The objective of this work was to investigate the risk of major osteoporotic fracture (MOF; hip, proximal humerus, wrist and distal forearm, and clinical spine) in bariatric surgery patients versus matched controls. Bariatric surgery is associated with an increase in fracture risk. However, it remains unclear whether the same degree of fracture risk is associated with sleeve gastrectomy, which has recently surpassed gastric bypass. Records from the French National Inpatient database were used from 2008 to 2018. Bariatric surgery patients, aged 40 to 65 years, with BMI ≥40 kg/m², hospitalized between January 1, 2010 and December 31, 2014, were matched to one control (1:1) by age, sex, Charlson comorbidity index, year of inclusion, and class of obesity (40 to 49.9 kg/m² versus ≥50 kg/m²). We performed a Cox regression analysis to assess the association between the risk of any MOF and, respectively, (i) bariatric surgery (yes/no) and (ii) type of surgical procedure (gastric bypass, gastric banding, vertical banded gastroplasty, and sleeve gastrectomy) versus no surgery. A total of 81,984 patients were included in the study (40,992 in the bariatric surgery group, and 40,992 matched controls). There were 585 MOFs in the surgical group (2.30 cases per 1000 patient‐year [PY]) and 416 MOFs in the matched controls (1.93 cases per 1000 PY). The risk of MOF was significantly higher in the surgical group (hazard ratio [HR] 1.22; 95% CI, 1.08–1.39). We observed an increase in risk of MOF for gastric bypass only (HR 1.70; 95% CI, 1.46–1.98) compared with the matched controls. In patients aged 40 to 65 years, gastric bypass but not sleeve gastrectomy or the other procedures increased risk of major osteoporotic fractures. © 2020 American Society for Bone and Mineral Research.

中文翻译：

---

一项基于法国人群的队列研究显示，胃绕道手术但无袖胃切除术会增加严重骨质疏松性骨折的风险。

这项工作的目的是调查减肥手术患者与对照患者发生重大骨质疏松性骨折（MOF；髋部，肱骨近端，腕部和远端前臂以及临床脊柱）的风险。减肥手术会增加骨折风险。但是，尚不清楚套管胃切除术是否与同等程度的骨折风险相关，而套管胃切除术最近已超过了胃旁路手术。使用2008年至2018年法国国家住院患者数据库中的记录。2010年1月1日至2014年12月31日住院的BMI≥40 kg / m ^2的40至65岁的减肥手术患者与一名对照患者相匹配。 （1：1）按年龄，性别，查尔森合并症指数，纳入年份和肥胖症类别分类（40至49.9 kg / m ²与≥50kg / m²）。我们进行了Cox回归分析以评估任何MOF的风险与（i）减肥手术（是/否）和（ii）外科手术类型（胃旁路手术，胃束带，垂直束带胃成形术和袖胃切除术）与不进行手术相比。该研究共纳入81,984名患者（减肥手术组为40,992名，配对对照组为40,992名）。手术组有585个MOF（每1000个患者年[PY]为2.30例），配对对照组有416个MOF（每1000个PY为1.93个病例）。手术组的MOF风险明显更高（危险比[HR] 1.22； 95％CI，1.08–1.39）。我们观察到，与匹配的对照组相比，仅通过胃旁路术的MOF风险增加（HR 1.70； 95％CI，1.46-1.98）。在40至65岁的患者中，进行胃旁路手术但不行袖胃切除术或其他手术会增加发生严重骨质疏松性骨折的风险。©2020美国骨骼和矿物质研究学会。