Biomechanical CT to Assess Bone After Sleeve Gastrectomy in Adolescents With Obesity: A Prospective Longitudinal Study
ABSTRACT Sleeve gastrectomy (SG) is effective in treating cardiometabolic complications of obesity but is associated with bone loss. Our aim was to determine the effect of SG on the lumbar spine by biomechanical CT analysis in adolescents/young adults with obesity. We hypothesized that SG would lead...
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| Veröffentlicht in: | Journal of bone and mineral research 2023-07, Vol.38 (7), p.933-942 |
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| creator | Huber, Florian A Singhal, Vibha Tuli, Shubhangi Stanford, Fatima C Carmine, Brian Bouxsein, Mary L Misra, Madhusmita Bredella, Miriam A |
| description | ABSTRACT
Sleeve gastrectomy (SG) is effective in treating cardiometabolic complications of obesity but is associated with bone loss. Our aim was to determine the effect of SG on the lumbar spine by biomechanical CT analysis in adolescents/young adults with obesity. We hypothesized that SG would lead to a decrease in strength and bone mineral density (BMD) compared with nonsurgical controls. In a 12‐month prospective nonrandomized study, adolescents/young adults with obesity underwent SG (n = 29, 18.0 ± 2.1 years, 23 female) or were followed without surgery (controls, n = 30, 17.95 ± 3.0 years, 22 female). At baseline and 12 months, participants underwent quantitative computed tomography (QCT) of L1 and L2 for biomechanical assessment and MRI of the abdomen and mid‐thigh for body composition assessment. Twelve‐month changes between groups and within groups were assessed. Analyses were controlled for baseline and 12‐month changes in body mass index (BMI) by multivariable analyses. Regression analysis was performed to evaluate the effect of body composition on bone parameters. Our institutional review board (IRB) approved the study, and informed consent/assent was obtained. Participants in the SG group had a higher baseline BMI than controls (p = 0.01) and lost an average of 34.3 ± 13.6 kg 12 months after surgery, whereas weight was unchanged in controls (p |
| doi_str_mv | 10.1002/jbmr.4784 |
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Sleeve gastrectomy (SG) is effective in treating cardiometabolic complications of obesity but is associated with bone loss. Our aim was to determine the effect of SG on the lumbar spine by biomechanical CT analysis in adolescents/young adults with obesity. We hypothesized that SG would lead to a decrease in strength and bone mineral density (BMD) compared with nonsurgical controls. In a 12‐month prospective nonrandomized study, adolescents/young adults with obesity underwent SG (n = 29, 18.0 ± 2.1 years, 23 female) or were followed without surgery (controls, n = 30, 17.95 ± 3.0 years, 22 female). At baseline and 12 months, participants underwent quantitative computed tomography (QCT) of L1 and L2 for biomechanical assessment and MRI of the abdomen and mid‐thigh for body composition assessment. Twelve‐month changes between groups and within groups were assessed. Analyses were controlled for baseline and 12‐month changes in body mass index (BMI) by multivariable analyses. Regression analysis was performed to evaluate the effect of body composition on bone parameters. Our institutional review board (IRB) approved the study, and informed consent/assent was obtained. Participants in the SG group had a higher baseline BMI than controls (p = 0.01) and lost an average of 34.3 ± 13.6 kg 12 months after surgery, whereas weight was unchanged in controls (p < 0.001). There were significant reductions in abdominal adipose tissue and thigh muscle area in the SG group compared with controls (p < 0.001). Bone strength, bending stiffness, and average and trabecular volumetric BMD decreased in the SG group compared with controls (p < 0.001). After controlling for change in BMI, a 12‐month reduction in cortical BMD was significant in the SG group compared with controls (p = 0.02). Reductions in strength and trabecular BMD were associated with reductions in BMI, visceral adipose tissue, and muscle (p ≤ 0.03). In conclusion, SG in adolescents decreased strength and volumetric BMD of the lumbar spine compared with nonsurgical controls. These changes were associated with decreases in visceral fat and muscle mass. © 2023 American Society for Bone and Mineral Research (ASBMR).