Shapses Sue A, Riedt Claudia S
Department of Nutritional Sciences, Rutgers University, New Brunswick, New Jersey, USA.
J Nutr. 2006 Jun;136(6):1453-6. doi: 10.1093/jn/136.6.1453.
Of the U.S. population, 65% is either overweight or obese, and weight loss is recommended to reduce co-morbid conditions. However, bone mobilization and loss may also occur with weight loss. The risk for bone loss depends on initial body weight, age, gender, physical activity, and conditions of dieting such as the extent of energy restriction and specific levels of nutrient intake. Older populations are more prone to bone loss with weight loss; in women, this is due at least in part to a reduced dietary Ca intake and/or efficiency of absorption. Potential hormonal mechanisms regulating bone loss during weight loss are discussed, including decreases in estrogen, leptin, glucagon-like peptide-2, growth hormone, and insulin-like growth factor-1, or an increase in cortisol. In contrast, the rise in adiponectin and ghrelin with weight reduction should not be detrimental to bone. Combining energy restriction with exercise does not necessarily prevent bone loss, but may attenuate loss as was shown with additional Ca intake or osteoporosis medications. Future controlled weight loss trials should be designed to further address mechanisms influencing the density and quality of bone sites vulnerable to fracture, in the prevention of osteoporosis.
在美国人口中，65%的人超重或肥胖，建议通过减肥来减少合并症。然而，减肥过程中也可能发生骨质动员和流失。骨质流失的风险取决于初始体重、年龄、性别、身体活动以及节食情况，如能量限制程度和特定营养素摄入水平。老年人群在减肥时更容易发生骨质流失；在女性中，这至少部分归因于饮食中钙摄入量的减少和/或吸收效率降低。文中讨论了减肥期间调节骨质流失的潜在激素机制，包括雌激素、瘦素、胰高血糖素样肽 -2、生长激素和胰岛素样生长因子 -1 的减少，或皮质醇的增加。相比之下，减肥过程中脂联素和胃饥饿素的升高对骨骼应该没有损害。将能量限制与运动相结合不一定能预防骨质流失，但可能会像额外摄入钙或使用骨质疏松症药物那样减轻骨质流失。未来的对照减肥试验应旨在进一步研究影响易骨折骨部位密度和质量的机制，以预防骨质疏松症。
