Division of Geriatric Medicine, Department of Medicine, University of Colorado Denver, Aurora, Colorado, USA.
Obesity (Silver Spring). 2011 Dec;19(12):2345-50. doi: 10.1038/oby.2011.263. Epub 2011 Aug 18.
Previously, we reported significant bone mineral density (BMD) loss in postmenopausal women after modest weight loss. It remains unclear whether the magnitude of BMD change in response to weight loss is appropriate (i.e., proportional to weight loss) and whether BMD is recovered with weight regain. We now report changes in BMD after a 1-year follow-up. Subjects (n = 23) in this secondary analysis were postmenopausal women randomized to placebo as part of a larger trial. They completed a 6-month exercise-based weight loss program and returned for follow-up at 18 months. Dual-energy X-ray absorptiometry (DXA) was performed at baseline, 6, and 18 months. At baseline, subjects were aged 56.8 ± 5.4 years (mean ± s.d.), 10.0 ± 9.2 years postmenopausal, and BMI was 29.6 ± 4.0 kg/m(2). They lost 3.9 ± 3.5 kg during the weight loss intervention. During follow-up, they regained 2.9 ± 3.9 kg. Six months of weight loss resulted in a significant decrease in lumbar spine (LS) (-1.7 ± 3.5%; P = 0.002) and hip (-0.04 ± 3.5%; P = 0.03) BMD that was accompanied by an increase in a biomarker of bone resorption (serum C-terminal telopeptide of type I collagen, CTX: 34 ± 54%; P = 0.08). However, weight regain was not associated with LS (0.05 ± 3.8%; P = 0.15) or hip (-0.6 ± 3.0%; P = 0.81) bone regain or decreased bone resorption (CTX: -3 ± 37%; P = 0.73). The findings suggest that BMD lost during weight reduction may not be fully recovered with weight regain in hormone-deficient, postmenopausal women. Future studies are needed to identify effective strategies to prevent bone loss during periods of weight loss.
此前，我们报道了绝经后妇女适度减肥后骨密度（BMD）显著下降。目前尚不清楚体重减轻引起的 BMD 变化幅度是否合适（即与体重减轻成比例），以及体重恢复时 BMD 是否恢复。我们现在报告了一年随访后的 BMD 变化。作为更大试验的一部分，本二次分析的受试者（n = 23）被随机分配至安慰剂组。他们完成了为期 6 个月的基于运动的减肥计划，并在 18 个月时返回进行随访。基线、6 个月和 18 个月时进行双能 X 射线吸收法（DXA）检查。基线时，受试者年龄为 56.8 ± 5.4 岁（平均值 ± s.d.），绝经后 10.0 ± 9.2 年，BMI 为 29.6 ± 4.0 kg/m2。他们在减肥干预期间减轻了 3.9 ± 3.5 kg。随访期间，体重又增加了 2.9 ± 3.9 kg。6 个月的减肥导致腰椎（LS）（-1.7 ± 3.5%；P = 0.002）和髋部（-0.04 ± 3.5%；P = 0.03）BMD 显著下降，同时伴有骨吸收生物标志物（血清 I 型胶原 C 端肽，CTX：34 ± 54%；P = 0.08）增加。然而，体重恢复与 LS（0.05 ± 3.8%；P = 0.15）或髋部（-0.6 ± 3.0%；P = 0.81）骨恢复或骨吸收减少（CTX：-3 ± 37%；P = 0.73）无关。这些发现表明，在激素缺乏的绝经后妇女中，减肥期间丢失的 BMD 可能无法在体重恢复时完全恢复。需要进一步的研究来确定在减肥期间预防骨丢失的有效策略。
