Adachi Y, Shiota E, Matsumata T, Iso Y, Yoh R, Kitano S
First Department of Surgery, Oita Medical University, Japan.
Calcif Tissue Int. 2000 Feb;66(2):119-22. doi: 10.1007/s002230010025.
Although osteoporosis is a common clinical disorder associated with gastric surgery, long-term effects of gastrectomy on bone metabolism are still unclear. The purpose of this study was to clarify the incidence and risk factors of osteoporosis after gastrectomy using univariate and multivariate analyses of quantitative measurements. The study included 59 patients who had undergone gastrectomy more than 5 years before. There were 38 men and 21 women, aged 37-81 years, mean 64 years. Bone mineral density (BMD) of L2-L4 spine was measured using dual-energy X-ray absorptiometry (DXA). Absolute value of BMD (g/cm2) and age- and sex-matched BMD (%) were given. The mean BMD was 0.766 g/cm2, and the incidence of osteoporosis (BMD less than 0.70 g/cm2) was 37%: 18% in men and 71% in women. The mean age- and sex-matched BMD was 85.9%: 87.5% in men and 83.1% in women. Univariate and multivariate analyses revealed that BMD was significantly associated with the age and sex of patients, but was not influenced by the type of gastrectomy (partial versus total) and years after operation (< 20 versus 20 <). Our study clarified the fact that postgastrectomy osteoporosis was frequent in the aged or female patients. BMD should be evaluated after gastrectomy, especially in the aged and in women.
尽管骨质疏松症是一种与胃部手术相关的常见临床病症,但胃切除术后对骨代谢的长期影响仍不明确。本研究的目的是通过对定量测量结果进行单因素和多因素分析,阐明胃切除术后骨质疏松症的发生率及危险因素。该研究纳入了59例在5年多以前接受过胃切除术的患者。其中男性38例,女性21例,年龄37 - 81岁,平均64岁。使用双能X线吸收法(DXA)测量L2 - L4椎体的骨密度(BMD)。给出了BMD的绝对值(g/cm²)以及年龄和性别匹配的BMD(%)。平均BMD为0.766 g/cm²,骨质疏松症(BMD低于0.70 g/cm²)的发生率为37%:男性为18%,女性为71%。平均年龄和性别匹配的BMD为85.9%:男性为87.5%,女性为83.1%。单因素和多因素分析显示,BMD与患者的年龄和性别显著相关,但不受胃切除术类型(部分切除与全切除)及术后年限(< 20年与20年<)的影响。我们的研究阐明了胃切除术后骨质疏松症在老年或女性患者中较为常见这一事实。胃切除术后应评估BMD,尤其是在老年患者和女性患者中。