Bone Mineral Densit Y After Bariatric Surgery A Systematic Review And Meta Analysis

Objective:Bariatric surgery is an effective treatment to cure obesity and reduce complications,However,it's influence on bone mineral density is inconclusive.The purpose of this paper is to elucidate the bone mineral density changes before and after bareitric surgery and whetherBMD changes is comparable after different bariatric surgeries.Methods:1.Search strategy:Pub Med,Embase,the Cochrane,Medline,China National Knowledge Infrastructure were searched for relevant reports,and the reference lists of identified articles were hand-searched.2.Selection criteria:Studies of morbid obese adults,undergone to bariatric surgery,with BMD measured by dual-energy X-ray absorptiometry at baseline and after surgery was included.Bone mineral density data should be represented by mean X and standard deviation SD,or X and SD can be obtained by calculation.3.Data extraction and analysis:The random effect model is affect when I~2>50%,The fixed effect model is affect when I~2<50%,calculate the total mean difference.Results:Eighteen studies met the selection criteria.After one year,reduction in total BMD in patients with bariatric surgical procedures was significant.BMD was reduced by 0.04 g/cm2(CI 95%0.02 to 0.06,P<0.00001)in total body,0.04 g/cm2(CI 95%0.01 to 0.06,P=0.004)in the spine,0.09 g/cm2(CI 95%0.07to 0.11,P<0.00001)in the total hip,and0.08g/cm2(CI 95%0.06to 0.10,P<0.00001)in femoral neck,the Degree of bone loss in RYGB surgery is more obvious compared with SG,the spinal bone mineral density and whole body bone mineral density of people tho accept SG and VBG respectively show increasing,but the result lack of statistical significance.Studies included showed high heterogeneity and quality of evidence.Conclusion:Patients undergone to bariatric surgery hadsignificant higher BMD deterioration as demonstrated in this review,the mixed surgical procedures is more pronounced compare to restrictive surgical procedures,suggesting that more attention for preventing osteoporosis fractures and other side effects caused by bariatric surgery related bone loss is required.