Effects of Laparoscopic Sleeve Gastrectomy on Bone Mineral Density and Bone Metabolism in Chinese Patients with Obesity.
Effects of Laparoscopic Sleeve Gastrectomy on Bone Mineral Density and Bone Metabolism in Chinese Patients with Obesity.
复制标题
腹腔镜袖状胃切除术对中国肥胖患者骨密度和骨代谢的影响
DOI：
10.2147/dmso.s274614
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Zhou Z
中科院分区：
文献类型：
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作者：
Chen X;Zhang C;Li J;Liu W;Zhang J;Zhou Z
目的腹腔镜袖状胃切除术(LSG)是治疗肥胖最有效的方法之一。由于缺乏纵向研究，我们探讨了中国肥胖患者在LSG治疗前后骨密度和骨代谢的变化。材料与方法选择中南大学湘雅二医院收治的49例中国人肥胖患者。术后2、6、12个月分别测定血清骨钙素(OC)、I型前胶原末端总肽(TPINP)、I型胶原羧基末端多肽(CTX)水平。用双能X线骨密度仪(DEXA)测量LSG前和术后12个月的体成分和骨密度。结果术后12个月体重指数(BMI)明显下降，无骨质疏松症。术后12个月股骨颈、全髋部骨密度较术前明显下降，腰椎骨密度无明显变化。术后12个月OC、TPINP和CTX水平显著升高。术后12个月超额体重指数丢失(EBMIL)与内脏脂肪组织(VAT)质量下降呈正相关，与股骨颈和全髋部BMD下降呈负相关。OC的升高与股骨颈骨密度的降低呈负相关，而TPINP的升高与全髋骨密度的降低呈正相关。结论根据12个月的随访结果，中国肥胖患者LSG治疗后股骨颈和全髋部骨密度降低，骨重建活跃。这一发现表明，体重减轻、VAT质量的减少和骨骼重塑的增加可能与BMD的减少有关。
Objective Laparoscopic sleeve gastrectomy (LSG) is one of the most effective therapies to treat obesity. Due to a lack of longitudinal research, we explored the changes in BMD and bone metabolism in Chinese patients with obesity before and after LSG. Materials and Methods A total of 49 obese Chinese patients with obesity were recruited from the Second Xiangya Hospital of Central South University. All patients underwent LSG, and the metabolic indicators were evaluated, including the serum osteocalcin (OC), total-terminal propeptide of type I procollagen (TPINP) and carboxy terminal telopeptide of collagen type I (CTX) levels at baseline and 2, 6 and 12 months postoperatively. Dual energy X-ray absorptiometry (DEXA) was used to measure body composition and BMD before and 12 months after LSG. Results The body mass index (BMI) significantly decreased at 12 months postoperatively, and no patients developed osteoporosis. The BMD of femoral neck and total hip significantly decreased from the baseline to 12 months postoperatively, while the BMD of lumbar spine did not change significantly. The OC, TPINP and CTX levels significantly increased at 12 months postoperatively. The excess BMI loss (EBMIL) was positively related while the reduction in visceral adipose tissue (VAT) mass was negatively related to the decreases in BMD of the femoral neck and total hip at 12 months postoperatively. The increase in OC was negatively correlated with the decrease in BMD of the femoral neck, while the increase in TPINP was positively correlated with the decrease in BMD of total hip. Conclusion Based on the 12-month follow-up results, the BMD of the femoral neck and total hip was decreased in Chinese patients with obesity after LSG, while bone remodelling was active. This finding suggested that weight loss, a decrease in the VAT mass and an increase in bone remodelling may be correlated with a reduction in BMD.