Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA.
J Clin Densitom. 2013 Oct-Dec;16(4):450-4. doi: 10.1016/j.jocd.2013.08.010. Epub 2013 Sep 22.
Historically, obesity was thought to be advantageous for maintaining healthy bones due to the greater bone mineral density observed in overweight individuals. However, recent observations of increased fracture in some obese individuals have led to concern that common metabolic complications of obesity, such as type 2 diabetes, metabolic syndrome, impaired glucose tolerance, insulin resistance, hyperglycemia, and inflammation may be associated with poor bone health. In support of this hypothesis, greater visceral fat, a hallmark of insulin resistance and metabolic syndrome, is associated with lower bone mineral density. Research is needed to determine if and how visceral fat and/or poor metabolic health are causally associated with bone health. Clinicians should consider adding a marker metabolic health, such as waist circumference or fasting plasma glucose concentration, to other known risk factors for osteoporosis and fracture.
从历史上看，由于超重个体的骨矿物质密度较高，肥胖被认为有利于维持健康的骨骼。然而，最近观察到一些肥胖个体骨折增加，这引起了人们的担忧，即肥胖的常见代谢并发症，如 2 型糖尿病、代谢综合征、葡萄糖耐量受损、胰岛素抵抗、高血糖和炎症，可能与骨骼健康不良有关。支持这一假说的是，内脏脂肪是胰岛素抵抗和代谢综合征的标志，与较低的骨矿物质密度有关。需要研究来确定内脏脂肪和/或代谢健康不良是否以及如何与骨骼健康相关。临床医生应考虑将代谢健康标志物（如腰围或空腹血糖浓度）添加到其他已知的骨质疏松症和骨折风险因素中。
