Research on DXA bone density measurements and trabecular bone scores in obese Chinese women and men before and after bariatric surgery

Abstract

Objective Dual energy X-ray absorptiometry (DXA) was used to analyze body composition, bone mineral density (BMD) parameters and the trabecular bone score (TBS) in obese patients before, 3 months after and 1 year after bariatric surgery as a method to evaluate the changes in BMD and skeletal microarchitecture (MA) in obese patients after bariatric surgery and to provide a basis for further accurate assessment of the bone health status of this population and subsequent treatment. Methods This study was a retrospective analysis of 167 patients who underwent bariatric surgery and DXA bone density measurements in our hospital from June 2017 to December 2022. Forty-one patients underwent DXA imaging before surgery and 3 months and 1 year after surgery. First, the changes in BMD and TBS before and after surgery were analyzed. Then, the changes in BMD and TBS before and after surgery were analyzed according to sex and obesity groups. Finally, the correlations between the TBS or BMD and body composition 1 year after surgery were analyzed. Results Before bariatric surgery, the Z scores of the lumbar spine, femoral neck and total hip and the BMD of the femoral neck of females were lower than those of males (p < 0.05), but the average values were normal. 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 obese individuals of different sexes. A negative correlation was observed between the TBS and fat percentage (total body, legs, trunk, android area) and the lumbar spine Z score in patients 1 year after bariatric surgery (p < 0.05). Conclusions Bariatric surgery in obese patients has no obvious adverse effects on BMD or TBS. DXA can better evaluate the changes in BMD and MA in obese patients after bariatric surgery, providing a basis for the clinical evaluation of the postbariatric efficacy of bariatric surgery in obese patients and subsequent accurate assessment of the bone health status and treatment of this population.