Bariatric Surgery Ups the Risk of Major and Any Fracture, but Not Peripheral Fracture

Takeaway

• Patients with obesity had an increased risk of major and any fracture, but not peripheral fracture within 5 years of bariatric surgery.

Why this matters

• Findings suggest that patients undergoing bariatric surgery should be evaluated for their risk of fracture.
• Future studies are warranted to determine the risk-benefit of calcium and vitamin D supplementation following bariatric surgery.

Study design

• Researchers performed 2 retrospective studies (1 self-controlled case series [SCCS] and 1 cohort) involving 5487 participants with obesity (age, ≥18 years; body mass index, ≥30 kg/m²) who underwent bariatric surgery, identified from the UK Clinical Practice Research Datalink (CPRD).

• Funding: National Institute for Health Research.

Key results

• In SCCS analyses:
  • Compared with 5 years before bariatric surgery, the relative incidence of major fractures was higher in the 5 years after surgery (incidence rate ratio [IRR], 2.70; 95% CI, 1.31-5.57).
  • The relative incidence of major fractures (IRR, 4.98; 95% CI, 1.94-12.78) and any fractures (IRR, 1.73; 95% CI, 1.08-2.77) was higher at 2-5 years post-surgery.
  • The relative incidence of peripheral fracture did not increase in the 5 years post-surgery.
• In the cohort study:
  • Female gender (adjusted OR [aOR], 3.32; 95% CI, 1.18-9.36) was the strongest predictor of major fracture, followed by the use of anxiolytics/sedatives/hypnotics (aOR, 2.56; 95% CI, 1.29-5.05) and age (aOR, 1.23 per 5-year increase; 95% CI, 1.09-1.40).

Limitations

• Retrospective design.

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.