Frechette Danielle M, Krishnamoorthy Divya, Pamon Tee, Chan M Ete, Patel Vihitaben, Rubin Clinton T
Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York.
Ann N Y Acad Sci. 2017 Dec;1409(1):33-50. doi: 10.1111/nyas.13442. Epub 2017 Sep 11.
The incidence of obesity is rapidly rising, increasing morbidity and mortality rates worldwide. Associated comorbidities include type 2 diabetes, heart disease, fatty liver disease, and cancer. The impact of excess fat on musculoskeletal health is still unclear, although it is associated with increased fracture risk and a decline in muscular function. The complexity of obesity makes understanding the etiology of bone and muscle abnormalities difficult. Exercise is an effective and commonly prescribed nonpharmacological treatment option, but it can be difficult or unsafe for the frail, elderly, and morbidly obese. Exercise alternatives, such as low-intensity vibration (LIV), have potential for improving musculoskeletal health, particularly in conditions with excess fat. LIV has been shown to influence bone marrow mesenchymal stem cell differentiation toward higher-order tissues (i.e., bone) and away from fat. While the exact mechanisms are not fully understood, recent studies utilizing LIV both at the bench and in the clinic have demonstrated some efficacy. Here, we discuss the current literature investigating the effects of obesity on bone, muscle, and bone marrow and how exercise and LIV can be used as effective treatments for combating the negative effects in the presence of excess fat.
肥胖症的发病率正在迅速上升，导致全球范围内的发病率和死亡率不断增加。相关的合并症包括2型糖尿病、心脏病、脂肪肝和癌症。尽管多余的脂肪与骨折风险增加和肌肉功能下降有关，但其对肌肉骨骼健康的影响仍不明确。肥胖症的复杂性使得理解骨骼和肌肉异常的病因变得困难。运动是一种有效且常用的非药物治疗选择，但对于体弱、老年人和病态肥胖者来说，运动可能困难或不安全。运动替代方法，如低强度振动（LIV），有改善肌肉骨骼健康的潜力，特别是在脂肪过多的情况下。LIV已被证明会影响骨髓间充质干细胞向更高层次组织（即骨骼）分化，并远离脂肪。虽然确切机制尚未完全了解，但最近在实验室和临床中使用LIV的研究已显示出一定疗效。在此，我们讨论当前研究肥胖对骨骼、肌肉和骨髓影响的文献，以及运动和LIV如何作为有效治疗方法来对抗脂肪过多时的负面影响。
