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Previous work has suggested a deleterious short-term effect of Roux-en-Y Gastric Bypass (RYGB) on bone mineral density (BMD), but the long-term effects of RYGB on bone health are not well understood. To investigate this question, NORCH member Dr. Elaine Yu and colleagues prospectively followed serum bone markers and bone density in 21 adults who received RYGB. Bone density was assessed using serial dual-energy X-ray absorptiometry (DXA), quantitative computed tomography (QCT), and high resolution peripheral QCT (HR-pQCT) scanning. Bone turnover markers type I collage C-terminal telopeptide (CTX) and procollagen type I N-terminal propeptide (P1NP) were elevated 2 years after surgery and remained elevated at 5 years. Both spine and hip BMD had decreased significantly at 2 years post-RYGB and continued to decline between years 2-5, although most of the BMD loss occurred during the first two years after surgery. Peripheral volumetric BMD also continued to decline at a steady rate between 2-5 years after RYGB. Overall, the study, which is the first to date reporting outcomes 5 years after RYGB, shows continued high-turnover bone loss and deterioration in bone microarchitecture, demonstrating a need for close follow-up of bone density post-RYGB as well as further study into the mechanisms of post-RYGB bone loss and strategies for prevention.


Lindeman KG, Greenblatt LB, Rourke C, Bouxsein ML, Finkelstein JS, Yu EW. Longitudinal 5-year evaluation of bone density and microarchitecture after Roux-en-Y gastric bypass surgery. J Clin Endocrinol Metab. 2018 Sep 13. [Epub ahead of print]

Research Details:

  • Research Center: Harvard Medical School
  • Featured NORC Members: Elaine Yu, MD, Assistant Professor of Medicine, Massachusetts General Hospital and Harvard Medical School
  • Center Contributions: Dr. Yu is a Center Members and received a NORCH Pilot and Feasibility Grant for aspects of this work.


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