Meta-analysisindependent cross-checkabstract checked I-BAR-125 standard review
Meta-analysis: bone density after sleeve
Changes in bone mineral density and bone metabolism after sleeve gastrectomy: a systematic review and meta-analysis.
Overview
Jaruvongvanich et al.. Surg Obes Relat Dis 2019 · PMID 31311755 · DOI 10.1016/j.soard.2019.06.006
Bone density at the hip fell after sleeve, while the spine did not change significantly.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
BMD after SG
- How was the study done?
Meta-analysis
- How many people, animals or samples were studied?
1,905
- What was actually found?
Hip -0.06 g/cm2
- How large was the observed effect?
MD -0.06
- What do the results mean in everyday life?
Some bone loss at the hip
- What are the study's limitations?
No controls; DXA artefact
- What does it say about Elawady's specific claim?
Supports hip part
- Do the results apply to Germany and Europe?
Applicable
- What can explicitly not be concluded from this study?
Fracture risk
Scientific in-depth review
1. Full reference
- Authors
- Jaruvongvanich et al.
- Journal
- Surg Obes Relat Dis
- Year
- 2019
- Identifier
- PMID 31311755 DOI 10.1016/j.soard.2019.06.006
- Verification
- verified – PubMed efetch 2026-10-26 + Crossref API
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract
2. Research question
How do bone mineral density and bone metabolism change after sleeve gastrectomy?
3. Study design and population
- Study design
- Meta-analysis – Systematic review and meta-analysis of pre-post studies
- Population
Adults with obesity after SG (>=6 mo follow-up)
- Country
Multinational
- Period
Search to March 2019
- Sample size
22 studies, 1,905 patients
- Inclusion and exclusion criteria
BMD or bone biochemistry before and after SG
4. Methods and endpoints
- Exposure / intervention
Sleeve gastrectomy
- Comparator
Preoperative values
- Endpoints
Hip, femoral neck, lumbar spine BMD; calcium, vitamin D, PTH
- Statistical methods
Pooled mean differences, random effects
5. Actual results
- Results
Total hip BMD -0.06 g/cm2 (-0.09 to -0.03; I2 0%); femoral neck -0.05 g/cm2 (-0.09 to -0.02; I2 0%); lumbar spine no significant change. Calcium, 25-OH vitamin D and phosphate increased; PTH decreased.
- Absolute risks
not applicable (mean differences)
- Authors' conclusion
BMD decreased after SG.
6. Strengths
- Sleeve-specific
- Low heterogeneity for hip
7. Weaknesses
- DXA artefacts with large weight loss
- No control group
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Pre-post designs; measurement artefact possible.
9. Assessment of the statistical interpretation
Absolute BMD changes; no fracture outcome.
10. Relevance to the specific claim
Confirms measurable hip BMD loss after sleeve (not spine).
11. Independent contrary findings
No fracture data; part of BMD drop may reflect weight loss and DXA artefact.
12. Transferability to Germany and Europe
International.
13. Overall methodological judgement
Supports hip bone loss after sleeve; spine not confirmed.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Clinical significance.
15. Linked fact checks
- Bariatric surgery causes measurable hip and spine bone loss (and fracture risk). – Studies supporting the claim