Obesity, Type 2 Diabetes and Bone in Adults.

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Term Occurence Count Dictionary
rosiglitazone 1 endocrinologydiseasesdrugs
zoledronic acid 2 endocrinologydiseasesdrugs
Insulin 2 endocrinologydiseasesdrugs
Teriparatide 1 endocrinologydiseasesdrugs
metformin 2 endocrinologydiseasesdrugs
obesity 44 endocrinologydiseases
osteoporosis 9 endocrinologydiseases

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Select Drug Character Offset Drug Term Instance
Insulin 9875 [[26]].Pancreatic and gut hormone secretion is altered in obesity and may influence bone metabolism. Insulin , amylin and preptin are increased in obesity, and may have direct effects on bone cells to increase
Insulin 10023 obesity, and may have direct effects on bone cells to increase bone formation and decrease resorption. Insulin may also have indirect positive effects on bone by decreasing hepatic sex-hormone binding globulin production,
Teriparatide 21085 zoledronic acid trial, fracture reduction was similar in participants with and without diabetes [[69]]. Teriparatide and sclerostin antibodies increase BMD in Zucker diabetic rats, but the rats’ bone phenotype is different
metformin 18656 have neutral or slightly protective associations with fracture risk [[60], [61]]. It is possible that metformin increases osteoblast activity through Runt-related transcription factor 2 (Runx2) signalling. Thiazolidinediones
metformin 19217 ADOPT study reported cumulative incidence of fractures of 15.1% with rosiglitazone versus 7.3% with metformin [[63]]. Sodium–glucose cotransporter-2 (SGLT2) inhibitors have been associated with increased fracture
rosiglitazone 19186 increased fracture risk—the ADOPT study reported cumulative incidence of fractures of 15.1% with rosiglitazone versus 7.3% with metformin [[63]]. Sodium–glucose cotransporter-2 (SGLT2) inhibitors have been associated
zoledronic acid 12683 large numbers of obese people, but there are some available data. In the Horizon trial, 3 years of zoledronic acid decreased vertebral fracture more in postmenopausal women with BMI above 25 kg/m2 than women with BMI
zoledronic acid 20981 osteoporosis treatments do reduce fracture in T2DM. In post hoc analysis of the FIT alendronate and HORIZON zoledronic acid trial, fracture reduction was similar in participants with and without diabetes [[69]]. Teriparatide
Select Disease Character Offset Disease Term Instance
obesity 367 type 2 diabetes (T2DM) and osteoporotic fracture are major public health concerns. Understanding how obesity and type 2 diabetes modulate fracture risk is important to identify and treat people at risk of fracture.
obesity 536 identify and treat people at risk of fracture. Additionally, the study of the mechanisms of action of obesity and T2DM on bone has already offered insights that may be applicable to osteoporosis in the general
obesity 1468 density (BMD), but increased overall and hip fracture risk. There are some similarities between bone in obesity and T2DM, but T2DM seems to have additional harmful effects and emerging evidence suggests that glycation
obesity 1704 important factor. Higher BMD but higher fracture risk presents challenges in fracture prediction in obesity and T2DM. Dual energy X-ray absorptiometry underestimates risk, standard clinical risk factors may not
obesity 1999 However, the limited available evidence suggests that osteoporosis treatment does reduce fracture risk in obesity and T2DM with generally similar efficacy to other patients.Obesity, Type 2 Diabetes and BoneObesity
obesity 2784 health care planning and individual patients. Additionally, the study of the mechanisms of action of obesity and T2DM on bone has already offered insights that may be applicable in the broader study of osteoporosis,
obesity 3062 of collagen glycation on material properties of bone. There are some similarities in the effect of obesity and T2DM on bone, but some important differences such as cortical porosity and collagen glycation.In
obesity 3211 differences such as cortical porosity and collagen glycation.In this review, we describe the effects of obesity and T2DM on fracture risk and discuss possible mechanisms of their effects. We also consider the validity
obesity 3599 lower risk of proximal femur and vertebral fracture in obese adults [[3]]. However, fracture risk in obesity is not lower at all skeletal sites; the risk of some non-spine fractures including proximal humerus
obesity 3972 and the prevalence of low-trauma fractures is similar in obese and non-obese women [[6]]. Therefore, obesity is not entirely protective against fracture, and there are some site-specific effects on fracture.There
obesity 4641 some influence from surrounding soft tissue). Calcaneus bone stiffness by ultrasound is greater in obesity [[9]] and by high-resolution peripheral quantitative computed tomography (HR-pQCT), obese adults have
