Evidence map›Paper›PMID 25646793›Full record

Trial reportThe Journal of clinical endocrinology and metabolism2015

Two-year changes in bone density after Roux-en-Y gastric bypass surgery.

Elaine W Yu, Mary L Bouxsein, Melissa S Putman, Elizabeth L Monis, Adam E Roy, Janey S A Pratt, W Scott Butsch, Joel S Finkelstein

Open access · bronzeAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The Journal of clinical endocrinology and metabolism, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
86citing papers in PubMed, 9 pooled it
16.2field-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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

86 citing papers in PubMed, 9 syntheses or guidelines pooled it, 149 citations in OpenAlex.

  1. Pooled it
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  4. Changes in volumetric bone mineral density and bone quality after Roux-en-Y gastric bypass: A meta-analysis with meta-regression.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2022
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  7. The effects of weight loss approaches on bone mineral density in adults: a systematic review and meta-analysis of randomized controlled trials.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2016
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  19. Longitudinal variations of paraspinal muscle fatty infiltration in obese patients after bariatric surgery.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
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26 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Elaine W YuEndocrine Unit (E.W.Y., M.L.B., M.S.P., E.L.M., A.E.R., J.S.F.), and Weight Center (J.S.A.P., W.S.B.), Massachusetts General Hospital, Boston, Massachusetts 02114.
Mary L Bouxsein
Melissa S Putman
Elizabeth L Monis
Adam E Roy
Janey S A Pratt
W Scott Butsch
Joel S Finkelstein
Harvard University · USMassachusetts General Hospital · US

Funding

HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER (UL1)UL1RR025758 · NCRR · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2008 to 2011
$91.4M
ROLE OF DIETARY CONSTITUENTS ON GENE EXPRESSION IN INTESTINAL EPITHELIUMP30DK040561 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI Takara Leah Stanley · 1994 to 2026
$31.6M
Transgenic CoreP30DK046200 · NIDDK · TUFTS MEDICAL CENTER · PI CORKEY, BARBARA E. · 1992 to 2021
$25.0M
Hormones/Genes in Women's Health: From Bench to BedsideK12HD051959 · NICHD · BRIGHAM AND WOMEN'S HOSPITAL · PI GOLDSTEIN, JILL M, REXRODE, KATHRYN M · 2005 to 2023
$8.8M
Skeletal health in obesity and after bariatric surgeryK23DK093713 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI YU, ELAINE WEI-YIN · 2012 to 2016
$788k
X-Treme CT Equipment GrantS10RR023405 · NCRR · MASSACHUSETTS GENERAL HOSPITAL · PI FINKELSTEIN, JOEL S · 2007 to 2007
$380k
NCRR NIH HHS 1 UL1 RR025758NCRR NIH HHS S10 RR023405NCRR NIH HHS UL1 RR025758NICHD NIH HHS K12 HD051959NICHD NIH HHS K12 HD51959NIDDK NIH HHS K23 DK093713NIDDK NIH HHS P30 DK040561NIDDK NIH HHS P30 DK046200
6 · The paper itself

Abstract

contextBariatric surgery is increasingly popular but may lead to metabolic bone disease.

objectiveThe objective was to determine the rate of bone loss in the 24 months after Roux-en-Y gastric bypass. DESIGN AND

settingThis was a prospective cohort study conducted at an academic medical center.

participantsThe participants were adults with severe obesity, including 30 adults undergoing gastric bypass and 20 nonsurgical controls. OUTCOMES: We measured bone mineral density (BMD) at the lumbar spine and proximal femur by quantitative computed tomography (QCT) and dual-energy x-ray absorptiometry at 0, 12, and 24 months. BMD and bone microarchitecture were also assessed by high-resolution peripheral QCT, and estimated bone strength was calculated using microfinite element analysis.

resultsWeight loss plateaued 6 months after gastric bypass but remained greater than controls at 24 months (-37 ± 3 vs -5 ± 3 kg [ mean ± SEM]; P < .001). At 24 months, BMD was 5-7% lower at the spine and 6-10% lower at the hip in subjects who underwent gastric bypass compared with nonsurgical controls, as assessed by QCT and dual-energy x-ray absorptiometry (P < .001 for all). Despite significant bone loss, average T-scores remained in the normal range 24 months after gastric bypass. Cortical and trabecular BMD and microarchitecture at the distal radius and tibia deteriorated in the gastric bypass group throughout the 24 months, such that estimated bone strength was 9% lower than controls. The decline in BMD persisted beyond the first year, with rates of bone loss exceeding controls throughout the second year at all skeletal sites. Mean serum calcium, 25(OH)-vitamin D, and PTH were maintained within the normal range in both groups.

conclusionsSubstantial bone loss occurs throughout the 24 months after gastric bypass despite weight stability in the second year. Although the benefits of gastric bypass surgery are well established, the potential for adverse effects on skeletal integrity remains an important concern.

Indexed as

Bone DensityGastric BypassAbsorptiometry, PhotonAdultBone Diseases, MetabolicCase-Control StudiesFemaleFollow-Up StudiesHipHumansLumbar VertebraeMaleMiddle AgedObesity, MorbidRadiusTibia

Identifiers

PMID25646793
PMCPMC4399296
OpenAlexW2116360830

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.