Relationship between physical activity and bone mineral density loss after gastrectomy in gastric cancer patients

Abstract

Abstract Purpose: The prevention of osteoporosis is a particularly relevant issue for gastric cancer survivors. We investigated the relationship between postoperative physical activity and the change of bone mineral density (BMD) in patients with gastric cancer.Methods: Patients who underwent radical gastrectomy for gastric cancer were enrolled in this single-center prospective cohort study. Physical activity was evaluated using the International Physical Activity Questionnaire Short Form at postoperative month (POM) 6 and patients were classified into high, middle, and low physical activity groups accordingly. The primary outcome was the change in BMD from baseline at POM 12, which was expressed as a percentage of the young adult mean (YAM). The YAM of the lumbar spine and femoral neck was measured by dual-energy X-ray absorptiometry. Results: One hundred ten patients were enrolled in this study. The physical activity level at POM6 was classified as high (n=50; 45%), middle (n=25; 23%), and low (n=35; 32%). The mean decrease of YAM% was 5.1% in the lumbar spine and 4.2% in the femoral neck at POM 12. A multivariable-adjusted logistic regression model revealed that low physical activity at POM 6 was a significant risk factor for BMD loss at POM 12 (odds ratio, 3.63; 95% confidence interval, 1.45–9.11; p=0.006).Conclusion: Low physical activity after gastrectomy is an independent risk factor for decreased BMD at POM12. The introduction of exercise may prevent osteoporosis after the surgical treatment of gastric cancer.