PDF(Pubmed)
Abstract：
UNASSIGNED: The association of obesity with bone fragility fractures is complex and non-linear. Despite good efficacy on weight loss, bariatric surgery (BS) is also associated with bone loss. However, we lack information on risk factors of the long-term deleterious effects of BS on the skeleton.
UNASSIGNED: We aimed to assess the factors associated with low bone mineral density (BMD) performed a long time after Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG).
UNASSIGNED: This cross-sectional study involved patients at a long distance from their BS that underwent dual-energy x-ray absorptiometry (DXA) with biological factors (vitamins, micronutrients, bone and inflammation biomarkers). Simple and multiple linear models (stepwise and parsimony approach) were developed.
UNASSIGNED: A total of 131 patients (91 RYGB, 40 SG) underwent DXA (51.8 ± 11.08 years, 87.8% women). At a mean of 6.8 ± 3.7 years after surgery, the mean weight loss was -28.6 ± 9.6%, and only 6 patients (5.7%) had a T-score less than or equal to -2.5. On univariate analysis, BMD was lower in the RYGB than in the SG group (P < .001) at all sites, despite similar fat and fat-free mass and weight loss. Serum parathyroid hormone and phosphate levels were higher in RYGB than SG patients. A total of 10.1% of patients showed vascular calcifications. On multivariable analysis, BMD remained different between surgery groups after adjustment for age, body mass index, ethnicity, and sex. The model-adjusted R 2 values were 0.451 for the total hip; 0.462 the femoral neck, and 0.191 the lumbar spine for the inflammation model; 0.458, 0.462, and 0.254, respectively, for the bone marker model; and 0.372, 0.396, and 0.142 for the vitamin model. Serum zinc, ferritin, and uric acid levels were the markers associated with BMD to a low extent.
UNASSIGNED: BMD differed depending on the BS procedure. A few biological markers may be associated weakly with BMD well after the surgery.
UNASSIGNED: We aimed to assess the factors associated with low bone mineral density (BMD) performed a long time after Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG).
UNASSIGNED: This cross-sectional study involved patients at a long distance from their BS that underwent dual-energy x-ray absorptiometry (DXA) with biological factors (vitamins, micronutrients, bone and inflammation biomarkers). Simple and multiple linear models (stepwise and parsimony approach) were developed.
UNASSIGNED: A total of 131 patients (91 RYGB, 40 SG) underwent DXA (51.8 ± 11.08 years, 87.8% women). At a mean of 6.8 ± 3.7 years after surgery, the mean weight loss was -28.6 ± 9.6%, and only 6 patients (5.7%) had a T-score less than or equal to -2.5. On univariate analysis, BMD was lower in the RYGB than in the SG group (P < .001) at all sites, despite similar fat and fat-free mass and weight loss. Serum parathyroid hormone and phosphate levels were higher in RYGB than SG patients. A total of 10.1% of patients showed vascular calcifications. On multivariable analysis, BMD remained different between surgery groups after adjustment for age, body mass index, ethnicity, and sex. The model-adjusted R 2 values were 0.451 for the total hip; 0.462 the femoral neck, and 0.191 the lumbar spine for the inflammation model; 0.458, 0.462, and 0.254, respectively, for the bone marker model; and 0.372, 0.396, and 0.142 for the vitamin model. Serum zinc, ferritin, and uric acid levels were the markers associated with BMD to a low extent.
UNASSIGNED: BMD differed depending on the BS procedure. A few biological markers may be associated weakly with BMD well after the surgery.
摘要：
■肥胖与骨脆性骨折的关联是复杂且非线性的。尽管减肥效果很好，减肥手术（BS）也与骨丢失有关。然而,我们缺乏关于BS对骨骼的长期有害影响的危险因素的信息。
■我们旨在评估与Roux-en-Y胃旁路术（RYGB）或袖状胃切除术（SG）后长时间进行的低骨密度（BMD）相关的因素。
■这项横断面研究涉及远离BS的患者，这些患者接受了具有生物学因素（维生素，微量营养素,骨和炎症生物标志物)。开发了简单和多元线性模型（逐步和简约方法）。
■共有131名患者（91RYGB，40SG）接受DXA（51.8±11.08年，87.8％的妇女）。手术后平均6.8±3.7年，平均体重减轻为-28.6±9.6％，只有6例患者(5.7%)的T评分小于或等于-2.5.在单变量分析中，在所有部位，RYGB组的BMD均低于SG组（P<.001），尽管脂肪和无脂肪质量和体重减轻相似。RYGB患者的血清甲状旁腺激素和磷酸盐水平高于SG患者。共有10.1%的患者出现血管钙化。在多变量分析中，调整年龄后，手术组之间的BMD仍然不同，身体质量指数,种族,和性爱。模型调整后的R2值为全髋关节0.451；股骨颈0.462，和0.191腰椎为炎症模型；分别为0.458、0.462和0.254，用于骨标记物模型;和0.372、0.396和0.142用于维生素模型。血清锌，铁蛋白,和尿酸水平是与BMD相关程度较低的标志物。
■BMD因BS程序而异。手术后，一些生物学标志物可能与BMD弱相关。
■我们旨在评估与Roux-en-Y胃旁路术（RYGB）或袖状胃切除术（SG）后长时间进行的低骨密度（BMD）相关的因素。
■这项横断面研究涉及远离BS的患者，这些患者接受了具有生物学因素（维生素，微量营养素,骨和炎症生物标志物)。开发了简单和多元线性模型（逐步和简约方法）。
■共有131名患者（91RYGB，40SG）接受DXA（51.8±11.08年，87.8％的妇女）。手术后平均6.8±3.7年，平均体重减轻为-28.6±9.6％，只有6例患者(5.7%)的T评分小于或等于-2.5.在单变量分析中，在所有部位，RYGB组的BMD均低于SG组（P<.001），尽管脂肪和无脂肪质量和体重减轻相似。RYGB患者的血清甲状旁腺激素和磷酸盐水平高于SG患者。共有10.1%的患者出现血管钙化。在多变量分析中，调整年龄后，手术组之间的BMD仍然不同，身体质量指数,种族,和性爱。模型调整后的R2值为全髋关节0.451；股骨颈0.462，和0.191腰椎为炎症模型；分别为0.458、0.462和0.254，用于骨标记物模型;和0.372、0.396和0.142用于维生素模型。血清锌，铁蛋白,和尿酸水平是与BMD相关程度较低的标志物。
■BMD因BS程序而异。手术后，一些生物学标志物可能与BMD弱相关。
