Department of Pediatrics, Cincinnati Children's Hospital, Cincinnati, OH, USA.
University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Int J Obes (Lond). 2024 Apr;48(4):575-583. doi: 10.1038/s41366-023-01453-8. Epub 2024 Jan 4.
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.
In cases (RYGB: mean age 26.8 ± 1.9 years, mean BMI 42.1 ± 9.9 kg/m, VSG: mean age 25.1 ± 2.1 years, mean BMI 37.1 ± 8.4 kg/m), compared to controls (mean age 26.5 ± 2.7 years, mean BMI 40.2 ± 8.7 kg/m) (age p < 0.001, BMI p = 0.02), adjusted mean DXA-BMD (g/cm) 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 p < 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 (p < 0.001). Greater time since MBS was associated with lower BMD Z-scores at the hip (p = 0.05) and femoral neck (p = 0.045). Percent change in body mass index (BMI) from baseline or in the first year after MBS were not associated with bone measures at a median of 9.3 years post MBS.
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 were inversely associated with time since MBS but were not associated with BMI change.
代谢和减重手术（MBS）与成年人的骨密度（BMD）降低有关。MBS 在青少年时期对 BMD 的长期影响尚不清楚。我们报告了 Teen-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）后的青少年 5 至 11 年后的骨健康状况。
在 2016 年至 2022 年期间，通过双能 X 射线吸收法（DXA）测量了 106 名接受过 MBS 的年轻成年人的 BMD。对一部分人进行了外周定量计算机断层扫描的体积 BMD 测量。招募了 91 名未接受过 MBS 的对照组进行比较。
在病例组（RYGB：平均年龄 26.8±1.9 岁，平均 BMI 42.1±9.9kg/m，VSG：平均年龄 25.1±2.1 岁，平均 BMI 37.1±8.4kg/m）与对照组（平均年龄 26.5±2.7 岁，平均 BMI 40.2±8.7kg/m）相比（年龄 p<0.001，BMI p=0.02），RYGB（n=58）和 VSG（n=48）组的 DXA-BMD（g/cm）分别在髋部（-10.0%和-6.3%）、股骨颈（-9.6%和-5.7%）和超远端桡骨（-7.9%和-7.0%）处较低（均 p<0.001）。RYGB 和 VSG 组之间的 DXA-BMD 没有差异。与对照组相比，RYGB（-30%和-26%）和 VSG（-15%和-14%）组的桡骨和胫骨的小梁体积 BMD 较低（p<0.001）。MBS 后时间的增加与髋部（p=0.05）和股骨颈（p=0.045）的 BMD Z 评分降低相关。从基线或 MBS 后第一年开始，BMI 的变化百分比与 MBS 后中位数为 9.3 年的骨量测量值无关。
与未接受 MBS 的匹配同龄人相比，接受青少年时期 MBS 的年轻人的 BMD，尤其是髋部和股骨颈的 BMD 较低。股骨颈的 BMD Z 评分与 MBS 后时间呈负相关，但与 BMI 变化无关。
