Osteoporose bei/durch Adipositas – Schutz oder Risiko?

Zusammenfassung

Adipositas und Osteoporose sind häufige Erkrankungen, ein Zusammenhang zwischen beiden wird kontrovers beschrieben. Zum einen geht Adipositas mit einer Vielzahl von Komorbiditäten einher die den Knochenstoffwechsel beeinflussen und das Frakturrisiko erhöhen, zum anderen können die höhere Last auf den Knochen und der Weichteilmantel protektiv bei Stürzen wirken. Komorbiditäten der Adipositas fördern eine eingeschränkte Beweglichkeit und Stürze. Bei Adipositas findet sich daher eine Kombination aus peripheren Frakturen und Osteoporose-assoziierten Brüchen. Knochendichtemessungen und Bestimmungen der Knochenumbaumarker sind zur Abschätzung des Frakturrisikos bei dieser Klientel nur bedingt geeignet.

Abstract

Obesity and osteoporosis are common conditions, the relationship between the two is complex. On the one hand, obesity is associated with a variety of comorbidities that affect bone metabolism and increase fracture risk; on the other hand, the high mechanical loading and the larger soft tissue “envelope” maybe protective in falls. The increasing number of people in older age with obesity requires a differentiated view. Motion-associated peripheral fractures are most likely to be more common in obese people, especially ankle fractures, Osteoporotic fractures seem to be associated with increased frailty in obesity. Bone density measurements and determinations of bone remodeling markers are of limited use in estimating fracture risk in these patients.

Schlüsselwörter

Adipositas - Osteoporose - Frakturrisiko - Adipositas - 3

Key words

obesity - osteoporosis - fracture risk - obesity - 3

Publication History

Received: 15 May 2022
Received: 24 July 2022

Accepted: 20 July 2022

Article published online:
08 September 2022

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