Obesidade, Diabetes Mellitus tipo 2 e fragilidade óssea: uma revisão narrativa
DOI:
https://doi.org/10.34019/1982-8047.2018.v44.14058Keywords:
Obesidade, Osteoporose, Fraturas Ósseas, Diabetes MellitusAbstract
Durante anos a obesidade foi vista como um fator protetor para fraturas e osteoporose. Diversos estudos, no entanto, contestam esta tese, descrevendo que a obesidade na verdade afeta negativamente o sistema esquelético, em especial a homeostase óssea, diminuindo a rigidez do tecido ósseo e aumentando o risco de fraturas. A obesidade e o diabetes estão frequentemente associados no mesmo paciente, e a compreensão da alteração do tecido ósseo nestas duas condições clínicas é fundamental para o melhor cuidado destes pacientes, principalmente devido ao risco aumentado de fraturas, que estão associadas a maior número de complicações no seu tratamento. O presente estudo, em revisão narrativa, descreve a relação entre obesidade e homeostase óssea, a fragilidade óssea nos pacientes obesos, diabéticos ou não, e a relação entre obesidade e fraturas.
Downloads
References
AEBERLI, I. et al. Dietary intakes of fat and antioxidant vitamins are predictors of subclinical inflammation in overweight Swiss children. The American Journal of Clinical Nutrition, v. 84, n. 4, p. 748-755, oct. 2006.
AHDJOUDJ, S. et al. Transforming growth factor beta2 inhibits adipocyte differentia-tion induced by skeletal unloading in rat bone marrow stroma. Journal of Bone and Miner Research, v. 17, n. 4, p. 668–677, apr. 2002.
ANONYMOUS. Consensus development conference: prophylaxis and treatment of osteoporosis. The American Journal of Medicine, v. 90, n. 1, p. 107-110, jan. 1991.
ARITA, Y. et al. Paradoxical decrease of an adipose-specific protein, adiponectin, in obesity. Biochemical and Biophysical Research Communications, US, v. 257, n. 1, p. 79-83, Apr. 1999.
ASADIPOOYA, K.; GRAVES, L.; GREENE, L.W. Transient osteoporosis of the hip: review of the literature. Osteoporosis International, v. 28, n. 6, p. 1805-1816, jun. 2017.
BARBOUR, K.E. et al. Adipokines and the risk of fracture in older adults. Journal of Bone and Miner Research, v. 26, n. 7, p. 1568-1576, jul. 2011.
BONDS, D.E. et al. Risk of fracture in women with type 2 diabetes: the Women’s Health Initiative Observational Study. The Journal of Clinical Endocrinology and Metabolism., v. 91, n. 9, p. 3404-3410, sept. 2006.
CASTRO, J.P. et al. Differential effect of obesity on bone mineral density in White, Hispanic and African American women: a cross sectional study. Nutrition & Metabolism., v. 2, n. 9, p. 1-7, apr. 2005.
CAO, J.J. Effects of obesity on bone metabolism. Journal of Orthopaedic Surgery and Research, v. 6, p. 30-36, jun. 2011.
CHEN, Y.Y. et al. Body fat has stronger associations with bone mass density than body mass index in metabolically healthy obesity. PLoS One, US, v. 13, n. 11, p. 1-11, Nov. 2018.
CHUNG, J.H. et al. Association between Sarcopenic Obesity and Bone Mineral Density in Middle-Aged and Elderly Korean. Annals of Nutrition and Metabolism, Switzerland, v. 68, n. 2, p. 77-84, Dec. 2016.
COHEN, A. et al. Abdominal fat is associated with lower bone formation and inferior bone quality in healthy premenopausal women: a transiliac bone biopsy study. The Journal of Clinical Cndocrinology and Cetabolism., v. 98, n. 6, p. 2562-2572, jun. 2013.
COMPSTON, J.E. et al. Obesity is not protective against fracture in postmenopausal women: GLOW. The American Journal of Medicine., v. 124, n. 11, p. 1043-1050, nov. 2011.
