Obesity and osteoporosis share many features and recent studies have identified many similarities suggesting common pathophysiological mechanisms. Obesity is associated with a higher risk of non traumatic fractures, despite bone mineral density (BMD) is normal or even increased. Bone strength depends on both BMD and bone quality. Spinal deformity index (SDI) is a semiquantitative method that may be a surrogate index of bone microarchitecture, a component of bone quality. The objective of this study was to assess in obese patients levels of 25 OH vitamin D (25OHD), parathyroid hormone (PTH), serum and urinary calcium (Ca) and phosphorus (P), BMD and SDI evaluated on T4-L4 quantitative morphometric analysis. We analyzed 54 obese subjects (56 ± 11 years, 10 males , 44 females). 22 female obese were postmenopausal and not taking hormone replacement therapy and 22 were pre-menopausal women, and 54 healthy subjects as controls. Among obese subjects, 48% had obesity class I, 32% obesity class II and 20% obesity class III. We assessed lumbar and femoral BMD using DEXA and a spine radiography to assess vertebral fractures and calculate SDI. SDI was calculated by quantifying the severity of fractures, using the classification of Genant, and assigning a value of 0,1,2 or 3 in case of no fracture or mild, moderate and severe fractures respectively. Vitamin D levels were lower in obeses than in controls (21.5 ± 6 vs 30.4 ± 14, p = 0.002). The levels of PTH, calcium, phosphorus were similar in obeses and controls. A severe deficiency of vitamin D (<20 ng / dl) was present in 37% vs 4%, a state of deficiency in 40% (20-30 ng / ml) vs. 52%, and normal levels of vitamin D (> 30ng/dl) in 22% vs. 44% respectively in obese subject and normal-weight controls. No significant difference was found in BMD both lumbar spine and femoral neck between obeses and controls. The percentage of radiological vertebral fractures was 75% in obese subjects vs LQ FRQWUROV Ȥ S DQG IUDFWXUHV ZHUH PLOGLQ SDWLHQWVDQG FRQWUROV Ȥ S PRGHUDWHLQ SDWLHQWVDQG FRQWUROV Ȥ S 0.015), and no patient and controls had severe fractures. SDI index was higher in patients than in controls (3.62 ± 2.5 vs 0.32 ± 0.2, p = 0.000). In 87.5% of patients and 10% of controls we found morphometric vertebral fractures, despite a DEXA T-score not GLDJQRVWLFRIRVWHRSRURVLV Ȥ S ,QFRQFOXVLRQLQREHVHSDWLHQWVYLWDPLQ D is lower than in controls. 87.5% of the obese subjects present non traumatic vertebral fractures and reduced bone quality as measured by SDI.
SPINAL DEFORMITY INDEX AND VITAMIN D STATUS IN OBESE SUBJECTS.
Barrea L;
2013-01-01
Abstract
Obesity and osteoporosis share many features and recent studies have identified many similarities suggesting common pathophysiological mechanisms. Obesity is associated with a higher risk of non traumatic fractures, despite bone mineral density (BMD) is normal or even increased. Bone strength depends on both BMD and bone quality. Spinal deformity index (SDI) is a semiquantitative method that may be a surrogate index of bone microarchitecture, a component of bone quality. The objective of this study was to assess in obese patients levels of 25 OH vitamin D (25OHD), parathyroid hormone (PTH), serum and urinary calcium (Ca) and phosphorus (P), BMD and SDI evaluated on T4-L4 quantitative morphometric analysis. We analyzed 54 obese subjects (56 ± 11 years, 10 males , 44 females). 22 female obese were postmenopausal and not taking hormone replacement therapy and 22 were pre-menopausal women, and 54 healthy subjects as controls. Among obese subjects, 48% had obesity class I, 32% obesity class II and 20% obesity class III. We assessed lumbar and femoral BMD using DEXA and a spine radiography to assess vertebral fractures and calculate SDI. SDI was calculated by quantifying the severity of fractures, using the classification of Genant, and assigning a value of 0,1,2 or 3 in case of no fracture or mild, moderate and severe fractures respectively. Vitamin D levels were lower in obeses than in controls (21.5 ± 6 vs 30.4 ± 14, p = 0.002). The levels of PTH, calcium, phosphorus were similar in obeses and controls. A severe deficiency of vitamin D (<20 ng / dl) was present in 37% vs 4%, a state of deficiency in 40% (20-30 ng / ml) vs. 52%, and normal levels of vitamin D (> 30ng/dl) in 22% vs. 44% respectively in obese subject and normal-weight controls. No significant difference was found in BMD both lumbar spine and femoral neck between obeses and controls. The percentage of radiological vertebral fractures was 75% in obese subjects vs LQ FRQWUROV Ȥ S DQG IUDFWXUHV ZHUH PLOGLQ SDWLHQWVDQG FRQWUROV Ȥ S PRGHUDWHLQ SDWLHQWVDQG FRQWUROV Ȥ S 0.015), and no patient and controls had severe fractures. SDI index was higher in patients than in controls (3.62 ± 2.5 vs 0.32 ± 0.2, p = 0.000). In 87.5% of patients and 10% of controls we found morphometric vertebral fractures, despite a DEXA T-score not GLDJQRVWLFRIRVWHRSRURVLV Ȥ S ,QFRQFOXVLRQLQREHVHSDWLHQWVYLWDPLQ D is lower than in controls. 87.5% of the obese subjects present non traumatic vertebral fractures and reduced bone quality as measured by SDI.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
