Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; Division of Pediatric Endocrinology, Mass General Hospital for Children and Harvard Medical School, Boston, Massachusetts.
Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Surg Obes Relat Dis. 2020 Dec;16(12):2022-2030. doi: 10.1016/j.soard.2020.07.020. Epub 2020 Jul 31.
Sleeve gastrectomy (SG), the most commonly performed metabolic and bariatric surgery, is associated with reductions in areal bone mineral density at multiple sites, and changes in bone structure at the distal radius and tibia without reductions in strength estimates at these peripheral sites. Data are lacking regarding effects on hip strength estimates.
To evaluate effects of SG on measures of hip structural analysis in adolescents and young adults over 12 months using dual-energy x-ray absorptiometry.
Translational and Clinical Research Center.
We enrolled 48 youth 14- to 22-years old with moderate-to-severe obesity; 24 underwent SG and 24 controls were followed without surgery (18 females, 6 males in each group). Hip structure was assessed using dual-energy x-ray absorptiometry at baseline and 12 months. Analyses are adjusted for age, sex, race, and the baseline bone measure.
The SG group lost 25.9% weight versus .3% in controls. Compared with controls, SG had reductions in narrow neck, intertrochanteric and femoral shaft bone mineral density Z-scores (P ≤ .012). Furthermore, SG had greater reductions in narrow neck and intertrochanteric region (but not femoral shaft) cross-sectional area, cortical thickness, cross-sectional moment of inertia and section modulus, and increases in buckling ratio (P ≤ .039). Differences were attenuated after adjusting for 12-month body mass index change. At 12 months, differences were minimal after adjusting for age, sex, race, and weight.
Over 12 months, SG had negative effects at the narrow neck and intertrochanteric regions of the hip, but not the femoral shaft. Reduced body mass index may compensate for these deleterious effects on bone.
袖状胃切除术（SG）是最常进行的代谢和减重手术，与多个部位的骨面积密度降低以及桡骨远端和胫骨的骨结构改变有关，但这些外周部位的骨强度估计值没有降低。关于对髋部骨强度估计值的影响，目前数据尚缺乏。
使用双能 X 射线吸收法评估 SG 对青少年和年轻成人髋部结构分析测量值的 12 个月影响。
转化和临床研究中心。
我们招募了 48 名 14 至 22 岁的中重度肥胖青少年；其中 24 名接受了 SG，24 名对照组未接受手术（每组 18 名女性，6 名男性）。基线和 12 个月时使用双能 X 射线吸收法评估髋部结构。分析调整了年龄、性别、种族和基线骨测量值。
SG 组体重减轻了 25.9%，而对照组仅减轻了 0.3%。与对照组相比，SG 患者的窄颈、转子间区和股骨干骨密度 Z 评分降低（P ≤.012）。此外，SG 患者的窄颈和转子间区（但不是股骨干）横截面积、皮质厚度、截面惯性矩和截面模数减小，而内翻比增加（P ≤.039）。调整 12 个月 BMI 变化后，差异减弱。调整年龄、性别、种族和体重后，12 个月时差异较小。
在 12 个月内，SG 对髋部的窄颈和转子间区有负面影响，但对股骨干没有影响。较低的 BMI 可能会抵消这些对骨骼的有害影响。
