Background/Purpose: The objectives were to evaluate bone fragility on computed tomography (CT) in patients with obesity before and 2 years after bariatric surgery and to identify risk factors for a decrease in the scanographic bone attenuation coefficient of the first lumbar vertebra (SBAC-L1).

Methods:
Patients with obesity who underwent bariatric surgery and CT before and two years (±6 months) after bariatric surgery were included. SBAC-L1 was measured on CT with a fracture threshold at 145 HU.

Results: 78 patients were included, 85.9% women, mean age of 48.5 years (±11.4); the mean BMI was 46.2 kg/m² (±7) before surgery and 29.8 kg/m² (±6.7) 2 years after surgery. There was a significant change in SBAC-L1 two years after surgery (p=0.037). In multivariate analysis, the risk factors for having an SBAC-L1 ≤145HU 2 years after bariatric surgery in those with an SBAC-L1 >145HU before surgery were age and sex, with men and older patients having a higher risk (OR = 32.6, CI95% = [1.86-568.77], and OR = 0.85, CI95% = [0.74-0.98], respectively).

Conclusion: SBAC-L1 was significantly lower two years after bariatric surgery. Men sex and older patients were the risk factors for having an SBAC-L1 below the fracture threshold 2 years after surgery.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/ct-evaluation-of-bone-fragility-2-years-after-bariatric-surgery-in-patients-with-obesity-an-observational-study/