Lee Hyun-Jae, Ahn Hye Seong, Han Dong-Seok
Department of Surgery, Seoul National University Hospital, Seoul, 03080, Korea.
Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Boramae-ro 5-20, Dongjak-gu, Seoul, 07061, Republic of Korea.
BMC Surg. 2024 Dec 27;24(1):420. doi: 10.1186/s12893-024-02717-4.
Osteoporosis, a frequent complication of gastrectomy, increases with age, and the average age of gastric cancer patients continues to rise. This study aims to analyze perioperative factors of osteoporosis after radical gastrectomy.
This retrospective cohort study included patients who underwent dual-energy-X-ray absorptiometry after gastrectomy due to gastric cancer between 2016 and 2019 at Seoul Boramae Medical Center. Data were analyzed from before surgery to 12 months after surgery. Statistical analyses identified osteoporosis risk factors among perioperative factors.
Among 189 patients, osteoporosis was diagnosed in 72 patients and peaked at 36 months postoperatively (46.3%; 24 out of 54) with the lowest mean T score of -3.34 although Ca and vitamin D supplements were prescribed to 157 patients (83.1%) on average 32.4 months postoperatively. In multivariate analysis, age (P = 0.002; Adjusted OR: 1.059, 95% CI: 1.020-1.098), body weight (P = 0.009; Adjusted OR: 0.950, 95% CI: 0.914-0.987), sex (P = 0.021; Adjusted OR: 2.322, 95% CI: 1.138-4.739), and serum ALP (P = 0.009; Adjusted OR: 1.023, 95% CI: 1.006-1.040) were significant preoperatively. Additionally, age (P = 0.005; Adjusted OR: 1.067, 95% CI: 1.020-1.116), serum Ca (P = 0.046; Adjusted OR: 0.357, 95% CI: 0.130-0.980), Cr (P = 0.003; Adjusted OR: 0.021, 95% CI: 0.002-0.268), and ALP (P = 0.014; Adjusted OR: 1.017, 95% CI: 1.003-1.030) were observed significantly at 12 months postoperatively.
38.1% of patients were diagnosed with osteoporosis after radical gastrectomy, despite Ca and vitamin D supplements. Age, body weight, sex, serum Ca, Cr, and ALP correlated with osteoporosis perioperatively.
骨质疏松是胃切除术后常见的并发症，其发病率随年龄增长而增加，且胃癌患者的平均年龄持续上升。本研究旨在分析根治性胃切除术后骨质疏松的围手术期因素。
这项回顾性队列研究纳入了2016年至2019年在首尔博拉梅医疗中心因胃癌接受胃切除术后进行双能X线吸收测定的患者。对手术前至术后12个月的数据进行分析。统计分析确定了围手术期因素中的骨质疏松危险因素。
189例患者中，72例被诊断为骨质疏松，术后36个月达到高峰（46.3%；54例中的24例），平均T值最低为-3.34，尽管平均在术后32.4个月为157例患者（83.1%）开具了钙和维生素D补充剂。多因素分析显示，术前年龄（P = 0.002；调整后OR：1.059，95%CI：1.020-1.098）、体重（P = 0.009；调整后OR：0.950，95%CI：0.914-0.987）、性别（P = 0.021；调整后OR：2.322，95%CI：1.138-4.739）和血清碱性磷酸酶（P = 0.009；调整后OR：1.023，95%CI：1.006-1.040）具有显著性。此外，术后12个月时，年龄（P = 0.005；调整后OR：1.067，95%CI：1.020-1.116）、血清钙（P = 0.046；调整后OR：0.357，95%CI：0.130-0.980）、肌酐（P = 0.003；调整后OR：0.021，95%CI：0.002-0.268）和碱性磷酸酶（P = 0.014；调整后OR：1.017，95%CI：1.003-1.030）也具有显著性。
尽管补充了钙和维生素D，但38.1%的患者在根治性胃切除术后被诊断为骨质疏松。年龄、体重、性别、血清钙、肌酐和碱性磷酸酶与围手术期骨质疏松相关。
