A health program to prevent a patient who received a gastrectomy from bone metabolism disorder

本研究旨在探讨胃切除术后骨代谢损害的影响，以及饮食生活和体育活动对骨密度的影响，为预防骨质疏松的生活方式教育提供基本信息。研究对象为39名年龄在80岁以下的男性患者，他们均在A、B医学院被诊断为胃癌并接受了胃切除术。所有受试者都给予了知情同意。采用骨细胞密度测定、超声骨密度仪测定骨代谢参数ALP_3、BAP、DPD、NTx、代偿钙等检测骨代谢损伤水平。采用步数测定体力活动，采用问卷调查饮食寿命。在这两所医学院，作为骨代谢损伤指标的SOS值在胃切除术后三周下降。SOS值虽有一次回升，但6个月后又出现下降趋势。术后恢复到术前水平。在A医学院，作为成骨标志物的ALP_3和BAP水平在胃切除术后3周显著下降，3个月后升高。骨吸收指标DPD水平显著升高。B医学院患者胃切除术后3周ALP_3和BAP水平明显下降，3个月后升高。然而，DPD水平在胃切除术后3周显著升高，3个月后显著降低。NTx水平在胃切除术后的任何时间都有升高的趋势，一年后与术前相比显著升高。在这两所大学中，体育活动和饮食生活对骨密度的影响尚未得到确认。虽然在胃切除术后3周出现骨代谢损伤，但骨吸收后的骨形成过程存在个体差异。少

The aim of this study is to examine effects of bone metabolism impairment after a gastrectomy, and the effects of dietary life and physical activity on bone density, in order to obtain basic information for education regarding lifestyle which prevent osteoporosis.The study subjects were 39 male patients aged 80 years old or less who had been diagnosed as having gastric cancer in A and B medical colleges and had received a gastrectomy. All subjects gave their informed consent. The level of the bone metabolism impairment was examined by bone cell density measurement, by ultrasound densitometer and measurement of bone metabolism parameters, i.e. ALP_3, BAP, DPD, NTx, compensation Ca. Physical activity was measured by the number of steps, and dietary life was investigated using a questionnaire.In both medical colleges, the SOS value, which is an index to the bone metabolism impairment, decreased three weeks after the gastrectomy. Although the SOS value recovered once, it appears to decreas … More e after sixth months again. Afterwards, it recovered to the preoperative level. In A medical college, the levels of ALP_3 and BAP, which are the osteogenesis markers, significantly decreased 3 weeks after gastrectomy and increased three months later. DPD level, which is a bone resorption marker, increased significantly. In B medical college, the levels of ALP_3 and BAP significantly decreased three weeks after gastrectomy, and increased three months later. However, DPD level significantly increased three weeks after gastrectomy, and significantly decreased after three months. NTx levels showed a tendency to increase at anytime after gastrectomy and significantly increased one year later compared with preoperative level. In both universities, the effect of physical activity and dietary life on the bone density was not recognized. Though the bone metabolism impairment appeared 3 weeks after the gastrectomy, the bone formation process after bone resorption was affected by individual differences. Less