Impact of gastrectomy for gastric cancer on postoperative bone mineral density loss and fracture risk: A multicenter study

IF 7.4 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2025-08-12 DOI:10.1016/j.clnu.2025.08.010

Atsushi Morito , Kojiro Eto , Hiroki Tsubakihara , Satoshi Ida , Rie Makuuchi , Naoki Miyazaki , Tomoyuki Irino , Masaru Hayami , Souya Nunobe , Masaaki Iwatsuki

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引用次数: 0

Abstract

Background

Bone mineral density (BMD) reduction and vertebral fractures (VFs) are complications following gastrectomy for gastric cancer (GC), impacting both quality of life and mortality. However, the longitudinal effects of gastrectomy on BMD and VFs remain unclear.

Methods

This multicenter retrospective study analyzed 485 patients with GC who underwent curative gastrectomy between 2005 and 2018. The patients were categorized by gastrectomy (distal gastrectomy [DG] or total gastrectomy [TG]) and reconstruction (Billroth-I [BI] or Roux-en-Y [RY]). BMD was assessed using L1 vertebral computed tomography attenuation, and VFs were evaluated preoperatively and 1, 3, and 5 years postoperatively. Statistical analyses identified predictive factors for BMD reduction and VFs.

Results

The TGRY group showed the greatest BMD reduction, followed by the DGRY and DGBI groups, over the 5-year period. Patients who underwent TGRY had a significantly greater decrease in BMD than those who underwent DGRY (coefficient: 10.02, 95 % confidence interval [CI]: 5.53–14.50, P < 0.001), while patients who underwent DGBI experienced a significantly smaller decrease (coefficient: −5.55, 95 % CI: −9.52 to −1.55, P = 0.007). The overall incidence of VFs at 5 years was 19.2 %, with a significantly greater BMD reduction observed in the VF group. The type of gastrectomy and reconstruction method were not significant risk factors for VFs.

Conclusions

BMD reduction was better contained in DGRY than TGRY and in DGBI than DGRY. While VFs were more frequent in TGRY, these differences were not statistically significant. However, significant BMD reduction was observed in patients with VFs, suggesting a potential correlation.

查看原文本刊更多论文

胃癌胃切除术对术后骨密度损失和骨折风险的影响：一项多中心研究

骨矿物质密度（BMD）降低和椎体骨折（VFs）是胃癌（GC）胃切除术后的并发症，影响患者的生活质量和死亡率。然而，胃切除术对BMD和VFs的纵向影响尚不清楚。方法本研究是一项多中心回顾性研究，对2005年至2018年间行根治性胃切除术的485例胃癌患者进行分析。患者按胃切除术（远端胃切除术[DG]或全胃切除术[TG]）和胃重建（Billroth-I [BI]或Roux-en-Y [RY]）进行分类。通过L1椎体计算机断层扫描衰减评估BMD，术前和术后1、3、5年评估VFs。统计分析确定了BMD降低和VFs的预测因素。结果在5年的时间里，TGRY组骨密度降低幅度最大，其次是DGRY组和DGBI组。接受TGRY患者的骨密度下降明显大于DGRY患者（系数：10.02,95%可信区间[CI]: 5.53-14.50, P < 0.001），而接受DGBI患者的骨密度下降明显较小（系数：- 5.55,95% CI: - 9.52至- 1.55,P = 0.007）。5年VFs的总发生率为19.2%，在VF组中观察到明显更大的BMD降低。胃切除术类型和胃重建方式不是VFs发生的显著危险因素。结论DGRY组的骨密度降低效果优于TGRY组，DGBI组的骨密度降低效果优于DGRY组。虽然VFs在TGRY中更常见，但这些差异没有统计学意义。然而，在VFs患者中观察到明显的BMD降低，提示潜在的相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.