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Bariatric surgery is associated with reduced bone mineral density, but whether it is associated with excess fracture risk is unclear. In this retrospective nested case-control study, Canadian researchers used medical billing codes to evaluate fracture incidence in 13,000 “severely” obese patients (mean age, 43; 72% women) who underwent bariatric surgery; 38,000 age- and sex-matched obese nonsurgical controls; and 127,000 nonobese controls.
At mean follow-up of 4.4 years, postoperative adjusted fracture risk was significantly higher in bariatric patients than in obese and nonobese controls (adjusted relative risks, 1.38 and 1.44, respectively). Fracture risk over time remained stable in the two control groups, whereas it rose postoperatively …