CUMMINGS, S.R.; NEVITT, M.C. Non-skeletal determinants of fractures: the poten-tial importance of the mechanics of falls. Study of Osteoporotic Fractures Research Group. Osteoporosis International, v. 4, n.1, p. 67-70, feb. 1994.
DIMITRI, P. et al. Obesity is a risk factor for fracture in children but is protective against fracture in adults: A paradox. Bone, v. 50, p. 457–66, may. 2012.
DIMITRI, P. Fat and bone in children – where are we now? Annals of Pediatric Endocrinology and Metabolism, v. 23, n. 2, p. 62-69, jun. 2018.
ELEFTERIOU, F. et al. Serum leptin level is a regulator of bone mass. Proceedings of the National Academy of Sciences of the United States of America, v. 101, n. 9, p. 3258-3263, mar. 2004.
FORD, E.S. Body mass index, diabetes, and C-reactive protein among U.S. adults. Diabetes Care, v. 22, n. 12, p. 1971-1977, dec. 1999.
FORLINO, A.; MARINI, J.C. Osteogenesis imperfecta. Lancet, v. 387, n. 10028, p. 1657-1671, apr. 2016.
GOULDING, A.; GRANT, A.M.; WILLIAMS, S.M. Bone and body composition of children and adolescents with repeated forearm fractures. Journal of Bone and Mineral Research, US, v. 20, n. 12, p. 2090-2096, aug. 2005.
GOULDING, A. et al. More broken bones: a 4-year double cohort study of young girls with and without distal forearm fractures. Journal of Bone and Mineral Research, US, v. 15, n. 10, p. 2011-2018, Dec. 2010.
GOULDING, A. et al. A concern for obese children and adolescents? Osteoporosis International, England, v. 12, n. 10, p. 835-840, oct. 2002.
GOULDING, A. et al. Overweight and obese children have low bone mass and area for their weight. International Journal of Obesity and Related Metabolic Disorders, v. 24, n. 5, p. 627-632, may. 2000.
HERNANDEZ, C.J. et al. Trabecular microfracture and the influence of pyridinium and non-enzymatic glycation-mediated collagen cross-links. Bone, v. 37, n. 6, p. 825-832, sep. 2005.
HOTAMISLIGIL, G.S. et al. Increased adipose tissue expression of tumor necrosis fac-tor-alpha in human obesity and insulin resistance. The Journal of Clinical Investigation, v. 95, n. 5, p. 2409-2415, may 1995.
HIMES, C.L.; REYNOLDS, S.L. Effect of obesity on falls, injury, and disability. Journal of the American Geriatrics Society, v. 60, n. 1, p. 124–129, jan. 2012.
HSU, Y.H. et al. Relation of body composition, fat mass, and serum lipids to osteopo-rotic fractures and bone mineral density in Chinese men and women. The American Journal of Clinical Nutrition., v. 83, n. 1, p.146-154, jan. 2006.
HUE, O. et al. Body weight is a strong predictor of postural stability. Gait & Posture, v. 26, n. 1, p. 32-38, jun. 2007.
JANGHORBANI, M. et al. Systematic review of type 1 and type 2 diabetes mellitus and risk of fracture. American Journal of Epidemiology, v. 166, n. 5, p. 495-505, Sep. 2007.
JIANG, N. et al. Assessment of bone quality in patients with diabetes mellitus. Osteoporosis International, v. 29, n. 8, p. 1721-1736, Apr. 2018.
JOHANSSON, H. et al. A meta-analysis of the association of fracture risk and body mass index in women. Journal of Bone and Mineral Research, US, v. 29, n. 1, p. 223-233, jan. 2014.
KIRMANI, S. et al. Bone structure at the distal radius during adolescent growth. Journal of Bone and Mineral Research, v. 24, n. 6, p. 1033-1042, jun. 2009.
LARSEN, K.I. et al. Glucose-dependent regulation of osteoclast H(+)-ATPase expres-sion: potential role of p38 MAP-kinase. The Journal of Cellular Biochemistry, v. 87, n. 1, p. 75-84, aug. 2002.