</description><identifier>ISSN: 0884-0431</identifier><identifier>ISSN: 1523-4681</identifier><identifier>EISSN: 1523-4681</identifier><identifier>DOI: 10.1002/jbmr.4784</identifier><identifier>PMID: 37073493</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Abdomen ; Adipose tissue ; Adolescent ; Adolescents ; ANALYSIS/QUANTITATION OF BONE ; BIOMECHANICS ; Body composition ; Body fat ; Body mass index ; Bone composition ; Bone Density - physiology ; Bone loss ; Bone mass ; Bone mineral density ; BONE QCT/MICROCT ; Bone strength ; CLINICAL TRIALS ; Computed tomography ; Female ; Gastrectomy ; Gastrointestinal surgery ; Humans ; Longitudinal Studies ; Mechanical properties ; Obesity ; ORTHOPEDICS ; Pediatric Obesity ; Prospective Studies ; RADIOLOGY ; Spine (lumbar) ; Surgery ; Teenagers ; THERAPEUTICS ; Tomography, X-Ray Computed ; Young Adult ; Young adults</subject><ispartof>Journal of bone and mineral research, 2023-07, Vol.38 (7), p.933-942</ispartof><rights>2023 American Society for Bone and Mineral Research (ASBMR).</rights><rights>2023 American Society for Bone and Mineral Research</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4444-d5ff44e1cbebca8e6ad9159e9c37478e362c56edee53329c4e47dcb72be11d2a3</citedby><cites>FETCH-LOGICAL-c4444-d5ff44e1cbebca8e6ad9159e9c37478e362c56edee53329c4e47dcb72be11d2a3</cites><orcidid>0000-0001-6317-4815 ; 0000-0002-9729-4433 ; 0000-0002-7027-7414</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjbmr.4784$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjbmr.4784$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37073493$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huber, Florian A</creatorcontrib><creatorcontrib>Singhal, Vibha</creatorcontrib><creatorcontrib>Tuli, Shubhangi</creatorcontrib><creatorcontrib>Stanford, Fatima C</creatorcontrib><creatorcontrib>Carmine, Brian</creatorcontrib><creatorcontrib>Bouxsein, Mary L</creatorcontrib><creatorcontrib>Misra, Madhusmita</creatorcontrib><creatorcontrib>Bredella, Miriam A</creatorcontrib><title>Biomechanical CT to Assess Bone After Sleeve Gastrectomy in Adolescents With Obesity: A Prospective Longitudinal Study</title><title>Journal of bone and mineral research</title><addtitle>J Bone Miner Res</addtitle><description>ABSTRACT
Sleeve gastrectomy (SG) is effective in treating cardiometabolic complications of obesity but is associated with bone loss. Our aim was to determine the effect of SG on the lumbar spine by biomechanical CT analysis in adolescents/young adults with obesity. We hypothesized that SG would lead to a decrease in strength and bone mineral density (BMD) compared with nonsurgical controls. In a 12‐month prospective nonrandomized study, adolescents/young adults with obesity underwent SG (n = 29, 18.0 ± 2.1 years, 23 female) or were followed without surgery (controls, n = 30, 17.95 ± 3.0 years, 22 female). At baseline and 12 months, participants underwent quantitative computed tomography (QCT) of L1 and L2 for biomechanical assessment and MRI of the abdomen and mid‐thigh for body composition assessment. Twelve‐month changes between groups and within groups were assessed. Analyses were controlled for baseline and 12‐month changes in body mass index (BMI) by multivariable analyses. Regression analysis was performed to evaluate the effect of body composition on bone parameters. Our institutional review board (IRB) approved the study, and informed consent/assent was obtained. Participants in the SG group had a higher baseline BMI than controls (p = 0.01) and lost an average of 34.3 ± 13.6 kg 12 months after surgery, whereas weight was unchanged in controls (p < 0.001). There were significant reductions in abdominal adipose tissue and thigh muscle area in the SG group compared with controls (p < 0.001). Bone strength, bending stiffness, and average and trabecular volumetric BMD decreased in the SG group compared with controls (p < 0.001). After controlling for change in BMI, a 12‐month reduction in cortical BMD was significant in the SG group compared with controls (p = 0.02). Reductions in strength and trabecular BMD were associated with reductions in BMI, visceral adipose tissue, and muscle (p ≤ 0.03). In conclusion, SG in adolescents decreased strength and volumetric BMD of the lumbar spine compared with nonsurgical controls. These changes were associated with decreases in visceral fat and muscle mass. © 2023 American Society for Bone and Mineral Research (ASBMR).