Shapses Sue A, Pop L Claudia, Wang Yang
Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ.
Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ.
Nutr Res. 2017 Mar;39:1-13. doi: 10.1016/j.nutres.2016.12.010. Epub 2017 Jan 18.
Accumulating evidence supports a complex relationship between adiposity and osteoporosis in overweight/obese individuals, with local interactions and endocrine regulation by adipose tissue on bone metabolism and fracture risk in elderly populations. This review was conducted to summarize existing evidence to test the hypothesis that obesity is a risk factor for bone health in aging individuals. Mechanisms by which obesity adversely affects bone health are believed to be multiple, such as an alteration of bone-regulating hormones, inflammation, oxidative stress, the endocannabinoid system, that affect bone cell metabolism are discussed. In addition, evidence on the effect of fat mass and distribution on bone mass and quality is reviewed together with findings relating energy and fat intake with bone health. In summary, studies indicate that the positive effects of body weight on bone mineral density cannot counteract the detrimental effects of obesity on bone quality. However, the exact mechanism underlying bone deterioration in the obese is not clear yet and further research is required to elucidate the effect of adipose depots on bone and fracture risk in the obese population.
越来越多的证据支持超重/肥胖个体中肥胖与骨质疏松症之间存在复杂关系,脂肪组织通过局部相互作用和内分泌调节对老年人群的骨代谢和骨折风险产生影响。本综述旨在总结现有证据,以验证肥胖是老年个体骨骼健康风险因素这一假设。肥胖对骨骼健康产生不利影响的机制被认为是多方面的,如骨调节激素的改变、炎症、氧化应激、内源性大麻素系统等,这些都会影响骨细胞代谢,本文对此进行了讨论。此外,本文还综述了脂肪量和分布对骨量和骨质量影响的证据,以及能量和脂肪摄入与骨骼健康相关的研究结果。总之,研究表明体重对骨密度的积极影响无法抵消肥胖对骨质量的不利影响。然而,肥胖人群骨骼退化的确切机制尚不清楚,需要进一步研究以阐明脂肪储存对肥胖人群骨骼和骨折风险的影响。