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Übergewicht und Osteoporose

Overweight and osteoporosis

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Zusammenfassung

Die Atherosklerose ist eine chronisch-entzündliche Gefäßerkrankung, die mit einer messbaren Erhöhung inflammatorischer Marker wie CRP — einem robusten Prädiktor kardiovaskulärer Komplikationen — einhergeht. Auch in der Pathogenese der Osteoporose spielt die Inflammation eine wichtige Rolle. So erwies sich IL-6 (Regulator der hepatischen CRP-Produktion) als wichtigster Prädiktor für den Knochenverlust am proximalen Oberschenkel.

Von Adipozyten produzierte proinflammatorische Zytokine werden heute als pathogenetische Bindeglieder zwischen der Adipositas und ihren metabolischen Folgen verstanden. Die Komponenten des metabolischen Syndroms wiederum sind Risikofaktoren auch der Osteoporose.

Training, Gewichtsverlust und Mittelmeerdiät führen zu einem nachweislichen Abfall proinflammatorischer Zytokine. Fettgewebe trägt im Gegensatz zu einer gut ausgebildeten Muskulatur nur wenig zum Erhalt der Knochenmasse bei. Eine Vermehrung der fettfreien Körpermasse bei gleichzeitigem Abbau von Fettgewebe erscheint somit der optimale Weg der Osteoporose- und Atheroskleroseprävention.

Abstract

Atherosclerosis is a chronic inflammatory disease associated with an elevation of inflammatory markers such as CRP — a robust predictor of cardiovascular events. Inflammation also plays a pivotal role in the pathogenesis of osteoporosis. IL-6 proved to be the most important predictor of bone loss in the proximal femur.

Adipocyte-produced inflammatory cytokines are the pathogenetic link between obesity and its metabolic consequences. The different components of the metabolic syndrome are at the same time well-established risk factors for osteoporosis.

Physical training, weight loss, and a Mediterranean-style diet all have a proven cytokine-lowering effect. Contrary to muscle mass, adipose tissue if at all contributes only marginally to the preservation of bone. As a consequence, increasing lean body mass while reducing fat mass seems to be the most effective way to prevent both atherosclerosis and osteoporosis.

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  1. Reha-Klinik Aukammtal, Wiesbaden

    H. Friebe

  2. Orthopädie, Schwarzwaldklinik, Bad Krozingen

    A. Peters

  3. Reha-Klinik Aukammtal, 65191, Wiesbaden

    H. Friebe

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Correspondence to H. Friebe.

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Friebe, H., Peters, A. Übergewicht und Osteoporose. Orthopäde 34, 645–651 (2005). https://doi.org/10.1007/s00132-005-0821-x

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