The
Endocrine Society's 91st Annual Meeting
Patients who underwent bariatric surgery had a twofold increased
risk for fractures — an even higher risk for foot and hand fracture —
following surgery, according to data presented this week.
"Our data suggest that there is a clinically relevant association between bariatric surgery and fractures. After two years, there was an increased risk for fractures, which was sustained throughout the study period, suggesting a late effect of bariatric surgery," Jackie Clowes, MD, PhD, assistant professor of medicine at the Mayo Clinic, said at a press conference.
Clowes and colleagues examined data from 97 patients (86 women; mean
age, 44) who underwent bariatric surgery at the Mayo Clinic during 1985 and
2004. Mean follow-up was 7 years.
Ninety percent of patients underwent bariatric surgery and 10% underwent
vertical banded gastroplasty or biliopancreatic diversion. Twenty-one patients
experienced 31 fractures following bariatric surgery.
When compared with the rate for fracture expected in an age-and-sex matched cohort, the Standardized Incidence ratio for a first fracture at any site for patients who underwent bariatric surgery was two times higher. The first fracture at hip, wrist, spine or humerus was 1.4 times higher and first fracture for any other site was 2.3 times higher - and these consisted predominantly of fractures of the hand (3.2 times higher) and foot (3.0 times higher).
“It is currently unclear why fractures are more common after
bariatric surgery, especially at the hand and foot,” said Clowes.
“There are data suggesting that obesity appears to protect against
fracture. Given this, it would suggest that it is a complication of the
procedure itself that leads to fractures.”
The researchers concluded that further research is needed to identify
risk factors and understand mechanisms for increased fracture risk following
bariatric surgery. - by Jennifer Southall
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