Yuan Xiaoqing, Zhu Wei, Hao Zhen, Li Jia, Zhang Ting, Li Weihua, Yu Fengxia, Wang Zhenchang, Guan Wenmin, Zhang Peng, Zhang Peng
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Division of Metabolic and Bariatric Surgery, General Surgery Center, Beijing Friendship Hospital, Capital Medical University and National Clinical Research Center for Digestive Diseases, Beijing, China.
Diabetes Obes Metab. 2025 Sep;27(9):4968-4977. doi: 10.1111/dom.16543. Epub 2025 Jun 25.
To explore the changes in bone mineral density (BMD) and body composition in patients after bariatric surgery using dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT), analyse the relationships between these changes and weight loss, and the correlations between the parameters of DXA and QCT.
Sixty-five patients who underwent surgery between March 2022 and September 2024 were prospectively enrolled. BMD and body composition were measured by DXA and QCT before and after surgery. Laboratory tests were performed.
The area BMD (aBMD) of lumbar spine (LS) decreased by 3.19 (0.09, 6.50) %, the aBMD of femoral neck decreased by 8.35 (4.66, 12.77) %, the aBMD of total hip decreased by 6.78 (3.98, 10.43) %, and the volumetric BMD (vBMD) of LS decreased by 1.57% ± 8.83%. ΔvBMD was smaller than ΔaBMD-LS (p < 0.05). BMI, fat tissue in the whole body and trunk, and lean soft tissue (LST) all decreased significantly (p < 0.05). The reduction rate of visceral adipose tissue was significantly higher than that of subcutaneous adipose tissue (p < 0.05). There was a weak positive correlation between ΔBMI and ΔaBMD-LS (r = 0.254, p < 0.05), and ΔBMI was positively correlated with the changes in various body compositions (p < 0.05).
The decline of BMI after surgery was accompanied by a decrease in BMD, fat and LST content, with different proportions of decrease. Our findings indicate that QCT can serve as a supplementary method for postoperative follow-up of BMD and body composition in patients undergoing bariatric surgery.
采用双能X线吸收法（DXA）和定量计算机断层扫描（QCT）探讨减重手术后患者骨密度（BMD）和身体成分的变化，分析这些变化与体重减轻之间的关系，以及DXA和QCT参数之间的相关性。
前瞻性纳入2022年3月至2024年9月期间接受手术的65例患者。术前和术后采用DXA和QCT测量BMD和身体成分。进行实验室检查。
腰椎（LS）的面积骨密度（aBMD）下降3.19（0.09，6.50）%，股骨颈的aBMD下降8.35（4.66，12.77）%，全髋的aBMD下降6.78（3.98，10.43）%，LS的体积骨密度（vBMD）下降1.57%±8.83%。ΔvBMD小于ΔaBMD-LS（p<0.05）。体重指数（BMI）、全身和躯干的脂肪组织以及瘦软组织（LST）均显著下降（p<0.05）。内脏脂肪组织的减少率显著高于皮下脂肪组织（p<0.05）。ΔBMI与ΔaBMD-LS之间存在弱正相关（r=0.254，p<0.05），且ΔBMI与各种身体成分的变化呈正相关（p<0.05）。
术后BMI的下降伴随着BMD、脂肪和LST含量的降低，降低比例不同。我们的研究结果表明，QCT可作为减重手术患者术后BMD和身体成分随访的补充方法。