obesity 4979 [[10], [11]]. Radius and tibia strength estimated by finite element analysis from HR-pQCT is greater in obesity than in normal weight controls [[10]]. Therefore, BMD probably is truly higher in obesity, and there
obesity 5069 greater in obesity than in normal weight controls [[10]]. Therefore, BMD probably is truly higher in obesity , and there is no site-specific BMD deficit to explain the site-specific fracture risk.It is possible
obesity 5220 to explain the site-specific fracture risk.It is possible that even if BMD increases in response to obesity , the capacity for increase is limited and eventually the load-to-strength ratio rises far enough to
obesity 5423 enough to cause fracture in low-trauma injuries. The increase in radius and tibia strength by HR-pQCT in obesity is proportionally less than the increase in BMI [[11]]. At the hip, by QCT and DXA, obese people have
obesity 5904 even when load-to-strength ratio is exceeded [[12], [14]]. Intramuscular fat content is increased in obesity , and may be associated with poorer muscle function and increased fracture risk (‘dynapenic obesity’)
obesity 6005 obesity, and may be associated with poorer muscle function and increased fracture risk (‘dynapenic obesity ’) [[15], [16]]. Poorer muscle function could increase falls and injury when falling, and there are
obesity 6201 and there are data showing an excess of falls in obese people [[17]].Thus, although BMD is higher in obesity , it may not be increased sufficiently to resist the greater forces acting when obese people fall. Non-bone
obesity 6500 as contributory and protective factors.Mechanisms of Action of Obesity on BoneSome insight into how obesity may exert effects on bone can be obtained from biochemical markers of bone turnover. Biochemical markers
obesity 6626 on bone can be obtained from biochemical markers of bone turnover. Biochemical markers are lower in obesity than in normal weight [[18]], but the difference in resorption markers may be greater than the difference
obesity 6807 may be greater than the difference in formation markers. This results in a higher uncoupling index in obesity , suggesting positive bone balance which helps to maintain bone mass in adulthood and with ageing [[10]].
obesity 7185 with slower menopausal bone loss [[19]] consistent with a tendency towards positive bone balance in obesity .One possible mechanism for higher BMD in obesity is increased mechanical loading and strain. Obese adults
obesity 7234 consistent with a tendency towards positive bone balance in obesity.One possible mechanism for higher BMD in obesity is increased mechanical loading and strain. Obese adults have increased body fat mass, but also increased
obesity 7802 by periosteal apposition might be expected. Hip cross-sectional area by DXA and QCT is increased in obesity [[12], [13]], but bone size at the radius and tibia by HR-pQCT does not differ between obese and normal
obesity 8004 and normal weight controls [[10]]. Therefore, loading probably does not explain all of the action of obesity on bone.Obesity has effects on a number of hormones known to act on bone, and so may act on bone through
obesity 9832 bone, particularly in postmenopausal women [[26]].Pancreatic and gut hormone secretion is altered in obesity and may influence bone metabolism. Insulin, amylin and preptin are increased in obesity, and may have
obesity 9920 altered in obesity and may influence bone metabolism. Insulin, amylin and preptin are increased in obesity , and may have direct effects on bone cells to increase bone formation and decrease resorption. Insulin
obesity 10464 food intake and more long-term energy balance [[27]].Serum 25-hydroxy vitamin D (25OHD) is lower in obesity than normal weight controls, but this is likely to reflect greater volume of distribution (into fat,
obesity 10681 and extracellular fluid). Therefore, serum 25OHD may not indicate low whole-body vitamin D status in obesity , and it does not seem to be associated with lower BMD or higher bone turnover. It is possible that the
obesity 10811 to be associated with lower BMD or higher bone turnover. It is possible that the lower vitamin D in obesity would adversely affect BMD, but that the other positive effects of obesity on BMD are dominant [[28]].Not
obesity 10886 that the lower vitamin D in obesity would adversely affect BMD, but that the other positive effects of obesity on BMD are dominant [[28]].Not all fat is the same, and some fat depots could have negative effects
obesity 11536 but the relationship may vary with age and gender [[30]–[32]].Fig. 1Fat depot actions on bone in obesity Fracture Risk Assessment and Osteoporosis Treatment in ObesityFracture risk assessment in clinical practice
obesity 11739 clinical practice uses bone densitometry by DXA and clinical risk factors. This offers some challenges in obesity —the precision of DXA measurements is reduced in obesity due to effects of soft tissue thickness [[8]].
