Evidence map›Paper›PMID 23912559›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2014

Fracture risk following bariatric surgery: a population-based study.

K M Nakamura, E G C Haglind, J A Clowes, S J Achenbach, E J Atkinson, L J Melton, K A Kennel

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04742010 (Zoledronic Acid for Prevention of Bone Loss After BAriatric Surgery), which is not on this map. Cited by 112 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
112citing papers in PubMed, 7 pooled it
14.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04742010 phase2completednot on this mapstarted 2021, after this paper: background citation

Zoledronic Acid for Prevention of Bone Loss After BAriatric Surgery (ZABAS)

TypeinterventionalSponsorStinus Gadegaard HansenRan2021 to 2024Enrolled59ConditionsBone Loss, Muscle Atrophy, Bariatric SurgeryArmsZoledronic Acid, Placebo
3 · Its place in the literature

Who cites it

112 citing papers in PubMed, 7 syntheses or guidelines pooled it, 233 citations in OpenAlex.

  1. Pooled it
  2. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2022
    Guideline
  3. Fracture risk following bariatric surgery: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022
    Pooled it
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  8. Trial
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  16. Intestinal Calcium Absorption Decreases Dramatically After Gastric Bypass Surgery Despite Optimization of Vitamin D Status.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2015
    Trial
  17. Two-year changes in bone density after Roux-en-Y gastric bypass surgery.The Journal of clinical endocrinology and metabolism · 2015
    Trial
  18. Observational
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52 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 1 country.

K M NakamuraJohns Hopkins Hospital, Baltimore, MD, USA.
E G C Haglind
J A Clowes
S J Achenbach
E J Atkinson
L J Melton
K A Kennel
Mayo Clinic · USMayo Clinic in Florida · USGuthrie Foundation · USHealthEast Care System · USJohns Hopkins Hospital · US

Funding

SEX STEROIDS, GROWTH FACTORS, &BONE CELL FUNCTIONP01AG004875 · NIA · MAYO CLINIC ROCHESTER · PI KHOSLA, SUNDEEP · 1985 to 2019
$30.8M
Rochester Epidemiology ProjectR01AG034676 · NIA · MAYO CLINIC ROCHESTER · PI ROCCA, WALTER A, ST SAUVER, JENNIFER LYNN · 2010 to 2019
$9.5M
NIA NIH HHS P01 AG004875NIA NIH HHS P01-AG-04875NIA NIH HHS R01 AG034676NIA NIH HHS R01-AG-034676
6 · The paper itself

Abstract

unlabelledThe effects of bariatric surgery on skeletal health are poorly understood. We found that bariatric surgery patients are more prone to fracture when compared to the general population. While further studies of fracture risk in this population are needed, bone health should be discussed in bariatric surgery clinics.

introductionBariatric surgery is an increasingly common treatment for medically complicated obesity. Adverse skeletal changes after bariatric surgery have been reported, but their clinical importance remains unknown. We hypothesized that bariatric surgery patients are at increased risk of fracture.

methodsWe conducted a historical cohort study of fracture incidence among 258 Olmsted County, Minnesota, residents who underwent a first bariatric surgery in 1985-2004. Relative fracture risk was expressed as standardized incidence ratios (SIRs), while potential risk factors were evaluated by hazard ratios (HR) obtained from a time-to-fracture regression model.

resultsThe mean (±SD) body mass index at bariatric surgery was 49.0 ± 8.4 kg/m(2), with an average age of 44 ± 10 years and 82% (212) females. Gastric bypass surgery was performed in 94% of cases. Median follow-up was 7.7 years (range, 6 days to 25 years), during which 79 subjects experienced 132 fractures. Relative risk for any fracture was increased 2.3-fold (95% confidence interval (CI), 1.8-2.8) and was elevated for a first fracture at the hip, spine, wrist, or humerus (SIR, 1.9; 95% CI, 1.1-2.9), as well as for a first fracture at any other site (SIR, 2.5; 95% CI, 2.0-3.2). Better preoperative activity status was associated with a lower age-adjusted risk (HR, 0.4; 95% CI, 0.2-0.8) while prior fracture history was not associated with postoperative fracture risk.

conclusionsBariatric surgery, which is accompanied by substantial biochemical, hormonal, and mechanical changes, is associated with an increased risk of fracture.

Indexed as

AdultBariatric SurgeryBody Mass IndexCohort StudiesFemaleFollow-Up StudiesFractures, BoneHumansIncidenceMaleMiddle AgedMinnesotaObesity, MorbidOsteoporotic FracturesRisk Factors

Identifiers

PMID23912559
PMCPMC3939838
OpenAlexW1996104146

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.