Endocrine Abstracts

Introduction: Obesity is a pathological condition characterized by a low-grade systemic inflammatory state that predisposes to the onset of some diseases, such as hypertension, diabetes, and hyperlipidemia. Also, obesity can impact bone metabolism, but its effects are controversial.

Aims: This observational study aimed to evaluate and correlate the bone mass with the lipidic profile, adipocytokines, glucose metabolism, hepatic function and purine metabolism in obese patients.

Methods: 372 obese patients were divided into three groups of bone mineral density (BMD) by DXA, according to the ISCD guidelines: normal (BMD-N; n=103), reduced (BMD-R; n=168), and osteoporosis (OST; n=101). The obesity classification was based on the fat mass index (FMI) criteria, accessed by DXA. In this classification, the body fat categories are divided into three classes, according to the sex- and race-specific reference ranges. Biochemical parameters were determined by standard methods. The Quantitative Insulin Sensitivity Check Index (QUICKI) was used to assess insulin sensitivity.

Results: The mean age was 62.4±8.80 years, 72% were female, and, for obesity classification, 84,1% of patients were in class 3, 10,8% in class 2, and 5,1% in class 1. FMI was increased in BMD-N (P<0.001) compared to BMD-R and OST groups. The three classes of obesity and the lipid profile were similar between the three groups of BMD. The alanine aminotransferase was increased in the BMD-N group (P=0.019), while the other hepatic enzymes were identical between the groups. Regarding glucose metabolism, despite the similar glycemia, the insulin level was increased in the BMD-N group (P=0.023). By contrast, the QUICKI was decreased in the BMD-N group (P=0.002). Concerning the adipocytokines analyzed, adiponectin was reduced in the BMD-N group (P=0.005). The uricemia was increased in the BMD-N group (P=0.015) and was directly correlated with insulin level (P<0,001, r=0,313).

Conclusions: In obese patients, impaired insulin sensitivity and increased purine metabolism suggested a protective role on bone, preserving its density.