Adolescent Sleeve Gastrectomy Linked to Adverse Skeletal Effects

Using quantitative CT and MR spectroscopy, researchers in Radiology linked adolescent sleeve gastrectomy procedures to adverse skeletal effects. After a two-year follow-up, the clinicians determined that adolescent patients who had a sleeve gastrectomy also had reduced vertebral bone strength and density.

The study focused on adolescents and young adults between 13 and 24 years old with a BMI of 35 or more among adults and a BMI of 120% or greater than the 95th percentile for adolescents. Patients were placed into two different groups depending on their treatment plan. The experimental group comprised patients who underwent a sleeve gastrectomy (SG) procedure, while the control group included patients who opted for diet and exercise interventions without surgery.

“Participants underwent quantitative CT of the lumbar spine (L1 and L2 levels) to assess bone density and strength, proton MR spectroscopy to assess BMAT (L1 and L2 levels), and MRI of the abdomen and thigh to assess body composition,” stated researchers in the publication.

The control group was slightly larger than the experimental group, with 29 participants compared to 25. BMI reduction was achieved in the experimental group but was not in the control group. The control group had an average 11.9 kg/m ² decrease in BMI, while the control group had an average increase of 1.49 kg/m².

Despite achieving the desired weight management, GS procedures came with unfavorable side effects, including reduced bone strength in the lumbar spine. Experimental patients had a 728 N reduction in lumbar bone strength, while the control group only had a 7.24 N reduction.

“In conclusion, our 24-month prospective longitudinal study showed that sleeve gastrectomy in adolescents and young adults impairs bone health, with a reduction in biomechanical bone properties and an increase in lumbar bone marrow adipose tissue (BMAT) when compared with control participants who did not undergo surgery,” concluded researchers in the publication.

“These changes were largely explained by reductions in body mass index. A longer-term study based on clinical outcomes, such as fractures, would be required to further investigate the impact of the reduction in biomechanical bone parameters and increase in BMAT on fracture risk,” they added.

Although weight loss surgery may be a valuable tool for minimizing some obesity comorbidities, doctors must weigh the benefits with the potential lifelong risks.