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. 2024 Dec 27;24(1):420.
doi: 10.1186/s12893-024-02717-4.

Perioperative risk factors for osteoporosis after radical gastrectomy for gastric cancer

Hyun-Jae Lee  1 , Hye Seong Ahn  2 , Dong-Seok Han  3
Affiliations

Perioperative risk factors for osteoporosis after radical gastrectomy for gastric cancer

Hyun-Jae Lee et al. BMC Surg. .

Abstract

Background: Osteoporosis, a frequent complication of gastrectomy, increases with age, and the average age of gastric cancer patients continues to rise. This study aims to analyze perioperative factors of osteoporosis after radical gastrectomy.

Materials and methods: This retrospective cohort study included patients who underwent dual-energy-X-ray absorptiometry after gastrectomy due to gastric cancer between 2016 and 2019 at Seoul Boramae Medical Center. Data were analyzed from before surgery to 12 months after surgery. Statistical analyses identified osteoporosis risk factors among perioperative factors.

Results: Among 189 patients, osteoporosis was diagnosed in 72 patients and peaked at 36 months postoperatively (46.3%; 24 out of 54) with the lowest mean T score of -3.34 although Ca and vitamin D supplements were prescribed to 157 patients (83.1%) on average 32.4 months postoperatively. In multivariate analysis, age (P = 0.002; Adjusted OR: 1.059, 95% CI: 1.020-1.098), body weight (P = 0.009; Adjusted OR: 0.950, 95% CI: 0.914-0.987), sex (P = 0.021; Adjusted OR: 2.322, 95% CI: 1.138-4.739), and serum ALP (P = 0.009; Adjusted OR: 1.023, 95% CI: 1.006-1.040) were significant preoperatively. Additionally, age (P = 0.005; Adjusted OR: 1.067, 95% CI: 1.020-1.116), serum Ca (P = 0.046; Adjusted OR: 0.357, 95% CI: 0.130-0.980), Cr (P = 0.003; Adjusted OR: 0.021, 95% CI: 0.002-0.268), and ALP (P = 0.014; Adjusted OR: 1.017, 95% CI: 1.003-1.030) were observed significantly at 12 months postoperatively.

Conclusions: 38.1% of patients were diagnosed with osteoporosis after radical gastrectomy, despite Ca and vitamin D supplements. Age, body weight, sex, serum Ca, Cr, and ALP correlated with osteoporosis perioperatively.

Keywords: Alkaline phosphatase; Calcium; Gastrectomy; Gastric cancer; Osteoporosis; Risk factor.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the ethics committee of the institutional review board of the Seoul Metropolitan Government Seoul National University (SMG-SNU) Medical Center (approval number: 10-2018-62-071) and waved the need for parental consent given the retrospective nature of the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of patient enrollment
Fig. 2
Fig. 2
The changes in bone status ratio after gastrectomy in patients with gastric cancer. m: months
Fig. 3
Fig. 3
The changes in the mean of the T score after gastrectomy in patients with gastric cancer. m: months
See this image and copyright information in PMC

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