariatric Surgery)
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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. View Full-Text
Keywords: bone mineral density; osteoporosis; body composition bone mineral density; osteoporosis; body composition
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MDPI and ACS Style

Marengo, A.P.; Guerrero Pérez, F.; San Martín, L.; Monseny, R.; Casajoana, A.; Valera, R.; Virgili, N.; Simó Servat, A.; Prats, A.; Gómez-Vaquero, C.; Vilarrasa, N. Is Trabecular Bone Score Valuable in Bone Microstructure Assessment after Gastric Bypass in Women with Morbid Obesity? Nutrients 2017, 9, 1314.

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