Department of Surgery, Osaka Rosai Hospital, Sakai, Japan.
Department of Surgery, Sakai City Medical Center, Sakai, Japan.
Surg Today. 2023 Apr;53(4):435-442. doi: 10.1007/s00595-022-02581-w. Epub 2022 Sep 6.
Osteoporosis leads to fragility fractures and is a major public health problem. We conducted this study to analyze the prevalence of and risk factors for osteoporosis after gastrectomy in older patients.
This multicenter prospective trial comprised older patients without recurrence of gastric cancer for > 3 years after curative surgery. The prevalence of osteoporosis was identified using the World Health Organization bone mineral density (BMD)-based definition. Univariate and multivariate analyses were performed to identify the risk factors for osteoporosis.
BMD values were measured in 267 of the 271 enrolled patients. The prevalence of osteoporosis was 38.2% (men 24.0%; women 60%). Analysis using FRAX revealed that 51.7% of patients were candidates for pharmacologic therapy. Female sex (odds ratio [OR] 5.16, 95% confidence interval [CI] 2.61-10.2), age (OR 1.06, 95% CI 1.00-1.12), low body mass index (< 19.0 kg/m) after gastrectomy (OR 5.31, 95% CI 2.79-10.13), and history of fracture (OR 2.06, 95% CI 1.06-4.02) were independently associated with osteoporosis.
The prevalence of osteoporosis in older patients after gastrectomy was 38.2%. Moreover, female sex, age, low body mass index after gastrectomy, and a history of fracture were risk factors significantly associated with osteoporosis. Thus, older patients undergoing gastrectomy should have proactive surveillance and receive treatment for osteoporosis.
骨质疏松症可导致脆性骨折，是一个主要的公共健康问题。我们进行这项研究旨在分析老年胃癌根治术后患者骨质疏松症的患病率和危险因素。
这项多中心前瞻性试验纳入了无胃癌复发且根治术后 3 年以上的老年患者。采用世界卫生组织基于骨密度的定义来确定骨质疏松症的患病率。采用单因素和多因素分析来确定骨质疏松症的危险因素。
在 271 名入组患者中，有 267 名患者测量了骨密度值。骨质疏松症的患病率为 38.2%（男性 24.0%；女性 60%）。使用 FRAX 分析显示，51.7%的患者适合药物治疗。女性（比值比 [OR] 5.16，95%置信区间 [CI] 2.61-10.2）、年龄（OR 1.06，95% CI 1.00-1.12）、胃癌术后低体重指数（<19.0 kg/m²，OR 5.31，95% CI 2.79-10.13）和骨折史（OR 2.06，95% CI 1.06-4.02）与骨质疏松症独立相关。
胃癌根治术后老年患者骨质疏松症的患病率为 38.2%。此外，女性、年龄、胃癌术后低体重指数和骨折史是与骨质疏松症显著相关的危险因素。因此，接受胃癌切除术的老年患者应进行积极的监测，并接受骨质疏松症的治疗。
