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Bone and Muscle Health Following Sleeve Gastrectomy in Men, Premenopausal and Postmenopausal Women

Recruiting
Conditions
Severe Obesity
Muscle Health
Bariatric Surgery
Bone Health
Interventions
Procedure: Bariatric surgery
Registration Number
NCT06547515
Lead Sponsor
CHU de Quebec-Universite Laval
Brief Summary

Background: Bariatric surgery is gaining in popularity. While it's health benefits are undisputed, the older malabsorptive bariatric procedures (Roux-in-Y gastric bypass - RYGB and biliopancreatic diversion - BPD) are associated with an increased risk of fractures and falls as early as 3-5 years after surgery. Sleeve gastrectomy - SG is now the most performed bariatric procedure. Although SG does not cause malabsorption, it is predicted to result in bone and muscle loss via weight loss and weight loss-independent mechanisms. Primary aim: to compare the changes in spine volumetric bone mineral density (vBMD) by quantitative computed tomography (QCT) and muscle mass at mid-femur by computed tomography (CT) at 3 years in the 3 groups of: 1) men; 2) premenopausal women; 3) postmenopausal women after SG versus their respective non-surgical peers who did not undergo SG in the 3-year period following recruitment. Secondary aims: to compare the changes in vBMD by QCT at skeletal sites other than the spine and in areal bone mineral density (aBMD) by dual-energy X-ray absorptiometry (DXA), whole-body muscle mass by DXA, muscle quality by CT at mid-femur and muscle strength as well as in selected physical performance and capacity tests shown to predict falls and fractures between 0-1 and 1-3 years after SG in the same 3 groups after SG vs. in the respective non-surgical groups.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
156
Inclusion Criteria
  • Men and women aged >18 years;
  • Awaiting SG for the bariatric group or meeting the criteria for SG but not undergoing surgery for the non-surgical group.
  • Menopause: defined as the absence of menses for a year and a serum follicular-stimulating hormone (FSH) >40 UI/L.
  • Women taking oral contraceptive pills or hormone replacement therapy
  • Patients with type 2 diabetes.
Exclusion Criteria
  • Type 1 diabetes;
  • Disease (e.g., uncontrolled thyroid disease, Malabsorptive or overt inflammatory disorder)
  • Metabolic bone disease other than osteoporosis or type 2 diabetes,
  • Creatinine clearance <30 ml/min) or medication (e.g., glucocorticoids, anti-epileptic drugs, osteoporosis therapy, thiazolidinediones) affecting bone metabolism;
  • Weight >204 kg (DXA weight limit) or BMI >60 kg/m2 (upper limit to allow for QCT examination);
  • Current or planned pregnancy during follow-up; breast-feeding.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Sleeve gastrectomy - MenBariatric surgeryn = 39 men with obesity undergoing sleeve gastrectomy
Sleeve gastrectomy - Premenopausal womenBariatric surgeryn = 39 premenopausal women with obesity undergoing sleeve gastrectomy
Sleeve gastrectomy - Postmenopausal womenBariatric surgeryn = 39 postmenopausal women with obesity undergoing sleeve gastrectomy
Primary Outcome Measures
NameTimeMethod
Change in vBMD at the spine (L2-L3) and proximal femurbefore, 1 year after and 3 years after bariatric surgery

assessed by QCT

Change in muscle mass at mid-femurbefore, 1 year after and 3 years after bariatric surgery

determined by measuring cross-sectional area at mid-femur (CT)

Secondary Outcome Measures
NameTimeMethod
Change in aBMD at skeletal sitesbefore, 1 year after and 3 years after bariatric surgery

assessed by DXA

Change in muscle quality at mid-femurbefore, 1 year after and 3 years after bariatric surgery

muscle fat infiltration, using CT attenuation in Hounsfield unit (HU)

Change in vBMD at skeletal sites other than the spinebefore, 1 year after and 3 years after bariatric surgery

assessed by QCT

Change in muscle strengthbefore, 1 year after and 3 years after bariatric surgery

assessed by CT

Change in lower extremity muscle strengthbefore, 1 year after and 3 years after bariatric surgery

knee extensor strength

Change in whole body muscle massbefore, 1 year after and 3 years after bariatric surgery

assessed by DXA

Change in upper extremity muscle strengthbefore, 1 year after and 3 years after bariatric surgery

by hand grip strength

Change in muscle mass (muscle cross-sectional area) and functionbefore, 1 year after and 3 years after bariatric surgery

by 6-minute walk test

Trial Locations

Locations (1)

Centre de recherche de l'IUCPQ

🇨🇦

Québec, Canada

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