Azzam Adel Ibrahim, Ghanem Saad, Elzayat Ahmed
Rheumatology and Rehabilitation Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mediterr J Rheumatol. 2025 Jan 24;36(1):86-91. doi: 10.31138/mjr.030324.tst. eCollection 2025 Mar.
To study short-term impact of sleeve gastrectomy (SG) on bone outcomes such as bone metabolism, bone turnover, and bone mineral density (BMD).
The study included 69 bariatric surgery-eligible patients (37 males and 32 females) ranging in age from 30 to 45 years. Dual-energy x-ray absorptiometry (DXA) scans were used to calculate areal BMD (g/cm2) and T scores in the total hip, femoral neck, and lumbar spine (L1-L4). Serum levels of C-terminal telopeptide (CTX), type 1 collagen propeptide (P1NP), parathyroid hormone (PTH), and 25-hydroxy vitamin D (25(OH)D) were measured. All patients received baseline and 12-month postoperative evaluations.
The study included 69 individuals, 37 (53.62%) male and 32 (46.38%) female, aged 36.86 ± 6.31, with morbid obesity (mean BMI 46.32 ± 4.21 kg/m2) who underwent SG. The mean levels of circulating calcium, 25(OH)D, and PTH did not change significantly after surgery (p > 0.05) and remained within normal ranges twelve months later. Following surgery, bone turnover markers increased significantly (p < 0.05), with CTX showing a higher overall percentage increase than P1NP. The total hip and femoral neck BMD decreased significantly after surgery, but there was no significant difference in lumbar spinal BMD before and after surgery.
This study demonstrates that BMD decreases drastically after SG, and bone loss is more pronounced at the hip and femoral neck sites 12 months after surgery than at the lumber spine. Regular follow-ups, including BMD measurements, are recommended after bariatric surgery, at least once a year.
研究袖状胃切除术(SG)对骨代谢、骨转换和骨密度(BMD)等骨骼结局的短期影响。
该研究纳入了69例符合减肥手术条件的患者(37例男性和32例女性),年龄在30至45岁之间。采用双能X线吸收法(DXA)扫描计算全髋、股骨颈和腰椎(L1-L4)的面积骨密度(g/cm²)和T值。测量血清C端肽(CTX)、1型胶原蛋白前肽(P1NP)、甲状旁腺激素(PTH)和25-羟维生素D(25(OH)D)水平。所有患者均接受了基线和术后12个月的评估。
该研究纳入了69例患者,其中37例(53.62%)男性和32例(46.38%)女性,年龄为36.86±6.31岁,患有病态肥胖(平均BMI为46.32±4.21kg/m²),接受了袖状胃切除术。术后循环钙、25(OH)D和PTH的平均水平无显著变化(p>0.05),12个月后仍保持在正常范围内。手术后,骨转换标志物显著升高(p<0.05),CTX的总体升高百分比高于P1NP。术后全髋和股骨颈骨密度显著降低,但手术前后腰椎骨密度无显著差异。
本研究表明,袖状胃切除术后骨密度急剧下降,术后12个月髋部和股骨颈部位的骨质流失比腰椎更明显。建议减肥手术后定期进行随访,包括测量骨密度,至少每年一次。