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1. Two-year outcomes on bone density and fracture incidence in patients with T2DM randomized to bariatric surgery versus intensive medical therapy

Author

Adam H, Maghrabi, Kathy, Wolski, Beth, Abood, Angelo, Licata, Claire, Pothier, Deepak L, Bhatt, Steven, Nissen, Stacy A, Brethauer, John P, Kirwan, Philip R, Schauer, and Sangeeta R, Kashyap

Subjects
Adult, Male, Incidence, Bariatric Surgery, Middle Aged, Fractures, Bone, Treatment Outcome, Diabetes Mellitus, Type 2, Bone Density, Body Composition, Humans, Hypoglycemic Agents, Female, Follow-Up Studies
Abstract

To determine the 2-year outcomes of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) vs. intensive medical therapy (IMT) on lean body mass, total bone mass, and bone mineral density (BMD) measures from the STAMPEDE trial.54 subjects (BMI: 36 ± 1 kg/m(2) , age: 48 ± 4 years) with type 2 diabetes (T2DM) (HbA1c : 9.7 ± 2%) were randomized to IMT, RYGB, or SG and underwent DXA at baseline and at 1 and 2 years.At 2 years, the reduction in BMI was similar after RYGB and SG and was greater than IMT (P 0.001). Lean mass was reduced by ∼10%, total bone mineral content reduced by ∼8%, and hip BMD reduced by ∼9% in both surgical groups and was significantly greater than IMT despite increases in vitamin D intake in all groups. The change in hip BMD correlated with weight loss (r = 0.84, P 0.0001) and changes in lean mass (r = 0.74, P 0.0001) and leptin (r = 0.53, P 0.0001). Peripheral fractures were self-reported in RYGB (4/18 patients), SG (2/19 patients), and IMT (4/16 patients).Surgically induced weight loss is associated with modest reductions in lean mass, bone mineral content, and BMD, despite calcium and vitamin D supplementation in patients with T2DM. Awareness for bone loss is indicated for patients undergoing bariatric procedures.

Published
2015

2. Effect of once-yearly zoledronic acid on the spine and hip as measured by quantitative computed tomography: results of the HORIZON Pivotal Fracture Trial

Author

Eastell, R, Lang, T, Boonen, S, Cummings, S, Delmas, Pd, Cauley, Ja, Horowitz, Z, Kerzberg, E, Bianchi, G, Kendler, D, Leung, P, Man, Z, Mesenbrink, P, Eriksen, Ef, Black, Dm, Eduardo, Kerzberg, Zulema, Man, Carlos, Mautalen, Maria, Ridruejo, Guillermo, Tate, Jorge, Velasco, Michael, Hooper, Mark, Kotowicz, Peter, Nash, Richard, Prince, Anthony, Roberts, Philip, Sambrook, Harald, Dobnig, Gerd, Finkenstedt, Guenter, Hoefle, Klaus, Klaushofer, Martin, Pecherstorfer, Peter, Peichl, Jean, Body, Steven, Boonen, JEAN PIERRE DEVOGELAER, Piet, Geusens, Jean, Kaufman, João, Brenol, Jussara, Kochen, Rubem, Lederman, Sebastiao, Radominski, Vera, Szejnfeld, Cristiano, Zerbini, Jonathan, Adachi, Jacques, Brown, Denis, Choquette, David, Hanley, Robert, Josse, David, Kendler, Richard, Kremer, Frederic, Morin, Wojciech, Olszynski, Alexandra, Papaioannou, Chiu, Kinyuen, Baoying, Chen, Shouqing, Lin, Nohemi, Casas, Monique, Chalem, Juan, Jaller, Jose, Molina, Hannu, Aro, Jorma, Heikkinen, Heikki, Kröger, Lasse, Mäkinen, Juha, Saltevo, Jorma, Salmi, Matti, Välimäki, CLAUDE LAURENT BENHAMOU, Pierre, Delmas, Patrice, Fardellone, Georges, Werhya, Bruno, Allolio, Dieter, Felsenberg, Joachim, Happ, Manfred, Hartard, Johannes, Hensen, Peter, Kaps, Joern, Kekow, Ruediger, Moericke, Bernd, Ortloff, Peter, Schneider, Siegfried, Wassenberg, PING CHUNG LEUNG, Adam, Balogh, Bela, Gomor, Tibor, Hidvégi, Laszlo, Koranyi, Péter, Lakatos, Gyula, Poór, Zsolt, Tulassay, RIVKA DRESNER POLLAK, Varda, Eshed, JOSEPH FOLDES, A., SOPHIA ISH SHALOM, Iris, Vered, Mordechai, Weiss, Silvano, Adami, Antonella, Barone, Gerolamo, Bianchi, Giannini, Sandro, GIOVANNI CARLO ISAIA, Luisetto, Giovanni, Salvatore, Minisola, Nicola, Molea, Ranuccio, Nuti, Sergio, Ortolani, Mario, Passeri, Alessandro, Rubinacci, Bruno, Seriolo, Luigi, Sinigaglia, WOONG HWAN CHOI, MOO II KANG, GHI SU KIM, HYE SOON KIM, YONG KI KIM, SUNG KIL LIM, HO YOUNG SON, HYUN KOO YOON, Carlos, Abud, Pedro, Garcia, Salomon, Jasqui, Luis, Ochoa, Javier, Orozco, Javier, Santos, Ian, Reid, Sigbjørn, Elle, Johan, Halse, Arne, Høiseth, Hans, Olav, HØIVIK INGUN RØED, Arne, Skag, Jacob, Stakkestad, Unni, Syversen, Janusz, Badurski, Edward, Czerwinski, Roman, Lorenc, EWA MARCINOWSKA SUCHOWIERSKA, Andrzej, Sawicki, Jerzy, Supronik, Eduard, Ailamazyan, Lidiya, Benevolenskaya, Alexander, Dreval, Leonid, Dvoretsky, Raisa, Dyomina, Vadim, Mazurov, Galina, Melnichenko, Ashot, Mkrtoumyan, ALEXANDER ORLOV MOROZOV, Olga, Ostroumova, Eduard, Pikhlak, Tatiana, Shemerovskaya, Nadezhda, Shostak, Irina, Skripnikova, Vera, Smetnik, Evgenia, Tsyrlina, Galina, Usova, Alsu, Zalevskaya, Irina, Zazerskaya, Eugeny, Zotkin, Osten, Ljunggren, Johan, Lofgren, Mats, Palmér, Maria, Saaf, Martin, Stenström, Paul, Hasler, Olivier, Lamy, Kurt, Lippuner, Claude, Merlin, René, Rizzoli, Robert, Theiler, Alan, Tyndall, Daniel, Uebelhart, JUNG FU CHEN, PO QUANG CHEN, LIN SHOW CHIN, JAWL SHAN HWANG, TZAY SHING YANG, Mayuree, Jirapinyo, Rojanasthien, Sattaya, Sutin, Sriussadaporn, Soontrapa, Supasin, Nimit, Taechakraichana, Kittisak, Wilawan, Hugh, Donnachie, Richard, Eastell, William, Fraser, Alistair, Mclellan, David, Reid, John, Abruzzo, Ronald, Ackerman, Robert, Adler, John, Aloia, Charles, Birbara, Barbara, Bode, Henry, Bone, Donald, Brandon, Jane, Cauley, Felicia, Cosman, Daniel, Dionne, Robert, Downs, James, Dreyfus, RONALD EMKEY, VICTOR E. L. I. N. O. F. F., Joseph, Fanciullo, Darrell, Fiske, Palmieri, Genaro, Gollapudi, M., Richard, Gordon, James, Hennessey, Paul, Howard, Karen, Johnson, Conrad, Johnston, Risa, Kagan, Shelly, Kafka, Jeffrey, Kaine, Terry, Klein, William, Koltun, Meryl, Leboff, Bruce, Levine, MICHAEL LEWIECKI, E., CORA ELIZABETH LEWIS, Angelo, Licata, Michael, Lillestol, Barry, Lubin, Raymond, Malamet, Antoinette, Mangione, Velimir, Matkovic, Daksha, Mehta, Paul, Miller, Sam, Miller, Murphy, FREDERIK T., Susan, Nattrass, David, Podlecki, Christopher, Recknor, Clifford, Rosen, Daniel, Rowe, Robert, Rude, Thomas, Schnitzer, Yvonne, Sherrer, Stuart, Silverman, Kenna, Stephenson, Barbara, Troupin, Joseph, Tucci, Reina, Villareal, Nelson, Watts, Richard, Weinstein, Robert, Weinstein, Michael, Weitz, and Richard, White