</description><subject>Abdomen</subject><subject>Adipose tissue</subject><subject>Adolescent</subject><subject>Adolescents</subject><subject>ANALYSIS/QUANTITATION OF BONE</subject><subject>BIOMECHANICS</subject><subject>Body composition</subject><subject>Body fat</subject><subject>Body mass index</subject><subject>Bone composition</subject><subject>Bone Density - physiology</subject><subject>Bone loss</subject><subject>Bone mass</subject><subject>Bone mineral density</subject><subject>BONE QCT/MICROCT</subject><subject>Bone strength</subject><subject>CLINICAL TRIALS</subject><subject>Computed tomography</subject><subject>Female</subject><subject>Gastrectomy</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Mechanical properties</subject><subject>Obesity</subject><subject>ORTHOPEDICS</subject><subject>Pediatric Obesity</subject><subject>Prospective Studies</subject><subject>RADIOLOGY</subject><subject>Spine (lumbar)</subject><subject>Surgery</subject><subject>Teenagers</subject><subject>THERAPEUTICS</subject><subject>Tomography, X-Ray Computed</subject><subject>Young Adult</subject><subject>Young adults</subject><issn>0884-0431</issn><issn>1523-4681</issn><issn>1523-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1DAUhS0EokNhwQsgS2xgkdZ_SRw2VWYELdWgIlrE0nKcm45HSTzYyaC8PU6nVAUJb2zJn889xweh15ScUELY6bbq_InIpXiCFjRlPBGZpE_RgkgpEiI4PUIvQtgSQrI0y56jI56TnIuCL9B-aV0HZqN7a3SLVzd4cLgMAULAS9cDLpsBPL5uAfaAz3UYPJjBdRO2PS5r10Iw0A8B_7DDBl9VEOwwfcAl_upd2EXUxmdr19_aYaxtH0dcx8P0Ej1rdBvg1f1-jL5_-nizukjWV-efV-U6MSKupE6bRgigpoLKaAmZrguaFlAYnse8wDNm0gxqgJRzVhgBIq9NlbMKKK2Z5sfo7KC7G6sO6tmq163aedtpPymnrfr7prcbdev2ihKecUZFVHh3r-DdzxHCoDobI7et7sGNQTFJ4mgpqYzo23_QrRt9zDxTXDJK85xF6v2BMvGHgofmwQ0laq5TzXWquc7Ivnls_4H8018ETg_AL9vC9H8ldbn88u1O8jeRIaxt</recordid><startdate>202307</startdate><enddate>202307</enddate><creator>Huber, Florian A</creator><creator>Singhal, Vibha</creator><creator>Tuli, Shubhangi</creator><creator>Stanford, Fatima C</creator><creator>Carmine, Brian</creator><creator>Bouxsein, Mary L</creator><creator>Misra, Madhusmita</creator><creator>Bredella, Miriam A</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TS</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6317-4815</orcidid><orcidid>https://orcid.org/0000-0002-9729-4433</orcidid><orcidid>https://orcid.org/0000-0002-7027-7414</orcidid></search><sort><creationdate>202307</creationdate><title>Biomechanical CT to Assess Bone After Sleeve Gastrectomy in Adolescents With Obesity: A Prospective Longitudinal Study</title><author>Huber, Florian A ; Singhal, Vibha ; Tuli, Shubhangi ; Stanford, Fatima C ; Carmine, Brian ; Bouxsein, Mary L ; Misra, Madhusmita ; Bredella, Miriam A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4444-d5ff44e1cbebca8e6ad9159e9c37478e362c56edee53329c4e47dcb72be11d2a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Abdomen</topic><topic>Adipose tissue</topic><topic>Adolescent</topic><topic>Adolescents</topic><topic>ANALYSIS/QUANTITATION OF BONE</topic><topic>BIOMECHANICS</topic><topic>Body composition</topic><topic>Body fat</topic><topic>Body mass index</topic><topic>Bone composition</topic><topic>Bone Density - physiology</topic><topic>Bone loss</topic><topic>Bone mass</topic><topic>Bone mineral density</topic><topic>BONE QCT/MICROCT</topic><topic>Bone strength</topic><topic>CLINICAL TRIALS</topic><topic>Computed tomography</topic><topic>Female</topic><topic>Gastrectomy</topic><topic>Gastrointestinal surgery</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Mechanical properties</topic><topic>Obesity</topic><topic>ORTHOPEDICS</topic><topic>Pediatric Obesity</topic><topic>Prospective Studies</topic><topic>RADIOLOGY</topic><topic>Spine (lumbar)</topic><topic>Surgery</topic><topic>Teenagers</topic><topic>THERAPEUTICS</topic><topic>Tomography, X-Ray Computed</topic><topic>Young Adult</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huber, Florian A</creatorcontrib><creatorcontrib>Singhal, Vibha</creatorcontrib><creatorcontrib>Tuli, Shubhangi</creatorcontrib><creatorcontrib>Stanford, Fatima