LOBSTEIN, T. et al. Child and adolescent obesity: part of a bigger picture. Lancet, v. 385, n. 9986, p. 2510-2520, feb. 2015.
MARTY, E. et al. A review of sarcopenia: Enhancing awareness of an increasingly prevalent disease. Bone, v. 105, p. 276-286, sep. 2017.
MCNERNY, E.M.B; NICKOLAS, T.L. Bone Quality in Chronic Kidney Disease: Def-initions and Diagnostics. Current Osteoporosis Reports, v. 15, n. 3, p. 207-213, Jun. 2017.
MIRZABABAEI, A. et al. Metabolically healthy/unhealthy components may modify bone mineral density in obese people. Archives of Osteoporosis, v. 12, n. 1, p. 94-102, oct. 2017.
MOERMAN, E.J. et al. Aging activates adipogenic and suppresses osteogenic programs in mesenchymal marrow stroma/stem cells: the role of PPAR-gamma2 transcription fac-tor and TGF-beta/BMP signaling pathways. Aging Cell, v. 3, n. 6, p. 379-389, dec. 2004.
MOREIRA, C.A.; BARRETO, F.C.; DEMPSTER, D.W. Novos conceitos em diabetes e metabolismo ósseo. Jornal Brasileiro de Nefrologia, Brasil, v. 37, n. 4, p. 490-5, mai. 2015.
MUKA, T. et al. The Association between Metabolic Syndrome, Bone Mineral Density, Hip Bone Geometry and Fracture Risk: The Rotterdam Study. PLoS ONE, US, v. 10, n. 6, p. 1-15, dec. 2015.
NAGASAKI, K. et al. Obese Japanese children have low bone mineral density after puberty. The Journal of Bone and Mineral Metabolism, v. 22, n. 4, p. 376-381, jan. 2004.
NIELSON, C.M. et al. BMI and fracture risk in older men: the osteoporotic fractures in men study (MrOS). The Journal of Bone and Mineral Research, v. 26, n. 3, p. 496-502, mar. 2011.
NIELSON, C.M.; SRIKANTH, P.; ORWOLL, E.S. Obesity and fracture in men and women: an epidemiologic perspective. The Journal of Bone and Mineral Research, v. 27, n. 1, p. 1-10, jan. 2012.
OSHIMA, K. et al. Adiponectin increases bone mass by suppressing osteoclast and acti-vating osteoblast. Biochem Biophys Res Commun, US, v. 331, n. 2, p. 520-6, Jun. 2005.
PRADHAN, A.D. et al. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. Jama, US, v. 286, n. 3, p. 327-34, Jul. 2001.
PREMAOR, M.O. et al. The association between fracture site and obesity in men: a population-based cohort study. The Journal of Bone and Mineral Research, US, v. 28, n. 8, p. 1771-7. Aug. 2013.
PREMAOR, M.O.; COMIM, F.V.; COMPSTON, J.E. Obesity and fractures. Arquivos Brasileiros de Endocrinologia & Metabologia, v. 58, n. 5, p. 470-7, Julho 2014.
REID, I.R. Fat and bone. Archives of Biochemistry and Biophysics, v. 503, n. 1, p. 20-7, nov. 2010.
ROMAS, E.; GILLESPIE, M.T.; MARTIN, T.J. Involvement of receptor activator of NFkappaB ligand and tumor necrosis factor-alpha in bone destruction in rheumatoid arthritis. Bone, US, v. 30, n. 2, p.340-6, Feb. 2002.
ROSEN, C.J.; BOUXSEIN, M.L. Mechanisms of disease: is osteoporosis the obesity of bone? Nature Clinical Practice Rheumatology, US, v. 2, n. 1, p. 35-43, Jan. 2006.
ROSEN, C.J.; KLIBANSKI, A. Bone, fat, and body composition: evolving concepts in the pathogenesis of osteoporosis. The American Journal of Medicine, US, v. 122, n. 5, p. 409-414, May 2009.
RUSSO, G.T. et al. Fracture Risk in Type 2 Diabetes: Current Perspectives and Gender Differences. International Journal of Endocrinology, v. 2016, p. 1-11, dec. 2016.
