The Bone Disorder Following Gastric Resection -Comparative Analysis of the MD and DEXA Methods-

Nobukuni Terata, Haruo Sano, Haruaki Ishibashi, Tohru Tani, Junsuke Shibata, Masashi Kodama, Itsuaki Yuu*, Itsuo Yamamoto*, Rikuji Morita*

First Department of Surgery, Shiga University of Medical Science
*Department of Radiological Medicine, Shiga University of Medical Science

The incidence of postgastrectomy bone disorder was assessed in gastric cancer patients who received a curative operation. The bone mineral content was measured using either microdensitometry (MD) method (n=81 patients) or dual energy X-ray absorptiometry (DEXA) method (n=55 patients). These two groups were comparable in age, sex (mostly women), and the period after gastric resection (significantly evident more than 3 years after surgery). A similar incidence of bone disorder was observed between the two methods, even though the scores of individual patients did not always show a good correlation. We further investigated the MD method (which was easily and conveniently performed by clinicians) and the DEXA method to exclude the effect of surrounding soft tissue and directly estimate the BMD value of the lumbar bone. The discrepancy between the MD and DEXA methods can be partially explained by the fact that the former includes cortical bone and the latter measures trabecular bone. Of interest is the fact that there was a good correlation between the ΣGS value of the metacarpal MD method and the bone mineral density (BMD) value of the calcaneal single energy X-ray absorptiometry (SXA) method, but not between that of the metacarpal MD and lumbar DEXA methods. There was a remarkable drop in the total score of the MD method after the administration of 1α-OH-D₃. These improvements were noted in 12 of 19 cases.

Key words
bone disorder after gastrectomy, gastric cancer patient, microdensitometry, dual energy X-ray absorptiometry, single energy X-ray absorptiometry

Reprint requests
Nobukuni Terata First Department of Surgery, Siga University of Medical Science
Seta, Tsukinowa-cho, Ohtsu City, 520-21 JAPAN

Accepted
March 3, 1993

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