C</creatorcontrib><creatorcontrib>Carmine, Brian</creatorcontrib><creatorcontrib>Bouxsein, Mary L</creatorcontrib><creatorcontrib>Misra, Madhusmita</creatorcontrib><creatorcontrib>Bredella, Miriam A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of bone and mineral research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huber, Florian A</au><au>Singhal, Vibha</au><au>Tuli, Shubhangi</au><au>Stanford, Fatima C</au><au>Carmine, Brian</au><au>Bouxsein, Mary L</au><au>Misra, Madhusmita</au><au>Bredella, Miriam A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Biomechanical CT to Assess Bone After Sleeve Gastrectomy in Adolescents With Obesity: A Prospective Longitudinal Study</atitle><jtitle>Journal of bone and mineral research</jtitle><addtitle>J Bone Miner Res</addtitle><date>2023-07</date><risdate>2023</risdate><volume>38</volume><issue>7</issue><spage>933</spage><epage>942</epage><pages>933-942</pages><issn>0884-0431</issn><issn>1523-4681</issn><eissn>1523-4681</eissn><abstract>ABSTRACT
Sleeve gastrectomy (SG) is effective in treating cardiometabolic complications of obesity but is associated with bone loss. Our aim was to determine the effect of SG on the lumbar spine by biomechanical CT analysis in adolescents/young adults with obesity. We hypothesized that SG would lead to a decrease in strength and bone mineral density (BMD) compared with nonsurgical controls. In a 12‐month prospective nonrandomized study, adolescents/young adults with obesity underwent SG (n = 29, 18.0 ± 2.1 years, 23 female) or were followed without surgery (controls, n = 30, 17.95 ± 3.0 years, 22 female). At baseline and 12 months, participants underwent quantitative computed tomography (QCT) of L1 and L2 for biomechanical assessment and MRI of the abdomen and mid‐thigh for body composition assessment. Twelve‐month changes between groups and within groups were assessed. Analyses were controlled for baseline and 12‐month changes in body mass index (BMI) by multivariable analyses. Regression analysis was performed to evaluate the effect of body composition on bone parameters. Our institutional review board (IRB) approved the study, and informed consent/assent was obtained. Participants in the SG group had a higher baseline BMI than controls (p = 0.01) and lost an average of 34.3 ± 13.6 kg 12 months after surgery, whereas weight was unchanged in controls (p < 0.001). There were significant reductions in abdominal adipose tissue and thigh muscle area in the SG group compared with controls (p < 0.001). Bone strength, bending stiffness, and average and trabecular volumetric BMD decreased in the SG group compared with controls (p < 0.001). After controlling for change in BMI, a 12‐month reduction in cortical BMD was significant in the SG group compared with controls (p = 0.02). Reductions in strength and trabecular BMD were associated with reductions in BMI, visceral adipose tissue, and muscle (p ≤ 0.03). In conclusion, SG in adolescents decreased strength and volumetric BMD of the lumbar spine compared with nonsurgical controls. These changes were associated with decreases in visceral fat and muscle mass. © 2023 American Society for Bone and Mineral Research (ASBMR).</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>37073493</pmid><doi>10.1002/jbmr.4784</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-6317-4815</orcidid><orcidid>https://orcid.org/0000-0002-9729-4433</orcidid><orcidid>https://orcid.org/0000-0002-7027-7414</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Abdomen Adipose tissue Adolescent Adolescents ANALYSIS/QUANTITATION OF BONE BIOMECHANICS Body composition Body fat Body mass index Bone composition Bone Density - physiology Bone loss Bone mass Bone mineral density BONE QCT/MICROCT Bone strength CLINICAL TRIALS Computed tomography Female Gastrectomy Gastrointestinal surgery Humans Longitudinal Studies Mechanical properties Obesity ORTHOPEDICS Pediatric Obesity Prospective Studies RADIOLOGY Spine (lumbar) Surgery Teenagers THERAPEUTICS Tomography, X-Ray Computed Young Adult Young adults |
| title | Biomechanical CT to Assess Bone After Sleeve Gastrectomy in Adolescents With Obesity: A Prospective Longitudinal Study |
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