Department of Endocrinology, the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Department of Nuclear Medicine, the First Affiliated Hospital of Jinan University, Guangzhou, China.
Sci Rep. 2024 Nov 26;14(1):29355. doi: 10.1038/s41598-024-80107-9.
Dual energy X-ray absorptiometry (DXA) was used to analyze body composition, bone mineral density (BMD) parameters and the trabecular bone score (TBS) in patients with obesity before, 3 months after and 1 year after bariatric surgery as a method to evaluate the changes in BMD and skeletal microarchitecture (MA) in patients with obesity after bariatric surgery and to provide a basis for further accurate assessment of the bone health status of this population and subsequent treatment.
This study was a retrospective analysis of 41 patients that underwent DXA imaging before, 3 months after and maximum 1 year after bariatric surgery. The follow-up rate in both periods was 100%. First, the changes in BMD and TBS before and after surgery were compared between patients grouped by sex and obesity degree. Secondly, the correlations between the TBS or BMD and body composition 1 year after surgery were analyzed.
The BMD and TBS were within the normal range after bariatric surgery. Changes in the BMD and TBS were related to time, the degree of obesity and sex. Changes in the TBS were closely related to changes in the BMD, and the trends in the changes in the BMD were basically the same among the different groups of individuals with obesity of different sexes. A negative correlation was observed between the TBS and fat percentage (total body, leg, trunk, android area), as well as the lumbar spine Z-score in patients 1 year after bariatric surgery (p < 0.05).
Bariatric surgery in patients with obesity has no obvious adverse effects on BMD or TBS. DXA can be used to better evaluate the changes in BMD and MA in patients with obesity after bariatric surgery, providing a basis for the clinical evaluation of post-bariatric surgery efficacy in these individuals and subsequent accurate assessment of the bone health status and treatment of this population.
双能 X 射线吸收法（DXA）用于分析肥胖患者在减肥手术前后 3 个月和 1 年内的身体成分、骨矿物质密度（BMD）参数和骨小梁评分（TBS），以评估减肥手术后肥胖患者的 BMD 和骨骼微结构（MA）变化，并为进一步准确评估该人群的骨骼健康状况及后续治疗提供依据。
这是一项回顾性分析，纳入了 41 例在减肥手术后进行 DXA 成像的患者，分别在术前、术后 3 个月和 1 年内进行随访，两个时期的随访率均为 100%。首先，比较了按性别和肥胖程度分组的患者手术前后 BMD 和 TBS 的变化。其次，分析了手术后 1 年 TBS 或 BMD 与身体成分的相关性。
减肥手术后 BMD 和 TBS 均在正常范围内。BMD 和 TBS 的变化与时间、肥胖程度和性别有关。TBS 的变化与 BMD 的变化密切相关，不同性别肥胖患者的 BMD 变化趋势基本一致。减肥手术后 1 年，TBS 与体脂百分比（全身、腿部、躯干、安卓区）及腰椎 Z 评分呈负相关（p<0.05）。
肥胖患者减肥手术后对 BMD 或 TBS 无明显不良影响。DXA 可更好地评估减肥手术后肥胖患者 BMD 和 MA 的变化，为临床评估此类患者减肥手术疗效以及后续准确评估该人群的骨骼健康状况和治疗提供依据。
