Moderate energy restriction increases bone resorption in obese postmenopausal women.
Moderate energy restriction increases bone resorption in obese postmenopausal women.
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DOI：
10.1093/ajcn/73.2.347
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发表时间：
2001-02
期刊：
影响因子：
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通讯作者：
T. Ricci;Steven B. Heymsfield;Richard N. Pierson;Theodore Stahl;H. Chowdhury;S. Shapses
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文献类型：
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作者：
T. Ricci;Steven B. Heymsfield;Richard N. Pierson;Theodore Stahl;H. Chowdhury;S. Shapses
背景体重减轻会降低骨矿物质密度（BMD），增加骨质疏松症的风险。目的：我们调查绝经后妇女在能量限制期间是否有骨动员，以及激素是否调节骨转换和骨质量。设计：27名绝经后肥胖妇女完成了6个月的研究，平均年龄（± SD）为55.9 ± 7.9岁，体重指数（kg/m2）为33.0 ± 3.8。14名妇女遵循适度的能量限制饮食（WL组）和13名对照组保持体重（WM组）。在整个研究过程中测量体重、骨转换标志物、血清甲状旁腺激素（PTH）和饮食摄入量。在基线和第25周测量全身BMD、性激素结合球蛋白、瘦素和雌酮。结果WL组体重下降10.2 ± 5.5%（P < 0.001），体脂量下降18.7 ± 11.3%（P < 0.001），全身骨密度下降1.2 ± 1.2%，与WM组比较差异有统计学意义（P < 0.05）。连续测量显示，能量限制期间骨吸收和骨形成率慢性升高，高于WM组（P < 0.05）。血清性激素结合球蛋白随体重下降而升高，瘦素随体重下降而降低（P < 0.05）。血清PTH在WL组有升高趋势，而在WM组无升高趋势（P < 0.06）。随着体重减轻，脂肪量的减少与血清雌酮的降低直接相关（P < 0.01，R（2）= 0.50）。结论：适度的能量限制可增加肥胖绝经后妇女的骨转换，并可能部分受血清PTH和雌酮改变的调节。
BACKGROUND Weight reduction reduces bone mineral density (BMD) and increases the risk of osteoporosis. OBJECTIVE We investigated whether bone is mobilized in postmenopausal women during energy restriction and whether hormones regulate bone turnover and mass. DESIGN Twenty-seven obese postmenopausal women with a mean (+/-SD) age of 55.9 +/- 7.9 y and body mass index (in kg/m(2)) of 33.0 +/- 3.8 completed the 6-mo study. Fourteen women followed a moderate energy-restricted diet (WL group) and 13 control subjects maintained their body weight (WM group). Body weight, bone turnover markers, serum parathyroid hormone (PTH), and dietary intake were measured throughout the study. Total-body BMD, sex hormone binding globulin, leptin, and estrone were measured at baseline and at week 25. RESULTS In the WL group, body weight decreased by 10.2 +/- 5.5% (P < 0.001), body fat mass decreased by 18.7 +/- 11.3% (P < 0.001), and total-body BMD decreased by 1.2 +/- 1.2%; these changes were significantly different from those in the WM group (P < 0.05). Serial measurements showed chronically elevated rates of bone resorption and formation during energy restriction that were greater than in the WM group (P < 0.05). Serum sex hormone binding globulin increased and leptin decreased with weight loss (P < 0.05). Serum PTH tended to increase in the WL group but not in the WM group (P < 0.06). The reduction in fat mass with weight loss was directly associated with a decrease in serum estrone (P < 0.01, R(2) = 0.50). CONCLUSIONS Moderate energy restriction increases bone turnover in obese postmenopausal women and may be regulated in part by alterations in serum PTH and estrone.