肥胖与骨质疏松

Obesity and osteoporosis

肥胖与骨质疏松症这两种复杂遗传病,从发病机制而言,两者可能共享某些环境因素和遗传因素。有研究显示,体重增加对预防骨质疏松症发生有保护性作用,降低骨折风险。肥胖形成过程中,与体重相关的许多激素与骨量变化有关,如:脂肪组织分泌的瘦素、雌激素、脂联素;消化道分泌的胃饥饿素;胰腺分泌胰岛素、胰淀素。然而,近年来也有一些不同的研究发现,过度脂肪组织增加并不能预防骨折的发生。可见肥胖和骨质疏松之间内因与外因的相互作用错综复杂,导致不同人群出现不同的研究结果。推测可能在不同体脂比例条件下,体脂与骨量形成呈现不同的关联。

Obesity and Osteoporosis belong to polygenic disease, and both have mutifactorial etiologies including environmental factors and hereditary factors, with potential interactions between them. Some researches conclude that body weight is correlated with high bone mass. In obesity, there are some mechanisms that produce the higher bone mass, including the secretion of bone-active hormones from adipocyte （i. e., estrogen, leptin, adiponectin）, and the secretion from other organs such as the gut （ i. e., ghrelin ） and the pancreas （ including insulin and amylin）. While, there are other different results which have shown excess adipose tissue may not against fracture. It reveals a much more complex genetic and environmental relationship between obesity and osteoporosis. We may speculate that the positive or negative relationship between obesity and osteoporosis depend on the different rate of fat mass.