Ko Byung-Joon, Myung Seung Kwon, Cho Kyung-Hwan, Park Yong Gyu, Kim Sin Gon, Kim Do Hoon, Kim Seon Mee
Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, 100-742, South Korea.
Molecular Epidemiological Branch, Research Institute, National Cancer Center, Goyang, 410-769, South Korea.
Obes Surg. 2016 Jul;26(7):1414-21. doi: 10.1007/s11695-015-1928-8.
A meta-analysis regarding bone loss after bariatric surgery, designed to compare surgical and nonsurgical groups, has not yet been performed. Therefore, we performed a meta-analysis to compare the differences between bariatric surgical groups and nonoperated controls with regard to bone mineral density.
In March 2015, we performed a review of the literature using PubMed, EMBASE, and the Cochrane Library. The search focused on retrospective and prospective studies, including but not limited to randomized studies published in English.
Among 1299 studies that were initially screened, ten met the selection criteria. For all types of bariatric surgery, bone density at the femoral neck was lower in the surgical group than in the nonsurgical control group (mean difference [MD] -0.05 g/cm(2); 95 % confidence interval [CI], -0.07 to -0.02; p = 0.001); no difference in bone density was found between the two groups at the lumbar spine (MD -0.01 g/cm(2); 95 % CI -0.07 to 0.05; p = 0.661). The analysis of Roux-en-Y gastric bypass showed similar results.
Bone density at the femoral neck decreased after bariatric surgery, compared to that in nonsurgical controls, whereas bone density at the lumbar spine did not show a difference between groups. Further larger scale studies with comparative nonsurgical controls are warranted to overcome the heterogeneity among studies in this analysis and to add evidence of possible bone loss subsequent to bariatric surgical procedures.
尚未进行一项对比减肥手术后骨量丢失情况的荟萃分析，该分析旨在比较手术组和非手术组。因此，我们进行了一项荟萃分析，以比较减肥手术组和未手术对照组在骨矿物质密度方面的差异。
2015年3月，我们使用PubMed、EMBASE和Cochrane图书馆对文献进行了综述。检索重点为回顾性和前瞻性研究，包括但不限于以英文发表的随机研究。
在最初筛选的1299项研究中，有10项符合入选标准。对于所有类型的减肥手术，手术组股骨颈的骨密度低于非手术对照组（平均差值[MD]-0.05 g/cm²；95%置信区间[CI]，-0.07至-0.02；p = 0.001）；两组腰椎的骨密度无差异（MD -0.01 g/cm²；95% CI -0.07至0.05；p = 0.661）。Roux-en-Y胃旁路手术的分析显示了类似结果。
与非手术对照组相比，减肥手术后股骨颈的骨密度降低，而腰椎的骨密度在两组之间未显示出差异。有必要进行进一步的、规模更大的、有对比非手术对照组的研究，以克服本分析中各研究之间的异质性，并补充减肥手术后续可能发生骨量丢失的证据。
