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Introduction <p>The impact of menopausal status on metabolic and densitometric outcomes following metabolic-bariatric surgery (MBS) remains insufficiently characterized. This study aims to evaluate the association between menopausal status at the time of MBS and changes in bone mineral density (BMD) and body composition.</p> Methods <p>Prospective, single-center study including 162 patients undergoing MBS either Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG), between November/2019 and December/2022. Participants were divided into two groups based on menopause status at the time of surgery. Clinical and biochemical parameters were assessed preoperatively and at 6-, 12-, and 24-month post-surgery. Linear and logistic regression analyses were performed, adjusting for age, type of surgery, and baseline body mass index.</p> Results <p>Postmenopausal patients showed a higher prevalence of T2D, hypertension and osteopenia. Two years after MBS, postmenopausal patients revealed to have a steeper decrease in bone mineral content (-0.31 ± 0.13&#xa0;g vs. -0.23 ± 0.14&#xa0;g, adjusted <i>p</i> = 0.037), a higher loss of total femur (-0.18 ± 0.08&#xa0;g/cm<sup>2</sup> vs. -0.14 ± 0.08&#xa0;g/cm<sup>2</sup>, <i>p</i> = 0.008) and whole-body bone mineral density (-0.14 ± 0.07&#xa0;g/cm<sup>2</sup> vs. -0.10 ± 0.13&#xa0;g/cm<sup>2</sup>, <i>p</i> = 0.074). Postmenopausal patients presented a greater decrease in total body lean mass (-7.52 ± 3.06&#xa0;kg vs. -7.27 ± 3.22&#xa0;kg, <i>p</i> = 0.014) and arms lean mass (-1.00 ± 1.16&#xa0;kg vs. -0.68 ± 0.90&#xa0;kg, <i>p</i> = 0.020).</p> Conclusion <p>This study demonstrates that, although weight loss is comparable between groups, postmenopausal women undergoing MBS experience a more significant loss of lean mass and bone mineral density. These findings underscore the need for tailored post-surgical strategies, including optimized nutritional support and vigilant bone health monitoring, to mitigate potential adverse effects in this population.</p>

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Impact of Menopausal Status on Bone Metabolism and Body Composition After Metabolic-Bariatric Surgery: a Two-Year Prospective Study in Middle-Aged Women

  • 期刊论文

  • 发表日期：

    2026年3月17日

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  • Mafalda Maia,
  • Fernando Mendonça,
  • Ana Rita Leite,
  • Pietra Soares,
  • João Sérgio Neves,
  • Carla Luís,
  • Ilda Rodrigues,
  • Telma Moreno,
  • Jorge Pedro,
  • Diana Festas,
  • Ana Varela,
  • Ana Oliveira,
  • Teresa Faria,
  • Ana Fernandes,
  • Sónia Vieira,
  • Altin Ndrio,
  • João Tiago Guimarães,
  • Eduardo Lima da Costa,
  • CRIO,
  • Raquel Soares,
  • Paula Freitas

摘要

Introduction

The impact of menopausal status on metabolic and densitometric outcomes following metabolic-bariatric surgery (MBS) remains insufficiently characterized. This study aims to evaluate the association between menopausal status at the time of MBS and changes in bone mineral density (BMD) and body composition.

Methods

Prospective, single-center study including 162 patients undergoing MBS either Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG), between November/2019 and December/2022. Participants were divided into two groups based on menopause status at the time of surgery. Clinical and biochemical parameters were assessed preoperatively and at 6-, 12-, and 24-month post-surgery. Linear and logistic regression analyses were performed, adjusting for age, type of surgery, and baseline body mass index.

Results

Postmenopausal patients showed a higher prevalence of T2D, hypertension and osteopenia. Two years after MBS, postmenopausal patients revealed to have a steeper decrease in bone mineral content (-0.31 ± 0.13 g vs. -0.23 ± 0.14 g, adjusted p = 0.037), a higher loss of total femur (-0.18 ± 0.08 g/cm2 vs. -0.14 ± 0.08 g/cm2, p = 0.008) and whole-body bone mineral density (-0.14 ± 0.07 g/cm2 vs. -0.10 ± 0.13 g/cm2, p = 0.074). Postmenopausal patients presented a greater decrease in total body lean mass (-7.52 ± 3.06 kg vs. -7.27 ± 3.22 kg, p = 0.014) and arms lean mass (-1.00 ± 1.16 kg vs. -0.68 ± 0.90 kg, p = 0.020).

Conclusion

This study demonstrates that, although weight loss is comparable between groups, postmenopausal women undergoing MBS experience a more significant loss of lean mass and bone mineral density. These findings underscore the need for tailored post-surgical strategies, including optimized nutritional support and vigilant bone health monitoring, to mitigate potential adverse effects in this population.