SAFAROVA, S.S. The impact of metabolic changes in type 2 diabetes on bone turno-ver. Medychni Perspektyvy, v. 23, n. 2, p. 143-147, 2018.
SHAPSES, S.A.; POP, L.C.; WANG, Y. Obesity is a concern for bone health with ag-ing. Nutrition Research, v. 39, p. 1-13, mar. 2017.
SHOELSON, S.E.; HERRERO, L.; NAAZ, A. Obesity, inflammation, and insulin re-sistance. Gastroenterology, v. 132, n. 6, p. 2169-2180, may. 2007.
SJÖBLOM, S. et al. Relationship between postmenopausal osteoporosis and the components of clinical sarcopenia. Maturitas, v. 75, p. 175–180, mar. 2013.
SUKUMAR, D. et al. Obesity alters cortical and trabecular bone density and geometry in women. Osteoporosis International, v. 22, n. 2, p. 635–645, feb. 2011.
TAES, Y.E. et al. Fat mass is negatively associated with cortical bone size in young healthy male siblings.The Journal of Clinical Endocrinology and Metabolism, v. 94, n. 7, p. 2325–2331, Jul. 2009.
URANO, T.; INOUE, S. Recent genetic discoveries in osteoporosis, sarcopenia and
obesity. Endocrine Journal, v. 62, n. 6, p. 475-484, mar. 2015.
VAN DIELEN, F.M. et al. Increased leptin concentrations correlate with increased con-centrations of inflammatory markers in morbidly obese individuals. International Journal of Obesity and Related Metabolic Disorders, v. 25, n. 12, p. 1759-66, dec. 2001.
VAN DYKE, T.E.; SERHAN, C.N. Resolution of inflammation: a new paradigm for the pathogenesis of periodontal diseases. Journal of Dental Research, v. 82, n. 2, p. 82-90, Feb. 2003.
VESTERGAARD, P. Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes: a meta-analysis. Osteoporosis International, v. 18, n. 4, p. 427-44, apr. 2007.
WALSH, J.S.; VILAÇA, T. Obesity, Type 2 Diabetes and Bone in Adults. Calcified Tissue international, v. 100, p. 528–35, mar. 2017.
WANG, L. et al. Relation of Visceral and Subcutaneous Adipose Tissue to Bone Miner-al Density in Chinese Women. International Journal of Endocrinology, v. 2013, p. 2-5, may. 2013.
WEED D.L. Methodologic Guidelines for review papers. Journal of the National Cancer Institute, v. 89, n.1, p. 6-7, jan. 1997.
WORLD HEALTH ORGANIZATION. Obesity: Preventing and managing the global epidemic. WHO, Geneva, 2000. Disponível em: <https://www.who.int/nutrition/publications/obesity/WHO_TRS_894/en/>. Acesso em 19 mar. 2019.
WOSJE, K.S. et al. Dietary patterns associated with fat and bone mass in young chil-dren. The American Journal of Clinical Nutrition, v. 92, n. 2, p. 294-303, aug. 2010.
YAMAMOTO, M. Insights into bone fragility in diabetes: the crucial role of bone quali-ty on skeletal strength. Endocrine Journal, v. 62, n. 4, p. 299-308, mar. 2015.
ZIMMET, P.Z.; ALBERTI, K.G.M.M. Epidemiology of Diabetes-Status of a Pandemic and Issues around Metabolic Surgery. Diabetes Care, v. 39, n. 6, p. 878-883, Jun. 2016.
Downloads
Additional Files
Published
How to Cite
Issue
Section
License
Cessão de Primeira Publicação à HU Revista
Os autores mantém todos os direitos autorais sobre a publicação, sem restrições, e concedem à HU Revista o direito de primeira publicação, com o trabalho licenciado sob a Licença Creative Commons Attribution que permite o compartilhamento irrestrito do trabalho, com reconhecimento da autoria e crédito pela citação de publicação inicial nesta revista, referenciando inclusive seu DOI.