Subjects
musculoskeletal diseases, medicine.medical_specialty, Compressive Strength, Bone density, Endocrinology, Diabetes and Metabolism, Osteoporosis, Lumbar vertebrae, Zoledronic Acid, Article, Drug Administration Schedule, Bone densitometry, Absorptiometry, Photon, Clinical trials, Bone Density, Humans, Medicine, Quantitative computed tomography, Osteoporosis, Postmenopausal, Aged, Aged, 80 and over, Bone mineral, Lumbar Vertebrae, Bone Density Conservation Agents, Diphosphonates, medicine.diagnostic_test, Femur Neck, business.industry, musculoskeletal, neural, and ocular physiology, Imidazoles, Bone QCT, Bisphosphonates, musculoskeletal system, medicine.disease, body regions, Zoledronic acid, medicine.anatomical_structure, Female, Hip Joint, sense organs, Radiology, Tomography, X-Ray Computed, business, Densitometry, Follow-Up Studies, medicine.drug
Abstract

Changes in bone mineral density and bone strength following treatment with zoledronic acid (ZOL) were measured by quantitative computed analysis (QCT) or dual-energy X-ray absorptiometry (DXA). ZOL treatment increased spine and hip BMD vs placebo, assessed by QCT and DXA. Changes in trabecular bone resulted in increased bone strength.To investigate bone mineral density (BMD) changes in trabecular and cortical bone, estimated by quantitative computed analysis (QCT) or dual-energy X-ray absorptiometry (DXA), and whether zoledronic acid 5 mg (ZOL) affects bone strength.In 233 women from a randomized, controlled trial of once-yearly ZOL, lumbar spine, total hip, femoral neck, and trochanter were assessed by DXA and QCT (baseline, Month 36). Mean percentage changes from baseline and between-treatment differences (ZOL vs placebo, t-test) were evaluated.Mean between-treatment differences for lumbar spine BMD were significant by DXA (7.0%, p0.01) and QCT (5.7%, p0.0001). Between-treatment differences were significant for trabecular spine (p = 0.0017) [non-parametric test], trabecular trochanter (10.7%, p0.0001), total hip (10.8%, p0.0001), and compressive strength indices at femoral neck (8.6%, p = 0.0001), and trochanter (14.1%, p0.0001).Once-yearly ZOL increased hip and spine BMD vs placebo, assessed by QCT vs DXA. Changes in trabecular bone resulted in increased indices of compressive strength.

Published
2010
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