Department of Surgical Sciences, Uppsala University, Entrance 70, University Hospital, 751 85, Uppsala, Sweden.
BMC Surg. 2021 Jun 4;21(1):282. doi: 10.1186/s12893-021-01281-5.
Bariatric surgery, Roux-en-Y gastric bypass (RYGBP) in particular, is associated with weight loss as well as low bone mineral density. Bone mineral density relies upon multiple factors, some of which are lifestyle factors. The aim of this study was to compare lifestyle factors in order to eliminate them as culprits of the suspected difference in BMD in RYGBP operated and controls.
Study participants included 71 RYGBP-operated women (42.3 years, BMI 33.1 kg/m) and 94 controls (32.4 years, BMI 23.9 kg/m). Each completed a DEXA scan, as well as survey of lifestyle factors (e.g. physical activity in daily life, corticosteroid use, and calcium intake). All study participants were premenopausal Caucasian women living in the same area. Blood samples were taken in RYGBP-patients.
BMD was significantly lower in RYGBP, femoral neck 0.98 vs. 1.04 g/cm compared to controls, despite higher BMI (present and at 20 years of age) and similar physical activity and calcium intake. In a multivariate analysis, increased time since surgery and age were negatively associated with BMD of the femoral neck and total hip in RYGBP patients.
Despite similar lifestyle, RYGBP was followed by a lower BMD compared to controls. Thus, the reduced BMD in RYGBP cannot be explained, seemingly nor prevented, by lifestyle factors. As the reduction in BMD was associated with time since surgery, strict follow-up is a lifelong necessity after bariatric surgery, and especially important in younger bariatric patients.
减重手术，尤其是 Roux-en-Y 胃旁路术（RYGBP），与体重减轻和低骨密度有关。骨密度依赖于多种因素，其中一些是生活方式因素。本研究的目的是比较生活方式因素，以消除它们作为 RYGBP 手术和对照组之间 BMD 差异的罪魁祸首。
研究参与者包括 71 名 RYGBP 手术女性（42.3 岁，BMI 33.1 kg/m）和 94 名对照组（32.4 岁，BMI 23.9 kg/m）。每个人都完成了 DEXA 扫描，以及生活方式因素的调查（例如日常生活中的体力活动、皮质类固醇使用和钙摄入量）。所有研究参与者均为绝经前白种女性，居住在同一地区。RYGBP 患者抽取了血液样本。
尽管 RYGBP 的 BMI（现在和 20 岁时）和相似的体力活动和钙摄入量更高，但 RYGBP 的骨密度（股骨颈为 0.98 比 1.04 g/cm）明显低于对照组。在多变量分析中，手术时间和年龄的增加与 RYGBP 患者的股骨颈和全髋关节的骨密度呈负相关。
尽管生活方式相似，但 RYGBP 的骨密度仍低于对照组。因此，RYGBP 降低的骨密度似乎不能通过生活方式因素来解释或预防。由于骨密度的降低与手术时间有关，因此减重手术后需要终生进行严格的随访，尤其是对年轻的减重患者更为重要。
