IMPACT OF SEVERE WEIGHT LOSS INDUCED BY BARIATRIC SURGERY ON BONE MINERAL DENSITY AND REMODELING
DOI:
https://doi.org/10.36557/2674-8169.2025v7n2p879-889Keywords:
bariatric surgery, bone density, bone remodeling.Abstract
Introduction: Brazil, from a global perspective, is the country with the second highest number of bariatric surgeries (BS) performed. In this context, numerous studies have observed that patients undergoing bariatric procedures experience an increase in bone renewal patches and a reduction in bone mineral density (BMD). Objective: To analyze the impact of weight loss caused by bariatric surgery on BMD and remodeling. Methodology: This is an integrative review of the literature, used as PubMed and Scielo databases. The search totaled 80 articles, of which 20 met the inclusion and exclusion criteria, being selected to compose the present study. Results and discussion: The reduction in BMD is more significant in patients undergoing Roux-en-Y gastric bypass (RYGB), especially in the femoral neck region. This decrease in BMD is not only associated with weight loss, but also with changes in bone metabolism as a consequence of surgery, including impaired calcium absorption. Conclusion: Even carrying out supplementary interventions, the risk of bone loss and fractures remains high, which reinforces the need for continuous monitoring of bone and nutritional interventions in post-CB patients.
Downloads
References
ANDRADE, R. S. DE; CESSE, E. Â. P.; FIGUEIRÓ, A. C. Cirurgia bariátrica: complexidades e caminhos para a atenção da obesidade no SUS. Saúde em Debate, v. 47, p. 641–657, 15 set. 2023.
CINTRA, OSÉ F. M. et al. Impacto da cirurgia bariátrica no metabolismo do cálcio. Pubsaúde, v. 4, p. 1–5, 2020.
COURCOULAS, A. P.; DAIGLE, C. R.; ARTERBURN, D. E. Long term outcomes of metabolic/bariatric surgery in adults. BMJ, v. 383, p. e071027, 18 dez. 2023.
DE HOLANDA, N. C. P. et al. Prevalence of Morphometric Vertebral Fractures After Bariatric Surgery and Its Relationship with Bone Mineral Density and Bone Markers. Obesity Surgery, v. 34, n. 3, p. 733–740, 1 mar. 2024.
DE HOLANDA, N. C. P. et al. Secondary Hyperparathyroidism, Bone Density, and Bone Turnover After Bariatric Surgery: Differences Between Roux-en-Y Gastric Bypass and Sleeve Gastrectomy. Obesity Surgery, v. 31, n. 12, p. 5367–5375, 1 dez. 2021.
FEITOSA, V. M. C.; ARAÚJO, D. K. L. DE; SOUSA, M. N. A. DE. Risco de osteoporose em pacientes submetidos à cirurgia bariátrica. Revista Contemporânea, v. 2, n. 3, p. 446–468, 30 maio 2022.
GAMBA, F. P. et al. O impacto do Bypass Gástrico em Y de Roux e da Gastrectomia Vertical na perda de peso: um estudo retrospectivo e longitudinal no Estado do Paraná, Brasil. Revista do Colégio Brasileiro de Cirurgiões, v. 50, 2023.
GASMI, A. et al. Dietary supplements and bariatric surgery. Critical Reviews in Food Science and Nutrition, p. 1–12, 15 abr. 2022.
GUERRERO-PÉREZ, F. et al. Changes in Bone Mineral Density in Patients with Type 2 Diabetes After Different Bariatric Surgery Procedures and the Role of Gastrointestinal Hormones. Obesity Surgery, v. 30, n. 1, p. 180–188, 16 ago. 2020.
HOFSØ, D. et al. Bone Mineral Density and Turnover After Sleeve Gastrectomy and Gastric Bypass: A Randomized Controlled Trial (Oseberg). The Journal of Clinical Endocrinology & Metabolism, v. 106, n. 2, p. 501–511, 5 nov. 2020.
HUPPLER, L. et al. How safe bariatric surgery is—An update on perioperative mortality for clinicians and patients. Clinical Obesity, 9 mar. 2022.
KIM, T. Y. et al. Increases in PYY and uncoupling of bone turnover are associated with loss of bone mass after gastric bypass surgery. Bone, v. 131, p. 115115, fev. 2020.
LUPINO SANCHEZ, C. Atualidades sobre cirurgia bariátrica. Brazilian Journal of Implantology and Health Sciences, v. 3, n. 4, p. 07-21, 3 maio 2021.
NERY, M. D. A.; CÂMERA, V. D. J.; SILVEIRA, M. S. Reganho de peso pós cirurgia bariátrica: uma revisão de literatura. Revista Ciência (In) Cena, v. 1, n. 11, 2020.
NÓBREGA, M. P. et al. Perfil alimentar e reganho de peso de pacientes submetidos à cirurgia bariátrica em um hospital universitário / food profile and weight regain of patients submitted to bariatric surgery in an university hospital. Brazilian Journal of Development, v. 6, n. 12, p. 94771–94785, 2020.
PACCOU, J. et al. Bariatric surgery and skeletal health: A narrative review and position statement for management by the European Calcified Tissue Society (ECTS). Bone, v. 154, p. 116236, jan. 2022.
RODRIGUES, A. F. S. et al. Impacto da cirurgia bariátrica em pacientes com incontinência urinária de esforço. Einstein (São Paulo), v. 19, p. eAO5701, 15 mar. 2021.
SALMAN, M. A. et al. Effects of Gastric Bypass and Sleeve Gastrectomy on Bone Mineral Density and Bone Turnover Markers: A Systematic Review and Meta-Analysis. World Journal of Surgery, v. 46, n. 4, p. 865–875, 10 jan. 2022.
SIERŻANTOWICZ, R.; ŁADNY, J. R.; LEWKO, J. Quality of Life after Bariatric Surgery—A Systematic Review. International Journal of Environmental Research and Public Health, v. 19, n. 15, p. 9078, 26 jul. 2022.
VARGAS, J. A. et al. Avaliação do padrão ósseo alveolar em mulheres obesas e não obesas, antes e após a cirurgia bariátrica: um estudo de coorte prospectivo. ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), v. 33, p. e1501, 8 jul. 2020.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Sarah Giovanna, Samara Gabryela Rodrigues Gonçalves, Denise Rodrigues Chagas Gonçalves, Dênia Rodrigues Chagas, Letícia Martinelli Chagas Nunes, Luma Gomes Madeira, Nayara da Silva Galdino, Letícia Uinatanny Silva Bessa, Bruna de Jesus Carneiro, Yasmin Cruvinel Vieira de Miranda , Maiara dos Santos Sena Dias, Larissa de Sá Santos
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors are copyright holders under a CCBY 4.0 license.
