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胖的人更容易骨折吗一起看专家怎么说

2019-07-13 点击:967
老葡京平台

With the improvement of living standards, more and more obese people. We all know that obesity is a risk factor for many diseases. Osteoporosis is a common disease in the elderly. What is the relationship between obesity and osteoporosis? Let's see what the experts say.

More and more obese people

In the past, people thought that chubby fat is a blessing, and in fact it is too fat to be sick. Chen Jinping, deputy director of the Osteoporosis and Bone Minerals Branch of the Zhejiang Medical Association and the chief physician of the Department of Orthopaedics of the People's Hospital of Zhejiang Province, said that obesity is a chronic metabolic disease caused by multiple factors, which is caused by the increase of body fat volume and cell number. Body fat accounts for an abnormally high percentage of body weight and is characterized by some local deposition. The World Health Organization defines body mass index greater than 30 as obese, and 25 to 29.9 as overweight. China's nutrition and health survey released that residents overweight and obesity were 23.2%, overweight patients were 215 million, and obese patients were 64.88 million.

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Obesity problem

The prevalence of obesity is a global growth trend and is a risk factor for type 2 diabetes, hypertension, dyslipidemia, cardiovascular and cerebrovascular diseases, and cancer. It is listed by the World Health Organization as one of the top ten risk factors for disease burden. Economic and biological impacts are enormous.

Obesity may not protect bones

So, what is the relationship between obesity and osteoporosis? Experts say that osteoporosis is a major manifestation of reduced bone mass, destruction of bone tissue microstructure, weakened bone strength, resulting in bone fragility and increased risk of fracture. The clinical common metabolic bone disease, its clinical symptoms mainly include bone pain, shortened body and fragility fracture. The relationship between osteoporosis and obesity is currently controversial. In the past, obesity was a protective factor for osteoporosis or fragility fractures, as obese patients had more soft tissue to protect bone tissue. But recent research suggests that obesity may increase the risk of certain types of fractures.

xx最近,加拿大的一项研究表明,低体重可能是骨质疏松症和骨质疏松性骨折的危险因素,但肥胖并不一定对骨质疏松症或骨质疏松性骨折有保护作用。美国的一项研究还表明,肥胖并不能显着保护绝经后妇女的骨骼。

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强壮的骨头

随着研究的进展,体重的一般概念逐渐被细分。在已发表的文献中,有助于体重的两种软组织,即体脂含量和肌肉质量,对体重和骨密度的贡献一直存在争议。许多研究表明,肌肉质量与骨密度的相关性高于体重和体重指数,而脂肪量与骨密度无显着相关性。

研究还发现,随着年龄的增长,特别是绝经后,骨密度和肌肉含量下降,体重和脂肪含量增加。种族对体重与骨密度之间关系的影响不容忽视。一项针对中国女性的临床调查发现,体脂含量较高的女性患骨质疏松症,骨量减少或非椎骨骨折的风险增加。

通常,肌肉含量有益于预防骨质疏松症,并且脂肪组织对骨密度的影响相对复杂。具体的相关性仍然没有定论。

另外,不同部位脂肪与骨密度的关系也不尽相同。研究表明,皮下脂肪与骨量直接相关,而男孩则对骨密度有保护作用。内脏脂肪与骨量无关,与骨密度呈负相关。髓腔中的脂肪组织与骨形成率呈负相关。在脂肪细胞分泌的脂肪因子中,瘦蛋白与骨形成正相关。脂联素通过促进骨形成和抑制骨吸收来增加骨量。抵抗素与骨密度呈负相关。

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骨密度

更胖的人可能更容易骨折

体重指数与骨密度和骨折风险之间的关系是什么?专家指出,肥胖会增加骨质疏松性骨折的风险,并且是骨折风险的独立危险因素。

具体而言,在大多数人中,高体重指数具有较高的骨密度,但不能保证理想的骨量。在一些超重和肥胖的人群中,骨质脆性增加可能导致骨折倾向,这可能会随着超重的人群而下降。由此产生的强大机械力是相关的。研究表明,低骨密度值和既往骨折史是肥胖女性非椎骨骨折的危险因素。低骨密度是肥胖骨折的危险因素,因此加强肥胖人群的骨密度筛查有助于预防骨折。一项关于英国肥胖绝经后妇女低创伤性骨折的研究指出,肥胖并不能预防骨折。

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肥胖容易骨折

此外,尽管在骨折人群中,肥胖人群的骨密度高于非肥胖人群,但相对于他们的体重可能较低。脂肪的叠加会导致高骨密度的错觉。肥胖的绝经后妇女和老年男性的总体骨折比例显着增加。

在治疗方面,专家强调,体重,肥胖和骨代谢之间的关系目前似乎更复杂。对于骨质疏松症,没有安全的体重指数水平。临床上有必要实际测量骨密度的年变化率并制定个性化的预防和治疗方案。患者应注意防止跌倒,注意减肥,并控制一条腿是最简单,最有效,最经济,最安全的方法之一。

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