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中华肥胖与代谢病电子杂志 ›› 2025, Vol. 11 ›› Issue (03) : 222 -226. doi: 10.3877/cma.j.issn.2095-9605.2025.03.009

综述

肥胖青少年接受减重代谢手术后骨骼健康的研究进展
王思雨1, 高丽莲2, 于影1, 杨华2, 张雯1, 林清然2,()   
  1. 1510632 广州,暨南大学护理学院
    2510630 广州,暨南大学附属第一医院
  • 收稿日期:2025-05-30 出版日期:2025-08-30
  • 通信作者: 林清然

Research advances in bone health following metabolic and bariatric surgery in adolescents with obesity

Siyu Wang1, Lilian Gao2, Ying Yu1, Wah Yang2, Wen Zhang1, Qingran Lin2,()   

  1. 1School of Nursing, Jinan University, Guangzhou, 510632, China
    2The First Affiliated Hospital of Jinan University, Guangzhou, 510630, China
  • Received:2025-05-30 Published:2025-08-30
  • Corresponding author: Qingran Lin
引用本文:

王思雨, 高丽莲, 于影, 杨华, 张雯, 林清然. 肥胖青少年接受减重代谢手术后骨骼健康的研究进展[J/OL]. 中华肥胖与代谢病电子杂志, 2025, 11(03): 222-226.

Siyu Wang, Lilian Gao, Ying Yu, Wah Yang, Wen Zhang, Qingran Lin. Research advances in bone health following metabolic and bariatric surgery in adolescents with obesity[J/OL]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2025, 11(03): 222-226.

在全球青少年肥胖问题日益严峻及其传统干预措施效果不彰的背景下,减重代谢手术(MBS)作为一项高效的治疗选择应运而生。然而,MBS在为青少年带来显著减重获益的同时,也为其独特的生理特点骨骼快速生长期,带来了新的临床挑战:潜在的骨骼健康风险。目前对于MBS如何干扰青少年骨代谢的长效机制认识尚浅,其远期骨骼安全性的循证医学证据亟待完善。本文系统综述减重代谢手术对肥胖青少年骨骼健康的影响,评估肥胖青少年接受减重代谢手术后骨骼健康,为青少年营养补充提供循证依据。

Amidst the escalating global epidemic of adolescent obesity and the limited efficacy of traditional interventions, Metabolic and bariatric surgery (MBS) has emerged as a highly effective treatment option. However, while MBS provides significant weight loss benefits for adolescents, it also presents new clinical challenges related to their unique physiological stage of rapid skeletal growth, posing potential risks to bone health. Currently, the long-term mechanisms by which MBS interferes with adolescent bone metabolism are not fully understood, and evidence-based data regarding its long-term skeletal safety are urgently needed. This review systematically examines the effects of MBS on bone health in adolescents with obesity, aiming to provide an evidence-based assessment of skeletal outcomes and to guide nutritional supplementation strategies postoperatively.

