Search

Introduction: The beneficial effect of obesity on bone mineral density (BMD) has not been definitely established., Objectives: The aim of the study was to evaluate changes in BMD in obese perimenopausal women during a 5-year follow-up., Patients and Methods: The study involved 54 obese women. The group was divided into 2 subgroups according to the menopausal status: postmenopausal women--M (n = 35) and premenopausal women--P (n = 19). Laboratory tests (parathyroid hormone, 25-hydroxyvitamin D₃, C-terminal telopeptide of type I collagen, osteocalcin, and osteoprotegerin), anthropometric measurements, and densitometry were performed twice during the 5-year follow-up. The control group consisted of 19 healthy women of the same age and with normal body weight., Results: Obese postmenopausal women were characterized by lower BMD in the proximal femur and lumbar spine, higher fracture risk, and higher serum osteocalcin levels at baseline. During the 5-year follow-up, there was a 1.52% and 6.86% decrease in proximal femur BMD and 2.34% and 5.17% in lumbar spine BMD (in premenopausal and postmenopausal women, respectively). In postmenopausal controls, BMD reduction was 2.36% and 4.3%, respectively. In the combined analysis including all postmenopausal women, there was an inverse correlation between the initial body mass index and the changes in proximal femur BMD (r = -0.25; P <0.05) and lumbar spine BMD (r = -0.28; P = 0.08) that occurred during the 5-year follow-up., Conclusions: Obesity appears not to protect against bone mineral loss in postmenopausal women.

Introduction: The protective effect of adipocity on bone metabolism has not been confirmed during long-term follow-up. It is not known whether the rate of bone turnover and changes in mineral metabolism in obese people result from endocrine properties of the adipose tissue or merely the mechanical load., Objectives: The aim of the study was to evaluate bone and calcium-phosphorus metabolism in obese women during a 5-year follow-up., Patients and Methods: The study involved 47 obese women who underwent a 3-month weight loss therapy. We evaluated changes in the serum levels of parathormone (PTH), calcidiol (25(OH)D3), collagen type I crosslinked C-telopeptide (CTx-I), osteocalcin, total calcium, inorganic phosphates, and in bone mineral density. The control group consisted of 17 healthy women with proper body weight., Results: We observed a similar decrease in bone mineral density (BMD) in the lumbar spine and femoral neck, and a comparable decrease in the serum levels of CTx-I and osteocalcin in both groups during the 5-year follow-up. Changes in serum PTH levels were not statistically significant. In obese women, a nonsignificant increase in the serum level of 25(OH)D3 was observed as early as after a 3-month weight loss therapy and during follow-up. In controls, serum 25(OH)D3 levels tended to decrease. During follow-up, the number of obese patients with disturbances in vitamin D metabolism decreased from 78.7% to 53.2% (P = 0.01). Such disturbances were observed in 35.3% of the control group. In obese patients, there was a positive correlation between the change in body mass and BMD in the proximal femur (r = 0.279, P = 0.04). In controls, there was a positive correlation between the change in body mass and BMD in the lumbar spine (r = 0.477, P = 0.05)., Conclusions: In obese women who underwent weight loss therapy, the levels of bone turnover markers decreased and abnormal vitamin D metabolism was still observed during the 5-year follow-up.

This paper reviews the structure, function, and pathophysiology of glucagon-like peptide 1 (GLP-1). It describes the physiology and pathophysiology of the incretin axis, of which GLP-1 is a component, as well as the biosynthesis, secretion, activity, and degradation of this intestinal hormone. Effects of GLP-1 on the endocrine function of the pancreas, cardiovascular system, central nervous system, and on water-electrolyte balance have been also presented.