Endocrine Abstracts

Introduction: Obesity has become a major health problem and a global epidemic, with a worldwide prevalence that has doubled over the last three decades. According to the WHO, obesity is defined as a body mass index of 30 kg/m2 or more The relationship between obesity and bone capital has been proven. A few years ago, it was thought that obesity had a protective effect on bone, a belief that influenced clinical practice. However, various pathogenic mechanisms, notably vitaminD deficiency through sequestration, may be responsible for bone loss in obese populations, increasing the risk of osteopenia, osteoporosis and fractures. The aim of our study is to determine bone status in obese population.

Materials and methods: Retrospective descriptive study conducted at the Department of Endocrinology, Diabetology and Metabolic Diseases, CHU MohamedVI, on 48 obese patients with BMI ≥ 30 kg/m²

Results: We identified 48 patients with a BMI ≥ 30 kg/m². The mean age was: 46.18 years, with extremes ranging from 22 to 71 years. The main comorbidities found were: cardiovascular in 31.25% of cases, diabetes in 27.08% of cases, dyslipidemia in 14.58% of cases and osteoarthritis in 10.41% of cases. Blood calcium and phosphorus levels were normal in all patients Vitamin D deficiency in 72.91%of cases, secondary osteoporosis in 4.17%, osteopenia in 25% and normal bone mineral density in 70.83%. Fractures occurred in 4% of cases, and vitamin D supplementation was performed in patients with vitamin D deficiency. All patients with osteoporosis or fracture received anti-osteoporotic treatment

Discussion: The association between bone and adipose tissue is complex both tissues are metabolically very active, interacting via adipokines, estrogens and metabolic factors of bone origin. The data currently available, provided by numerous studies in obese subjects, seem to show that obesity can affect bone metabolism via several mechanisms. It can increase adipocyte differentiation and fat accumulation, while decreasing osteoblast differentiation and bone formation. It is associated with chronic inflammation through increased pro-inflammatory cytokines, which can promote osteoclast activity and bone resorption by modifying the receptor activator of NF-κB (RANK)/RANK ligand/osteoprotegerin pathway In addition, excessive leptin secretion and/or reduced adiponectin production by adipocytes can affect bone formation, while high fat consumption can interfere with intestinal calcium absorption and reduce calcium availability for bone formation

Conclusions: In fact the prevalence of bone loss and vitamin Ddeficiency are quite frequent in obese people as our study shows, with a non-negligible risk of fractures