Table_1_Effect of regional body composition changes on bone density remodeling after sleeve gastrectomy.docx

BackgroundSleeve gastrectomy (SG) results in bone mineral density (BMD) loss and varying body composition parameters. However, the effects of body compositions on bone health are controversial. In order to accurately demonstrate their relationship and provide new insights into the causes of BMD loss after sleeve gastrectomy, this study is aimed to investigate the role of changes in body composition in BMD loss 12 months after SG.Methods41 Chinese individuals with obesity (25 women and 16 men) who underwent SG were prospectively examined for at least 12 months. Measurements of anthropometrics, body composition, BMD and blood samples were collected.ResultsFor 12 months, the femoral neck (FN) BMD and total hip (TH) BMD decreased significantly compared with baseline in both sexes but not lumbar spine (LS) BMD. Greater TH BMD loss was observed in men than in women. For the first 6 months post-SG, the FN BMD loss was positively associated with the estimated fat free mass index (eFFMI) reduction in women (adjusted β = 0.77, P = 0.004) and positively associated with reduction of subcutaneous fat area (SFA) in men (r = 0.931, P = 0.007). For 12 months post-SG, the FN BMD loss was negatively associated with visceral fat area (VFA) reduction in women (adjusted β = -0.58, P = 0.027) and men (adjusted β = -0.68, P = 0.032). TH BMD loss was positively associated with waist circumference reduction in women (r = 0.448, P = 0.028).ConclusionFN and TH BMD decrease after SG in both women and men. The changes in body compositions are associated with BMD loss at different time points and bone sites. Our data emphasize the limitation of simply taking the total weight loss (% TWL) as an influencing factor of bone mineral density and the necessity of delineating body composition in relevant studies.

背景：袖状胃切除术（SG）会导致骨矿物质密度（BMD）下降以及身体成分参数的波动。然而，身体成分对骨骼健康的影响尚存在争议。为了精确展示二者之间的关系，并就袖状胃切除术后BMD下降的成因提供新的见解，本研究旨在探讨袖状胃切除术12个月后身体成分变化在BMD下降中的作用。方法：对41名接受SG手术的肥胖中国个体（其中女性25名，男性16名）进行了至少12个月的前瞻性检查。收集了人体测量学、身体成分、BMD和血液样本的测量数据。结果：在12个月的观察期内，与基线相比，两性股骨颈（FN）BMD和总髋（TH）BMD显著下降，但腰椎（LS）BMD未发生显著变化。男性TH BMD下降幅度大于女性。在SG术后前6个月，女性FN BMD下降与估计的去脂质量指数（eFFMI）的减少呈正相关（调整后β = 0.77，P = 0.004），与男性皮下脂肪面积（SFA）的减少呈正相关（r = 0.931，P = 0.007）。在SG术后12个月，FN BMD下降与女性（调整后β = -0.58，P = 0.027）和男性（调整后β = -0.68，P = 0.032）的内脏脂肪面积（VFA）减少呈负相关。TH BMD下降与女性腰围的减少呈正相关（r = 0.448，P = 0.028）。结论：女性和男性在SG术后FN和TH BMD均下降。身体成分的变化与不同时间点和骨骼部位的BMD下降相关。我们的数据强调，将总体重减少百分比（% TWL）简单视为影响骨矿物质密度的因素具有局限性，相关研究中有必要细化身体成分的分析。