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| 胃旁路术与骨代谢 |
| Roux-en-Y gastric bypass and bone metabolism |
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| DOI： |
| 中文关键词: 胃旁路手术 维生素D 骨转换 脂联素 瘦素 |
| 英文关键词:Roux-en-Y gastric bypass Vitamin D Bone turnover Adiponectin Leptin |
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| 中文摘要: |
| 肥胖症在世界范围内的发病率逐渐升高，胃旁路术是近年来减肥手术的主要方法之一。手术成功减肥后，骨代谢指标以及骨质量的变化正日益受到重视。术后患者体内钙、维生素D的缺乏引发了PTH升高与BMD下降，PTH升高可引起继发性甲状旁腺功能亢进，骨生成尤其是骨吸收活跃，严重者可导致骨质疏松症。胃旁路术后患者体内脂肪组织减少，导致瘦素产生减少、脂联素产生增加，进而引起骨密度下降。术后补充一定量钙及维生素D可部分纠正二者的缺乏，但具体剂量尚不清楚。定期检测患者体内PTH、Ca、Vit D、骨转换指标、监测骨密度变化等有利于了解胃旁路术对骨代谢的长期影响。 |
| 英文摘要: |
| Abstract：With the increasing prevalence of obesity，Roux-en-Y gastric bypass has become one of the major bariatric surgeries in recent years．More attention has been paid in the changes of bone metabolic markers and bone mass after the successful surgery for weight reduction．After the surgery，the deficiency of calcium and vitamin D(Vit D)can lead to a increase of the parathyroid hormone(PTH)and decrease of the bone marrow density(BMD)．The increase of PTH can cause the secondary hyperparathyroidism，which activates bone formation and especially bone resorption，resulting in osteoporosis in severe cases. Because of the reduction of the adipose tissue in patients with gastric bypass，the leptin production decreases and the adiponectin production increases，resulting in the decrease of BMD．Postoperative supplementation of calcium and vitamin D can partially correct of the insufficiency，however，the specific doses are unknown．Periodic follow-up of PTH，calcium，serum Vit D，markers of bone turnover，and the change of BMD can help us understand the long-terra effect of gastric bypass on bone metabolism． |
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