Reid I R
Department of Medicine, University of Auckland, New Zealand.
Bone. 2002 Nov;31(5):547-55. doi: 10.1016/s8756-3282(02)00864-5.
Body weight impacts on both bone turnover and bone density, and is therefore an important risk factor for vertebral and hip fractures, ranking in importance alongside that of age. The effect of body weight is probably contributed to by both fat mass and lean mass, although in postmenopausal women fat mass has been more consistently demonstrated to be important. A number of mechanisms for the fat-bone relationship exist and include the effect of soft tissue mass on skeletal loading, the association of fat mass with the secretion of bone-active hormones from the pancreatic beta cell (including insulin, amylin, and preptin), and the secretion of bone-active hormones (e.g., estrogens and leptin) from the adipocyte. These factors alone probably do not fully explain the observed clinical associations, and further study of the actions on bone of novel hormones related to nutrition is an important area of further research. An understanding of this aspect of bone biology may open the way for new treatments of osteoporosis. More immediately, the role of weight maintenance in the prevention of osteoporosis is an important public health message that needs to be more widely appreciated.
体重对骨转换和骨密度均有影响，因此是椎体和髋部骨折的重要风险因素，其重要性与年龄相当。体重的影响可能是由脂肪量和瘦体重共同作用导致的，不过在绝经后女性中，脂肪量一直被更一致地证明是重要的。脂肪与骨骼关系的机制有多种，包括软组织质量对骨骼负荷的影响、脂肪量与胰腺β细胞分泌的骨活性激素（包括胰岛素、胰淀素和前胰岛素原）之间的关联，以及脂肪细胞分泌骨活性激素（如雌激素和瘦素）。仅这些因素可能无法完全解释所观察到的临床关联，进一步研究与营养相关的新型激素对骨骼的作用是一个重要的进一步研究领域。对骨生物学这一方面的理解可能为骨质疏松症的新治疗方法开辟道路。更直接的是，维持体重在预防骨质疏松症中的作用是一个重要的公共卫生信息，需要得到更广泛的认识。
