AbstractObjective: Dual energy X-ray absorptiometry (DXA) was used to analyze body composition, bone mineral density (BMD) parameters and the trabecular bone score (TBS) in patients with obesity before, 3 months after and 1 year after bariatric surgery as a method to evaluate the changes in BMD and skeletal microarchitecture (MA) in patients with obesity after bariatric surgery and to provide a basis for further accurate assessment of the bone health status of this population and subsequent treatment.

摘要目的：采用双能X线骨密度仪（DXA）分析肥胖患者减肥术前、术后3个月和术后1年的身体成分、骨密度（BMD）参数和骨小梁评分（TBS），评价肥胖患者减肥术后BMD和骨骼微结构（MA）的变化，为进一步准确评估该人群的骨骼健康状况和后续治疗提供依据。

Methods: This study was a retrospective analysis of 41 patients that underwent DXA imaging before, 3 months after and maximum 1 year after bariatric surgery. The follow-up rate in both periods was 100%. First, the changes in BMD and TBS before and after surgery were compared between patients grouped by sex and obesity degree.

方法：本研究回顾性分析了41例减肥手术前，术后3个月和最多1年接受DXA成像的患者。两个时期的随访率均为100%。首先，比较按性别和肥胖程度分组的患者手术前后BMD和TBS的变化。

Secondly, the correlations between the TBS or BMD and body composition 1 year after surgery were analyzed. Results: The BMD and TBS were within the normal range after bariatric surgery. Changes in the BMD and TBS were related to time, the degree of obesity and sex. Changes in the TBS were closely related to changes in the BMD, and the trends in the changes in the BMD were basically the same among the different groups of individuals with obesity of different sexes.

其次，分析术后1年TBS或BMD与身体成分之间的相关性。结果：减肥手术后BMD和TBS均在正常范围内。BMD和TBS的变化与时间，肥胖程度和性别有关。TBS的变化与BMD的变化密切相关，不同性别肥胖个体的BMD变化趋势基本相同。

A negative correlation was observed between the TBS and fat percentage (total body, leg, trunk, android area), as well as the lumbar spine Z-score in patients 1 year after bariatric surgery (p < 0.05). Conclusions: Bariatric surgery in patients with obesity has no obvious adverse effects on BMD or TBS.

减肥手术后1年患者的TBS与脂肪百分比（全身，腿部，躯干，机器人区域）以及腰椎Z评分呈负相关（p<0.05）。结论：肥胖患者的减肥手术对BMD或TBS没有明显的不良影响。

DXA can be used to better evaluate the changes in BMD and MA in patients with obesity after bariatric surgery, providing a basis for the clinical evaluation of post-bariatric surgery efficacy .

DXA可用于更好地评估肥胖患者减肥手术后BMD和MA的变化，为减肥手术后疗效的临床评估提供依据。

IntroductionSignificant changes in body composition and distribution occur in patients with obesity after bariatric surgery, and dual energy X-ray absorptiometry (DXA) measurements can provide many references for the evaluation of postoperative efficacy and the prevention of complications. In addition to concerns about changes in body composition resulting from weight loss surgery, the impact of weight loss surgery on bone health is becoming increasingly concerning, and people are beginning to worry about the adverse effects of weight loss on bone health, such as bone loss, increased fragility, and even an increased risk of fracture after weight loss surgery1.Bone mineral density (BMD), which is based on DXA measurements, is the primary measure for assessing bone strength and fracture risk.

引言减肥手术后肥胖患者的身体组成和分布发生了显着变化，双能X线吸收仪（DXA）测量可为评估术后疗效和预防并发症提供许多参考。除了担心减肥手术引起的身体成分变化外，减肥手术对骨骼健康的影响也越来越受到关注，人们开始担心减肥对骨骼健康的不利影响，例如骨质流失，脆性增加，甚至减肥手术后骨折风险增加1。基于DXA测量的骨矿物质密度（BMD）是评估骨骼强度和骨折风险的主要指标。

However, studies have shown that approximately 50% of clinical fractures in women with no osteoporosis (i.e., those with BMD T value > -2.5), are diagnosed according to BMD2. Even in patients with type 2 diabetes (T2DM), the BMD is often greater than normal, but the risk of fracture is increased, mainly due to decreased bone quality, especially the destruction of skeletal microarchitecture (MA)3.

