Prevalence and risk factors of eligibility for anti-osteoporosis medication in a cohort of men ≥50 years and postmenopausal women who had already experienced bariatric surgery

The 2022 recommendations of the European Calcified Tissue Society (ECTS) suggest initiating anti-osteoporotic medication (AOM) in case of a T-score ≤ -2 and/or in case of a fragility fracture within less than 2 years. Therefore, this study aimed to evaluate the eligibility for AOM in a cohort of patients referred for bone health assessment after bariatric surgery. This observational, cross-sectional, and monocentric study conducted at Lille University Hospital evaluated the prevalence of AOM eligibility according to the ECTS criteria in postmenopausal women and men aged ≥50 years referred for bone health assessment after bariatric surgery, either Roux-en-Y gastric bypass or sleeve gastrectomy, at least 2 years after bariatric surgery. Between June 2019 and June 2023, all participants were referred for bone health assessment, including systematic screening using dual-energy X-ray (DXA) and a standardized questionnaire by a radiology technician. Data between June 2023 and May 2024 were retrospectively reviewed. Among 140 patients (120 women, with an average age of 59 (55-63) years) seen for bone health assessment between June 2019 and June 2023, 33 met the ECTS guidelines for AOM, indicating a prevalence of 24% (CI 95%: 17-31%). Most patients met the BMD T-score ≤ -2 criterion (n = 26/140, 19% (CI 95%: 12-25%)) and/or had a recent fragility fracture history (n = 14/140, 10% (CI 95%: 5-15%)). In this study, one-fourth of the participants were eligible for AOM according to the ECTS guidelines.