A meta-analysis suggests an increased risk for total and non-vertebral fractures, particularly in upper limbs, among patients undergoing bariatric surgery. The findings were published in the journal Obesity Reviews.
Researchers performed a meta-analysis of 6 studies (5 cohort; 1 randomised controlled trial) identified through a literature search on the PubMed, Embase and Cochrane Library databases.
Patients undergoing bariatric surgery had a higher risk for any type of fracture compared with non-surgical individuals (risk ratio [RR], 1.29; 95% CI, 1.18-1.42). The risk for fractures in non-vertebral sites rose substantially after surgery (RR, 1.42; 95% CI, 1.08-1.87), particularly in the upper limbs (RR, 1.68; 95% CI, 1.15-2.45). Mixed surgical procedure was associated with a non-significant higher risk for fractures compared with restrictive surgical procedure.
According to the authors, post-operative secondary hyperparathyroidism may possibly have a more pronounced adverse effect on non-vertebral bones. Additionally, patients may be more prone to falls after surgery, thereby increasing the risk for upper limb fractures. They call for further research using high-quality, prospective studies to elucidate the fracture risk after bariatric surgery and determine the pathological mechanisms underlying the association.
