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本文引用的文献

1
G-CSF partially mediates effects of sleeve gastrectomy on the bone marrow niche.G-CSF 部分介导袖状胃切除术对骨髓龛的影响。
J Clin Invest. 2019 May 6;129(6):2404-2416. doi: 10.1172/JCI126173.
2
Longitudinal 5-Year Evaluation of Bone Density and Microarchitecture After Roux-en-Y Gastric Bypass Surgery.Roux-en-Y 胃旁路手术后骨密度和微结构的纵向 5 年评估。
J Clin Endocrinol Metab. 2018 Nov 1;103(11):4104-4112. doi: 10.1210/jc.2018-01496.
3
Comparison of metabolic outcomes in patients undergoing laparoscopic roux-en-Y gastric bypass versus sleeve gastrectomy - a systematic review and meta-analysis of randomised controlled trials.腹腔镜Roux-en-Y胃旁路手术与袖状胃切除术患者代谢结局的比较——一项随机对照试验的系统评价和荟萃分析
Swiss Med Wkly. 2018 Jul 5;148:w14633. doi: 10.57187/smw.2018.14633. eCollection 2018.
4
INCREASED BONE TURNOVER IN TYPE 2 DIABETES PATIENTS RANDOMIZED TO BARIATRIC SURGERY VERSUS MEDICAL THERAPY AT 5 YEARS.5 年随访:与药物治疗相比,接受减重手术的 2 型糖尿病患者的骨转换增加。
Endocr Pract. 2018 Mar;24(3):256-264. doi: 10.4158/EP-2017-0072. Epub 2017 Nov 16.
5
Fracture Risk After Bariatric Surgery: Roux-en-Y Gastric Bypass Versus Adjustable Gastric Banding.减重手术后的骨折风险:Roux-en-Y胃旁路术与可调节胃束带术对比
J Bone Miner Res. 2017 Jun;32(6):1229-1236. doi: 10.1002/jbmr.3101. Epub 2017 Mar 20.
6
Bone Turnover Markers in the Diagnosis and Monitoring of Metabolic Bone Disease.骨转换标志物在代谢性骨病诊断和监测中的应用
Clin Chem. 2017 Feb;63(2):464-474. doi: 10.1373/clinchem.2016.259085. Epub 2016 Dec 9.
7
Effects of Roux-en-Y gastric bypass and sleeve gastrectomy on bone mineral density and marrow adipose tissue.Roux-en-Y胃旁路术和袖状胃切除术对骨密度和骨髓脂肪组织的影响。
Bone. 2017 Feb;95:85-90. doi: 10.1016/j.bone.2016.11.014. Epub 2016 Nov 15.
8
Change in fracture risk and fracture pattern after bariatric surgery: nested case-control study.减肥手术后骨折风险和骨折类型的变化:巢式病例对照研究。
BMJ. 2016 Jul 27;354:i3794. doi: 10.1136/bmj.i3794.
9
Effects of Gastric Bypass and Gastric Banding on Bone Remodeling in Obese Patients With Type 2 Diabetes.胃旁路手术和胃束带术对2型糖尿病肥胖患者骨重塑的影响。
J Clin Endocrinol Metab. 2016 Feb;101(2):714-22. doi: 10.1210/jc.2015-3437. Epub 2015 Nov 24.
10
Effect of Sleeve Gastrectomy Plus Side-to-Side Jejunoileal Anastomosis for Type 2 Diabetes Control in an Obese Rat Model.袖状胃切除术联合空肠回肠侧侧吻合术对肥胖大鼠模型2型糖尿病控制的影响
Obes Surg. 2016 Apr;26(4):797-804. doi: 10.1007/s11695-015-1811-7.

Roux-en-Y 胃旁路术和袖状胃切除术对 Zucker 糖尿病肥胖大鼠骨密度的影响:一项短期比较研究。

Effects of Roux-en-Y Gastric Bypass and Sleeve Gastrectomy on Bone Mineral Density in Zucker Diabetic Fatty Rats: A Short-Term Comparative Study.

机构信息

Department of Orthopedics, China-Japan Friendship Hospital, Beijing, China.

Department of Nephrology, Beijing Hospital, Beijing, China.

出版信息

Obes Facts. 2021;14(2):178-189. doi: 10.1159/000514426. Epub 2021 Mar 4.

DOI:10.1159/000514426
PMID:33662956
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8138275/
Abstract

BACKGROUND

While bariatric surgery could result in weight loss as well as glycaemia improvement, the short-term impact on bone health in a high glycemic environment following Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) remains intriguing.

OBJECTIVE

The aim of this study was to compare the short-term effects of RYGB and SG procedures on bone health in Zucker diabetic fatty (ZDFfa/fa) rats.

METHODS

Thirty age-matched male ZDFfa/fa rats were randomized into RYGB, SG, and sham groups after establishment of the diabetic model. Body weight, blood glucose, bone mineral density (BMD), the level of bone turnover markers (BTM), vitamin D, and serum calcium and phosphorus were measured 4 weeks after the operation.

RESULTS

The RYGB procedure brought about lower blood glucose, BMD, serum calcium and phosphorus levels, as well as a relatively higher bone turnover rate and 1,25(OH)2VD level, compared to the SG and sham groups, while the influences of the SG procedure were not significant. 25(OH)VD demonstrated no significant difference among the 3 groups.

CONCLUSIONS

Despite its excellent ability to provide short-term glycemic control, the RYGB procedure could led to more severe impairment of bone health compared to the SG procedure. Bone health should be procured after bariatric surgery, especially with the RYGB procedure. Early detection of BMD and BTM may help to avoid deterioration of bone.

摘要

背景

减重手术不仅可以减轻体重,还可以改善血糖水平,但在 Roux-en-Y 胃旁路术(RYGB)和袖状胃切除术(SG)后高血糖环境下,其对骨骼健康的短期影响仍引人关注。

目的

本研究旨在比较 RYGB 和 SG 手术对 Zucker 糖尿病肥胖(ZDFfa/fa)大鼠骨骼健康的短期影响。

方法

30 只年龄匹配的雄性 ZDFfa/fa 大鼠在建立糖尿病模型后随机分为 RYGB、SG 和假手术组。术后 4 周测量体重、血糖、骨密度(BMD)、骨转换标志物(BTM)水平、维生素 D、血清钙和磷。

结果

与 SG 和假手术组相比,RYGB 组血糖、BMD、血清钙和磷水平较低,骨转换率和 1,25(OH)2VD 水平相对较高,而 SG 组的影响不显著。3 组间 25(OH)VD 无显著差异。

结论

尽管 RYGB 术式具有良好的短期血糖控制能力,但与 SG 术式相比,其可能导致更严重的骨骼健康损害。减重手术后应关注骨骼健康,尤其是 RYGB 术式。早期检测 BMD 和 BTM 可能有助于避免骨骼恶化。