Dolan Eimear, Swinton Paul A, Sale Craig, Healy Aoife, O'Reilly John
Applied Physiology & Nutrition Research Group, University of São Paulo, São Paulo, Brazil.
School of Health Sciences, Robert Gordon University, Aberdeen, United Kingdom.
Nutr Rev. 2017 Oct 1;75(10):858-870. doi: 10.1093/nutrit/nux046.
The scientific literature shows conflicting evidence about the relationship between adiposity and bone mass in overweight and obese populations. The aim of this review was to quantify the correlation between adipose mass (absolute and relative) and bone mineral density (BMD) in overweight and obese populations. Three databases were searched electronically. In addition, reference lists of relevant articles were screened. A total of 16 studies, comprising 2587 participants and 75 correlation coefficients were selected for inclusion in the review. Data were extracted from each study using a standardized form. Multilevel modeling indicated opposing relationships between BMD and adiposity: absolute adiposity correlated positively, and relative adiposity negatively, with BMD. Sex and age were the primary moderators of these relationships. Strong evidence supported a negative relationship between relative adipose mass and BMD in men (R = -0.37; 95%CI, -0.57 to -0.12) and in those aged less than 25 years (R = -0.28; 95%CI, -0.45 to -0.08). To prevent bone loss in overweight and obese populations, nutrition- and exercise-based interventions that focus on a controlled reduction of adipose mass with concomitant preservation of lean mass are recommended. : PROSPERO no. CRD42015024313.
科学文献表明，关于超重和肥胖人群中肥胖与骨量之间的关系，证据相互矛盾。本综述的目的是量化超重和肥胖人群中脂肪量（绝对和相对）与骨矿物质密度（BMD）之间的相关性。通过电子方式检索了三个数据库。此外，还筛选了相关文章的参考文献列表。总共选择了16项研究，包括2587名参与者和75个相关系数纳入本综述。使用标准化表格从每项研究中提取数据。多层次模型表明BMD与肥胖之间存在相反的关系：绝对肥胖与BMD呈正相关，相对肥胖与BMD呈负相关。性别和年龄是这些关系的主要调节因素。有力证据支持男性（R = -0.37；95%CI，-0.57至-0.12）和25岁以下人群（R = -0.28；95%CI，-0.45至-0.08）中相对脂肪量与BMD之间存在负相关关系。为预防超重和肥胖人群的骨质流失，建议采取基于营养和运动的干预措施，重点是在控制脂肪量减少的同时保留瘦体重。：PROSPERO编号CRD42015024313。