[1]
NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults [J]. Lancet, 2024, 403(10431): 1027-1050.
[2]
Raj M. Obesity and cardiovascular risk in children and adolescents [J]. Indian J Endocrinol Metab, 2012, 16(1): 13-19.
[3]
Inge TH, Courcoulas AP, Jenkins TM, et al. Five-year outcomes of gastric bypass in adolescents as compared with adults [J]. N Engl J Med, 2019, 380(22): 2136-2145.
[4]
Halloun R, Weiss R. Bariatric surgery in adolescents with obesity: long-term perspectives and potential alternatives [J]. Horm Res Paediatr, 2022, 95(2): 193-203.
[5]
Sperb LF, Leotti VB, Silveiro SP, et al. Long-term changes in bone density and bone metabolism after gastric bypass surgery: a retrospective cohort study [J]. Obes Surg, 2023, 33(3): 911-919.
[6]
Mao HL, Li L, Fan Q, et al. Endothelium-specific depletion of LRP1 improves glucose homeostasis through inducing osteocalcin [J]. Nat Commun, 2021, 12(1): 5296.
[7]
WHO. Global Accelerated Action for the Health of Adolescents (AA-HA!): guidance to support country implementation [M]. Geneva: WHO, 2017.
[8]
Eisenberg D, Shikora SA, Aarts E, et al. 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): indications for metabolic and bariatric surgery [J]. Surg Obes Relat Dis, 2022, 18(12): 1345-1356.
[9]
Janson A, Järvholm K, Sjögren L, et al. Metabolic and bariatric surgery in adolescents: for whom, when, and how? [J]. Horm Res Paediatr, 2023, 96(6): 609-619.
[10]
中国医师协会外科医师分会肥胖和糖尿病外科医师委员会. 中国儿童和青少年肥胖症外科治疗指南(2019版) [J/OL].中华肥胖与代谢病电子杂志, 2019, 5(1): 3-9.
[11]
Pratt JSA, Browne A, Browne NT, et al. ASMBS pediatric metabolic and bariatric surgery guidelines, 2018 [J]. Surg Obes Relat Dis, 2018, 14(7): 882-901.
[12]
Chalklin CG, Ryan Harper EG, Beamish AJ. Metabolic and bariatric surgery in adolescents [J]. Curr Obes Rep, 2021, 10(2): 61-69.
[13]
Xanthakos SA, Khoury JC, Inge TH, et al. Nutritional risks in adolescents after bariatric surgery [J]. Clin Gastroenterol Hepatol, 2020, 18(5): 1070-1081. e5.
[14]
Gu L, Chen B, Du N, et al. Relationship between bariatric surgery and gastroesophageal reflux disease: a systematic review and meta-analysis [J]. Obes Surg, 2019, 29(12): 4105-4113.
[15]
张丽,卜淑敏. 肥胖对骨骼的双重影响和机制以及在骨疾病中的作用 [J]. 中国骨质疏松杂志, 2022, 28(4): 585-589.
[16]
Ma CM, Lu N, Zhang MM, et al. The relationship between obesity and bone mineral density in children and adolescents: analysis of the National Health and Nutrition Examination Survey [J]. Arch Osteoporos, 2023, 18(1): 25.
[17]
Gil-Cosano JJ, Gracia-Marco L, Ubago-Guisado E, et al. Inflammatory markers and bone mass in children with overweight/obesity: the role of muscular fitness [J]. Pediatr Res, 2020, 87(1): 42-47.
[18]
Anand H, Jeremy C, Jill U. Leptin and the intervertebral disc: a biochemical link exists between obesity, intervertebral disc degeneration and low back pain-an in vitro study in a bovine model [J]. Eur Spine J, 2019, 28(2): 214-223.
[19]
Guss JD, Ziemian SN, Luna M, et al. The effects of metabolic syndrome, obesity, and the gut microbiome on load-induced osteoarthritis [J]. Osteoarthritis Cartilage, 2019, 27(1): 129-139.
[20]
Kelly AS, Armstrong SC, Michalsky MP, et al. Obesity in adolescents: a review [J]. JAMA, 2024, 332(9): 738-748.
[21]
Misra M, Singhal V, Carmine B, et al. Bone outcomes following sleeve gastrectomy in adolescents and young adults with obesity versus non-surgical controls [J]. Bone, 2020, 134: 115290.
[22]
Yu EW, Bouxsein ML, Roy AE, et al. Bone loss after bariatric surgery: discordant results between DXA and QCT bone density [J]. J Bone Miner Res, 2014, 29(3): 542-550.
[23]
Bezerra A, Boppre G, Freitas L, et al. Body composition changes in adolescents who underwent bariatric surgery: a systematic review and meta-analysis [J]. Curr Obes Rep, 2024, 13(1): 107-120.
