减肥手术对骨密度的影响

The effect of bariatric surgery on bone mineral density

目的通过双能X线吸收测定法（DXA）测量超重或肥胖患者的骨密度,对比分析减肥手术前后骨密度的改变情况。方法根据入选标准及排除标准纳入需要进行减肥手术治疗的超重或肥胖患者,手术前检测基线观察指标,其中包括简易人体测量参数、骨密度。然后,对纳入的患者行腹腔镜下胃旁路术或腹腔镜下袖状胃切除术,术后4~6月复查基线观察指标,重点对比分析减肥手术前后骨密度的改变情况。结果 1减肥手术后,体重、BMI、腰围均明显减少,差异有统计学意义（P〈0.05）。2减肥术后全身骨密度及髋部骨密度均有降低（P〈0.05）。结论腹腔镜下胃旁路术及腹腔镜下袖状胃切除术都是有效的减肥术式,骨密度有不同程度的降低,术后应注意骨密度的维护。

Objective To comparative analyze the change in the bone mineral density （BMD） of the overweight or obese patients before and after bariatric surgery using dual-energy X-ray absorptiometry （DEXA）. Methods Overweight or obese patients who need for bariatric surgery were enrolled based on the inclusion criteria and exclusion criteria. Basic clinical information was recorded and baseline indicators including simple anthropometric parameters and BMD were assessed before the surgery. The patients received laparoscopic Roux-en-Y gastric bypass （LRGBP） or laparoscopic sleeve gastrectomy （LSG）. After 4-6 months of the surgery, the baseline indicators were reassessed. The change of BMD before and after bariatric surgery was comparatively analyzed. Results After the surgery, body weight, BMI, and waist circumference reduced significantly （P 〈 0.05）. The BMD of total body and the hip reduced after bariatric surgery （P 〈 0. 05 ）. Conclusion LRGBP and LSG are effective bariatric surgery. BMD may reduce after the surgery, so it must be noticed and protected.