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Results Initially, investigators identified 23,263 patients at least 21 years of age with at least 1 RYGB or AGB procedure code on a date after 1 year of continuous enrollment in the health plan.After applying the eligibility criteria, investigators identified 12,482 patients who had undergone an RYGB procedure and 8922 patients who had undergone an AGB procedure.This procedure may be recommended if you have: If you smoke, you should stop several weeks before surgery and not start smoking again after surgery.Smoking slows recovery and increases the risks for problems.A total of 281 nonvertebral fractures occurred in the 2 surgical groups during the follow-up period.As demonstrated in the Table, the estimated incidence of nonvertebral fractures per 1000 person-years was 9.7% among patients who underwent an RYGB procedure and 6.8% among patients who underwent an AGB procedure.RYGB is a true metabolic surgery that is composed of both gastric reduction and intestinal reconstruction, resulting in greater metabolic improvements compared with surgeries that involve restriction, such as AGB.

At the time of this study, it was unknown whether RYGB was associated with an increased fracture risk compared with AGB.Conclusions In this population-based propensity score-matched cohort study, RYGB was associated with a 43% increase in the risk of clinically relevant fractures compared with AGB, especially those of the hip and wrist.The greater risk of fracture following RYGB procedures versus AGB became evident more than 2 years after surgery and increased in subsequent years.Therefore, Yu et al investigated the rate of incident fracture in patients who were obese and underwent RYGB compared with those who underwent AGB by examining longitudinal cohort data from a US commercial insurance claim database.Study Design This population-based propensity score-matched cohort study used claims data from 2005 to 2013 from a large US commercial health plan (United Health Care).

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