{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:58:18Z","timestamp":1790423898712,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,7,20]],"date-time":"2015-07-20T00:00:00Z","timestamp":1437350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Ethicon endo-surgery EESIIS 19900","award":["19900"],"award-info":[{"award-number":["19900"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the 2\u2010year outcomes of Roux\u2010en\u2010Y gastric bypass (RYGB) and sleeve gastrectomy (SG) vs. intensive medical therapy (IMT) on lean body mass, total bone mass, and bone mineral density (BMD) measures from the STAMPEDE trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>54 subjects (BMI: 36\u2009\u00b1\u20091 kg\/m<jats:sup>2<\/jats:sup>, age: 48\u2009\u00b1\u20094 years) with type 2 diabetes (T2DM) (HbA<jats:sub>1c<\/jats:sub>: 9.7\u2009\u00b1\u20092%) were randomized to IMT, RYGB, or SG and underwent DXA at baseline and at 1 and 2 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 2 years, the reduction in BMI was similar after RYGB and SG and was greater than IMT (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Lean mass was reduced by \u223c10%, total bone mineral content reduced by \u223c8%, and hip BMD reduced by \u223c9% in both surgical groups and was significantly greater than IMT despite increases in vitamin D intake in all groups. The change in hip BMD correlated with weight loss (<jats:italic>r<\/jats:italic>\u2009=\u20090.84, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) and changes in lean mass (<jats:italic>r<\/jats:italic>\u2009=\u20090.74, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) and leptin (<jats:italic>r<\/jats:italic>\u2009=\u20090.53, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). Peripheral fractures were self\u2010reported in RYGB (4\/18 patients), SG (2\/19 patients), and IMT (4\/16 patients).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Surgically induced weight loss is associated with modest reductions in lean mass, bone mineral content, and BMD, despite calcium and vitamin D supplementation in patients with T2DM. Awareness for bone loss is indicated for patients undergoing bariatric procedures.<\/jats:p><\/jats:sec>","DOI":"10.1002\/oby.21150","type":"journal-article","created":{"date-parts":[[2015,7,20]],"date-time":"2015-07-20T14:49:10Z","timestamp":1437403750000},"page":"2344-2348","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":97,"title":["Two\u2010year outcomes on bone density and fracture incidence in patients with T2DM randomized to bariatric surgery versus intensive medical therapy"],"prefix":"10.1002","volume":"23","author":[{"given":"Adam H.","family":"Maghrabi","sequence":"first","affiliation":[{"name":"Institutes of Clinical Nutrition and Gastroenterology, The Cleveland Clinic Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Wolski","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute The Cleveland Clinic Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth","family":"Abood","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism Institute The Cleveland Clinic Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Licata","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism Institute The Cleveland Clinic Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Pothier","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute The Cleveland Clinic Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak L.","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Institutes of Clinical Nutrition and Gastroenterology, The Cleveland Clinic Ohio USA"},{"name":"Brigham and Women's Hospital Heart &amp; Vascular Center and Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Nissen","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute The Cleveland Clinic Cleveland Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacy A.","family":"Brethauer","sequence":"additional","affiliation":[{"name":"Bariatric and Metabolic Institute The Cleveland Clinic Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Kirwan","sequence":"additional","affiliation":[{"name":"Lerner Research, The Cleveland Clinic Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip R.","family":"Schauer","sequence":"additional","affiliation":[{"name":"Bariatric and Metabolic Institute The Cleveland Clinic Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangeeta R.","family":"Kashyap","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism Institute The 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