Department of Medicine, University of Auckland, Auckland, New Zealand.
Arch Biochem Biophys. 2010 Nov 1;503(1):20-7. doi: 10.1016/j.abb.2010.06.027. Epub 2010 Jul 3.
Body weight is a principal determinant of bone density and fracture risk, and adipose tissue mass is a major contributor to this relationship. In contrast, some recent studies have argued that "fat mass after adjustment for body weight" actually has a deleterious effect on bone, but these analyses are confounded by the co-linearity between the variables studied, and therefore have produced misleading results. Mechanistically, fat and bone are linked by a multitude of pathways, which ultimately serve the function of providing a skeleton appropriate to the mass of adipose tissue it is carrying. Adiponectin, insulin/amylin/preptin, leptin and adipocytic estrogens are all likely to be involved in this connection. In the clinic, the key issues are that obesity is protective against osteoporosis, but underweight is a major preventable risk factor for fractures.
体重是骨密度和骨折风险的主要决定因素，而脂肪组织质量是这种关系的主要贡献者。相比之下，一些最近的研究认为，“调整体重后的脂肪量”实际上对骨骼有不良影响，但这些分析受到所研究变量之间的共线性的干扰，因此产生了误导性的结果。从机制上讲，脂肪和骨骼通过多种途径联系在一起，这些途径最终的功能是为承载的脂肪组织提供适当的骨骼。脂联素、胰岛素/胰岛淀粉样肽/前胃泌素、瘦素和脂肪细胞雌激素都可能参与其中。在临床上，关键问题是肥胖对骨质疏松症有保护作用，但体重过轻是骨折的一个主要可预防的危险因素。
