Increasing adiposity is associated with higher adipokine levels and lower bone mineral density in obese older adults

Context: Although obesity is associated with high bone mass, recent reports suggest an increase in the incidence of fractures in obese patients. Copyright

Objectives: The objectives of the study were to evaluate the influence of increasing body fat on bone mineral density (BMD) and to determine the influence of the different adipokines on BMD in frail obese elderly patients.

Design and Setting: This is a cross-sectional study of baseline characteristics of elderly obese patients participating in a lifestyle therapy with diet with or without exercise and conducted in a university setting.

Patients: One hundred seventy-three, elderly (≥65 y old), obese (body mass index of ≥30 kg/m²) who were mostly frail participated in the study.

Outcome Measures: BMD, percentage of total body fat, percentage of fat-free mass, percentage of lean mass, body mass index, adiponectin, leptin, IL-6, bone turnover markers (osteocalcin and C-telopeptide), high-sensitivity C-reactive protein, free estradiol, and 25-hydroxyvitamin D were measured.

Results: Higher tertiles of percentagebodyfatandlower lean masswereassociated with a lowerBMD. High-sensitivity C-reactive protein levels were highest in the highest fat tertile (third, 5.5±5.4 vs first, 1.5±1.3 mg/L, P

Conclusions: Increasing adiposity together with decreasing lean mass is associated with lower BMD, higher adipokine levels, and worsening frailty in elderly obese adults.