Metabolic Bone Disease

The prevalence of obesity is increasing worldwide with more than 500 million people estimated to be clinically obese worldwide. Obesity is an established risk factor for several cardiovascular, metabolic and respiratory conditions and is considered to be a major cause of increased mortality. It is estimated that more than 30,000 deaths each year in England are attributed to obesity alone, taking up to 9 years off a normal lifespan. The dramatic increase in the prevalence of obesity, coupled with the poor long-term outcomes of current nonsurgical treatment, has led to a rapid growth in the number of bariatric procedures performed worldwide. Data from the USA and Europe indicate that the number of bariatric procedures performed has increased exponentially. For example, the number of bariatric procedures performed in England has more than doubled in 2010 (10,000 procedures) compared to 2009 (~5000). In the USA the number rose by 50% to 1, 20, 000 compared with 2002. Whilst the beneficial effects of bariatric surgery have been clearly demonstrated and some of the short and long term complications have been extensively investigated the data on the long-term effects on bone metabolism are scarce. It is widely accepted that bariatric surgery is likely to place the patient at risk of developing metabolic bone disease, whether that is by reducing the intake of calcium or vitamin D or by impairing its absorption. This paper will review the current literature for further information on this clinically relevant issue.

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Last date updated on April, 2024