然而，研究表明，没有骨质疏松症的女性（即BMD T值>2.5的女性）中约有50%的临床骨折是根据BMD2诊断的。即使在2型糖尿病（T2DM）患者中，骨密度通常也高于正常值，但骨折的风险增加，主要是由于骨质量下降，特别是骨骼微结构（MA）3的破坏。

Moreover, the BMD of most patients with fragility fractures is characterized only as bone mass loss or even within the normal range, suggesting that the protection of bone structure quality is more important than the protection of bone mass4. DXA can only be used to evaluate bone mass and cannot reflect changes in MA or evaluate bone quality; thus, limitations exist in the diagnosis of osteoporosis and the assessment of fracture risk.

此外，大多数脆性骨折患者的骨密度仅表现为骨量减少甚至在正常范围内，这表明保护骨结构质量比保护骨量更重要4。DXA只能用于评估骨量，不能反映MA的变化或评估骨质量；因此，骨质疏松症的诊断和骨折风险的评估存在局限性。

Therefore, a noninvasive tool to evaluate MA, the trabecular bone score (TBS), was developed.Developed abroad in recent years, the TBS is an indicator that ref.

因此，开发了一种评估MA的无创工具，即小梁骨评分（TBS）。TBS是近年来在国外发展起来的一个指标。

Data availability

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Download referencesFundingGuangdong Provincial Bureau of Traditional Chinese Medicine, Project Number: 20222129Author informationAuthor notesThe first two authors participated equally in this article and would qualify for first authorship.These authors contributed equally: Hao Xu, Jian Gong.Authors and AffiliationsDepartment of Endocrinology, the Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, ChinaHuimin You, Zhenjun Huang & Chunping ZengDepartment of Nuclear Medicine, the First Affiliated Hospital of Jinan University, Guangzhou, ChinaHuimin You, Jingjie Shang, Wenjun He, Hao Xu & Jian GongAuthorsHuimin YouView author publicationsYou can also search for this author in.

下载参考文献资助广东省中医药管理局，项目编号：20222129作者信息作者注意到前两位作者平等参与了本文，并有资格成为第一作者。这些作者做出了同样的贡献：郝旭，建工。作者和附属机构广州医科大学第五附属医院内分泌科，中国广州惠民游，黄振军和曾春平暨南大学第一附属医院核医学科，中国广州惠民游，尚敬杰，何文军，郝旭和龚健作者惠民游查看作者出版物您也可以在中搜索作者。

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PubMed Google ScholarContributionsHuimin You and Jingjie Shang wrote the main manuscript text and Wenjun He and Zhenjun Huang prepared figures and tables. Jian Gong, Hao Xu and Chunping Zeng reviewed and guided article. All authors reviewed the manuscript.Corresponding authorsCorrespondence to.

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Reprints and permissionsAbout this articleCite this articleYou, H., Shang, J., Huang, Z. et al. Research on DXA bone density measurements and trabecular bone scores in Chinese men and women with obesity before and after bariatric surgery.

转载和许可本文引用本文You，H.，Shang，J.，Huang，Z。等人对中国肥胖男性和女性减肥手术前后DXA骨密度测量和骨小梁评分的研究。

Sci Rep 14, 29355 (2024). https://doi.org/10.1038/s41598-024-80107-9Download citationReceived: 18 June 2024Accepted: 14 November 2024Published: 26 November 2024DOI: https://doi.org/10.1038/s41598-024-80107-9Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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KeywordsBariatric surgeryBone mineral densityBody compositionTrabecular bone scoreSkeletal microarchitecture

关键词骨外科骨矿物质密度体成分骨小梁评分骨骼微结构