Zoledronic acid increases spine bone mass and prevents hip bone loss after bariatric surgery: a randomized placebo-controlled study.

Søren Gam, Simon Lysdahlgaard, Bibi Gram, Martin Weber Kusk, Anne Pernille Hermann, Claus Bogh Juhl, Stinus Gadegaard Hansen
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Abstract

Objective: The aim of this study was to investigate the effects of zoledronic acid for the prevention of bone loss after bariatric surgery.

Methods: In this randomized, double-blinded study, 59 patients undergoing Roux-en-Y gastric bypass or sleeve gastrectomy (mean [SD], age: 48.9 [6.3] years, BMI: 42.3 [5.3], 73% female) were randomly assigned (1:1) to receive either zoledronic acid (5 mg; intervention [INT]) or placebo (control [CON]) preoperatively. The primary endpoint was the change in spine volumetric bone mineral density (vBMD) at 12 months after surgery. Secondary outcomes included changes in hip and femoral neck vBMD and areal BMD.

Results: The estimated mean treatment effects of zoledronic acid on the spine and total hip were 6.8 mg/cm3 (95% CI 1.9-11.7; p = 0.003) and 5.0 mg/cm3 (95% CI: 1.4-8.5; p = 0.006), respectively. Bone mass in the spine increased by 2.6% in INT, whereas no changes were observed in CON. Additionally, bone loss in the total hip was prevented in INT compared with CON (vBMD: -0.6% vs. -3.6%; p = 0.006).

Conclusions: Zoledronic acid increases bone mass in the spine and prevents bone loss in the hip region after bariatric surgery compared with placebo.

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研究目的本研究旨在探讨唑来膦酸预防减肥手术后骨质流失的效果:在这项随机双盲研究中,59 名接受 Roux-en-Y 胃旁路手术或袖状胃切除术的患者(平均 [SD] 年龄:48.9 [6.3] 岁,BMI:42.3 [5.3],73% 为女性)被随机分配(1:1)至术前接受唑来膦酸(5 毫克;干预 [INT])或安慰剂(对照 [CON])治疗。主要终点是术后12个月时脊柱体积骨密度(vBMD)的变化。次要结果包括髋关节和股骨颈vBMD以及骨密度分布的变化:唑来膦酸对脊柱和全髋的估计平均治疗效果分别为 6.8 mg/cm3 (95% CI 1.9-11.7; p = 0.003) 和 5.0 mg/cm3 (95% CI: 1.4-8.5; p = 0.006)。在 INT 中,脊柱的骨量增加了 2.6%,而在 CON 中未观察到任何变化。此外,与CON相比,INT可防止全髋部骨质流失(vBMD:-0.6% vs. -3.6%;p = 0.006):结论:与安慰剂相比,唑来膦酸可增加减肥手术后脊柱的骨量并防止髋部骨质流失。
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