[24]
Mitchell DM, Singhal V, Animashaun A, et al. Skeletal effects of sleeve gastrectomy in adolescents and young adults: a 2-year longitudinal study [J]. J Clin Endocrinol Metab, 2023, 108(4): 847-857.
[25]
Weiner A, Cowell A, McMahon DJ, et al. The effects of adolescent laparoscopic adjustable gastric band and sleeve gastrectomy on markers of bone health and bone turnover [J]. Clin Obes, 2020, 10(6): e12411.
[26]
Misra M, Bredella MA. Bone metabolism in adolescents undergoing bariatric surgery [J]. J Clin Endocrinol Metab, 2021, 106(2): 326-336.
[27]
Beamish AJ, Ryan Harper E, Järvholm K, et al. Long-term outcomes following adolescent metabolic and bariatric surgery [J]. J Clin Endocrinol Metab, 2023, 108(9): 2184-2192.
[28]
Saltzman E, Karl JP. Nutrient deficiencies after gastric bypass surgery [J]. Annu Rev Nutr, 2013, 33: 183-203.
[29]
Hu L, Wang L, Li S, et al. Evaluation study of single-anastomosis duodenal-ileal bypass with sleeve gastrectomy in the treatment of Chinese obese patients based on efficacy and nutrition [J]. Sci Rep, 2024, 14(1): 6522.
[30]
Henfridsson P, Laurenius A, Wallengren O, et al. Micronutrient intake and biochemistry in adolescents adherent or nonadherent to supplements 5 years after Roux-en-Y gastric bypass surgery [J]. Surg Obes Relat Dis, 2019, 15(9): 1494-1502.
[31]
Ulloque-Badaracco JR, Alarcon-Braga EA, Hernandez-Bustamante EA, et al. Vitamin B12, folate, and homocysteine levels in children and adolescents with obesity: a systematic review and meta-analysis [J]. Front Public Health, 2025, 13: 1481002.
[32]
Zolfaghari F, Khorshidi Y, Moslehi N, et al. Nutrient deficiency after bariatric surgery in adolescents: a systematic review and meta-analysis [J]. Obes Surg, 2024, 34(1): 206-217.
[33]
Takahashi N, Udagawa N, Suda T. Vitamin D endocrine system and osteoclasts [J]. Bonekey Rep, 2014, 3: 495.
[34]
Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline [J]. J Clin Endocrinol Metab, 2011, 96(7): 1911-1930.
[35]
Ong MT, Tsang KC, Lu VYZ, et al. Effect of serum 25-hydroxyvitamin D level on quadriceps strength: a systematic review and meta-analysis [J]. BMC Sports Sci Med Rehabil, 2024, 16(1): 215.
[36]
McNulty H, Ward M, Hoey L, et al. Addressing optimal folate and related B-vitamin status through the lifecycle: health impacts and challenges [J]. Proc Nutr Soc, 2019, 78(3): 449-462.
[37]
Fullmer MA, Abrams SH, Hrovat K, et al. Nutritional strategy for adolescents undergoing bariatric surgery: report of a working group of the Nutrition Committee of NASPGHAN/NACHRI [J]. J Pediatr Gastroenterol Nutr, 2012, 54(1): 125-135.
[38]
Bellicha A, van Baak MA, Battista F, et al. Effect of exercise training before and after bariatric surgery: a systematic review and meta-analysis [J]. Obes Rev, 2021, 22(Suppl 4): e13296.
[39]
Diniz-Sousa F, Veras L, Boppre G, et al. The effect of an exercise intervention program on bone health after bariatric surgery: a randomized controlled trial [J]. J Bone Miner Res, 2021, 36(3): 489-499.
[40]
Tagliaferri C, Wittrant Y, Davicco MJ, et al. Muscle and bone, two interconnected tissues [J]. Ageing Res Rev, 2015, 21: 55-70.
[41]
Bolling CF, Armstrong SC, Reichard KW, et al. Metabolic and bariatric surgery for pediatric patients with severe obesity [J]. Pediatrics, 2019, 144(6): e20193224.
[42]
Mechanick JI, Kushner RF, Sugerman HJ, et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery medical guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient [J]. Obesity (Silver Spring), 2009, 17(Suppl 1): S1-70.
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