袖状胃切除术后骨损害的研究进展

Research progress of bone damage after sleeve gastrectomy

以袖状胃切除术(sleeve gastrectomy,SG)和胃旁路手术为代表的减重手术能有效改善肥胖,但会增加骨折风险,现有研究提示骨折发生风险为2~5倍。随着SG后对骨健康影响越来越受到关注,目前的研究发现SG对骨密度、骨转化指标(血清钙、骨钙蛋白、碱性磷酸酶、I型胶原N端前肽和I型胶原C端末端肽)和骨髓脂肪细胞的影响可能是增加骨折风险的重要因素。其中骨髓脂肪细胞的异常积聚可能与SG后胃肠道激素改变有关,特别是胃饥饿素酰基转移酶/胃饥饿素/生长激素促分泌素受体系统的变化有望为SG后骨代谢异常提出一种新的解释。

Weight loss operation,represented by sleeve gastrectomy(SG)and Roux-en-Y gastric bypass,can effectively improve obesity,but increase the risk of fractures by 2-5 times according to existing research.Recent studies found that the changed bone mineral density,bone transformation indexes(serum calcium,osteocalcin,alkaline phosphatase,N-terminal propeptide of typeⅠcollagen and C-terminal telopeptide) and bone marrow adipocytes following SG may be important influencing factors to increase the fracture risks.The abnormal accumulation of bone marrow adipocytes may be related to the changes of gastrointestinal hormones after SG,especially the changes of ghrelin O-acyltransferase/ghrelin/growth hormone secretagogues receptor system,which are expected to propose a new explanation for the abnormal bone metabolism after SG.