Bariatric and Metabolic Surgery Center, E-Da Hospital, Kaohsiung, Taiwan.
Department of Family Medicine, E-Da Hospital, Kaohsiung, Taiwan.
Obes Surg. 2021 May;31(5):2231-2240. doi: 10.1007/s11695-021-05262-8. Epub 2021 Feb 19.
The aim of this study is to investigate the impact of bariatric surgery on non-traffic accident-related fractures in patients with obesity.
This retrospective cohort study was conducted using the Taiwan National Health Insurance Research Database. Patients aged 18 to 55 years with obesity diagnosis between 2003 and 2008 were enrolled and divided into two groups: non-surgical and bariatric surgery groups. Patients with endocrine bone disease and malignancy history were excluded. Healthy patients were also randomly selected from the database and assigned to the general population group. The development of fracture was the primary end point. All patients were followed until the end of 2013 or death, whichever came first.
After propensity score matching, 1322, 1322, and 4359 subjects were included in the bariatric surgery (BS), non-surgical (NS), and general population (GP) groups, respectively. Based on multivariate analysis, the risk of overall fractures is similar between the BS group (hazard ratio [HR] = 0.774, p = 0.164) and the NS group; nevertheless, the risk of overall fractures was higher in the BS group (HR = 2.210, p<0.001) than in the GP group. The BS group had a significantly lower risk of non-traffic accident-related fractures (HR = 0.542, p = 0.010) than the NS group but a higher risk of non-traffic accident-related fractures (HR = 1.693, p = 0.023) than the GP group.
Bariatric surgery may decrease the risk of non-traffic accident-related fractures; however, the risk remains higher in patients with obesity than in the general population.
本研究旨在探讨肥胖患者接受减重手术后非交通意外相关骨折的影响。
这是一项使用台湾全民健康保险研究数据库进行的回顾性队列研究。纳入了 2003 年至 2008 年间诊断为肥胖症且年龄在 18 至 55 岁之间的患者，并将其分为两组：非手术组和减重手术组。排除了有内分泌骨病和恶性肿瘤病史的患者。还从数据库中随机选择健康患者并将其分配到一般人群组。骨折的发生是主要终点。所有患者均随访至 2013 年底或死亡，以先发生者为准。
经倾向评分匹配后，分别纳入 1322 例、1322 例和 4359 例患者进入减重手术（BS）组、非手术（NS）组和一般人群（GP）组。多变量分析显示，BS 组与 NS 组的总体骨折风险相似（风险比[HR] = 0.774，p = 0.164），但 BS 组的总体骨折风险高于 GP 组（HR = 2.210，p<0.001）。BS 组非交通意外相关骨折的风险明显低于 NS 组（HR = 0.542，p = 0.010），但高于 GP 组（HR = 1.693，p = 0.023）。
减重手术可能降低非交通意外相关骨折的风险；然而，肥胖患者的风险仍高于一般人群。
