Wasserman Halley, Jenkins Todd, Inge Thomas, Ryder Justin, Michalsky Marc, Sisley Stephanie, Xie Changchun, Kalkwarf Heidi
Cincinnati Children's Hospital Medical Center.
Lurie Children's Hospital of Chicago.
Res Sq. 2023 Sep 21:rs.3.rs-3345103. doi: 10.21203/rs.3.rs-3345103/v1.
Metabolic and bariatric surgery (MBS) is associated with decreased bone mineral density (BMD) in adults. The long-term impact of MBS during adolescence on BMD is unknown. We report bone health status 5 to 11 years after Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) from the Teen-LABS study cohort.
Between 2016 and 2022, BMD was measured by dual energy x-ray absorptiometry (DXA) in 106 young adults who had undergone MBS as adolescents. Volumetric BMD by peripheral quantitative computed tomography was measured on a subset. Ninety-one controls who had not undergone MBS were recruited for comparison.
Compared to controls, adjusted mean DXA-BMD of the RYGB (n = 58) and VSG (n = 48) groups were lower at the hip (-10.0% and - 6.3%), femoral neck (-9.6% and - 5.7%) and ultra-distal radius (-7.9% and - 7.0%; all < 0.001), respectively. DXA-BMD did not differ between RYGB and VSG groups. Trabecular volumetric BMD at the radius and tibia were lower in the RYGB (-30% and - 26%) and VSG (-15% and - 14%) groups compared to the control group ( < 0.001). Greater time since MBS was associated with lower BMD Z-scores at the hip ( = 0.05) and femoral neck ( = 0.045). Percent change in body mass index (BMI) from baseline or in the first year after MSB were not associated with bone measures at a median of 9.3 years post MSB.
BMD, especially of the hip and femoral neck, was lower in young adults who underwent MBS during adolescence compared to matched peers who had not undergone MBS. BMD Z-scores of the femoral neck decreased with time since MBS but were not associated with BMI change.
代谢与减重手术（MBS）与成人骨矿物质密度（BMD）降低有关。MBS在青少年期对BMD的长期影响尚不清楚。我们报告了青少年LABS研究队列中接受Roux-en-Y胃旁路术（RYGB）和垂直袖状胃切除术（VSG）5至11年后的骨骼健康状况。
2016年至2022年期间，对106名青少年期接受过MBS的年轻成年人进行了双能X线吸收法（DXA）测量BMD。对一个亚组进行了外周定量计算机断层扫描测量的体积骨密度。招募了91名未接受MBS的对照者进行比较。
与对照组相比，RYGB组（n = 58）和VSG组（n = 48）调整后的平均DXA-BMD在髋部（分别为-10.0%和-6.3%）、股骨颈（分别为-9.6%和-5.7%）和桡骨超远端（分别为-7.9%和-7.0%；均P < 0.001）较低。RYGB组和VSG组之间的DXA-BMD没有差异。与对照组相比，RYGB组（分别为-30%和-26%）和VSG组（分别为-15%和-14%）桡骨和胫骨的小梁体积骨密度较低（P < 0.001）。MBS后时间越长，髋部（P = 0.05）和股骨颈（P = 0.045）的BMD Z评分越低。在MBS后中位9.3年时，体重指数（BMI）从基线或MBS后第一年的百分比变化与骨骼测量指标无关。
与未接受MBS的匹配同龄人相比，青少年期接受MBS的年轻成年人的BMD，尤其是髋部和股骨颈的BMD较低。股骨颈的BMD Z评分随MBS后的时间而降低，但与BMI变化无关。
