Nonvertebral Fracture Risk After Roux-en-Y Gastric Bypass

HealthDay News — Roux-en-Y gastric bypass is associated with increased nonvertebral fracture risk compared with adjustable gastric banding, according to a study published online in the Journal of Bone and Mineral Research.

Elaine W. Yu, MD, from Massachusetts General Hospital in Boston, and colleagues compared fracture risk in obese adults after Roux-en-Y gastric bypass and adjustable gastric banding procedures using claims data from a US commercial health plan. They examined rates of nonvertebral fractures within a propensity-score matched cohort of 15,032 morbidly obese adults who underwent Roux-en-Y gastric bypass or adjustable gastric banding surgery from 2005 to 2013.

During a mean follow-up of 2.3±1.9 years there were 281 nonvertebral fractures. The researchers found that compared with adjustable gastric banding patients, Roux-en-Y gastric bypass patients had increased risk of nonvertebral fracture (hazard ratio [HR]: 1.43). Roux-en-Y gastric bypass patients had increased risk of fracture at the hip and wrist (HR: 1.54 and 1.45, respectively) in fracture site-specific analyses. The risk of nonvertebral fracture associated with Roux-en-Y gastric bypass manifested more than 2 years after surgery and increased in subsequent years; the highest risk was seen in the fifth year after surgery (HR: 3.91).

“Fracture risk should be considered in risk:benefit discussions of bariatric surgery, particularly among patients with high baseline risk of osteoporosis who are deciding between Roux-en-Y gastric bypass and adjustable gastric banding procedures,” the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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Yu EW, Lee MP, Landon JE, Lindeman KG, Kim SC. Fracture risk after bariatric surgery: Roux-en-Y gastric bypass versus adjustable gastric banding [published online March 2, 2017]. J Bone Miner Res. doi: 10.1002/jbmr.3101