obesity 11797 risk factors. This offers some challenges in obesity—the precision of DXA measurements is reduced in obesity due to effects of soft tissue thickness [[8]]. Also, because fracture pattern differs between obese
obesity 11992 between obese and normal weight groups, and we do not yet fully understand the cause of fractures in obesity , the usual fracture prediction tools might not be expected to perform so well. However, FRAX (with and
obesity 12403 osteoporosis are anti-resorptive. Because bone turnover and bone resorption are already reduced in obesity , the question has been raised whether anti-resorptive treatment is effective for fracture prevention
obesity 12515 question has been raised whether anti-resorptive treatment is effective for fracture prevention in obesity . The key clinical trials of bisphosphonates did not include large numbers of obese people, but there
obesity 14659 bone formation [[43]]. The increase in foot and ankle fractures is consistent with the pattern seen in obesity , but the increase in hip fracture risk is discrepant between T2DM and non-diabetic obese, so additional
obesity 21490 fractures, particularly hip fractures. However, some fractures, such as ankle and humerus are more common in obesity , and the prevalence of low-trauma fractures is similar in obese and non-obese women. BMD in obese people
obesity 21691 obese people is higher at all sites, bone turnover is lower, and bone strength measures suggest that obesity is favourable for bone strength, but bone strength does not seem sufficiently increased to protect against
obesity 21873 sufficiently increased to protect against all fractures. Therefore, explanations for the fracture pattern in obesity need to consider other factors such as load-to-strength ratio, soft tissue padding, muscle function
obesity 22296 investigation for these potential contributors.There are many possible mechanisms acting on bone metabolism in obesity , such as adipokines and gut hormones. Some of these are potential therapeutic targets for the treatment
obesity 22633 increased overall risk of fracture and hip fracture. Some of the mechanisms acting to increase BMD in obesity are likely to be relevant in T2DM, but the pathophysiology of bone fragility in T2DM is not yet clearly
obesity 23551 anabolic response.As our populations become older and more obese, understanding the interactions of obesity , T2DM and fracture is becoming a pressing need to reduce the societal and individual costs of fracture
osteoporosis 616 mechanisms of action of obesity and T2DM on bone has already offered insights that may be applicable to osteoporosis in the general population. Most available evidence indicates lower risk of proximal femur and vertebral
osteoporosis 1947 information, and risk is under-recognised by clinicians. However, the limited available evidence suggests that osteoporosis treatment does reduce fracture risk in obesity and T2DM with generally similar efficacy to other patients.Obesity,
osteoporosis 2406 prevalence of T2DM is likely to be 592 million by 2035 [[2]]. As the population ages, the burden of osteoporosis and fragility fracture also increases. Obesity and T2DM have effects on fracture risk, and fractures
osteoporosis 2885 obesity and T2DM on bone has already offered insights that may be applicable in the broader study of osteoporosis , such as the effects of adipokines on bone cells and the effects of collagen glycation on material properties
osteoporosis 3384 their effects. We also consider the validity of existing fracture risk prediction tools and efficacy of osteoporosis treatment in these patient groups.Obesity, Fracture and BMDMost of the available evidence supports a
osteoporosis 12304 non-obese postmenopausal women in the Study of Osteoporotic Fractures [[33]].Most currently used drugs for osteoporosis are anti-resorptive. Because bone turnover and bone resorption are already reduced in obesity, the question
osteoporosis 20806 assess their risk or treat.Although the pathophysiology of fracture in T2DM differs from postmenopausal osteoporosis , (particularly in that bone turnover is low in T2DM), osteoporosis treatments do reduce fracture in
osteoporosis 20873 T2DM differs from postmenopausal osteoporosis, (particularly in that bone turnover is low in T2DM), osteoporosis treatments do reduce fracture in T2DM. In post hoc analysis of the FIT alendronate and HORIZON zoledronic
osteoporosis 22411 as adipokines and gut hormones. Some of these are potential therapeutic targets for the treatment of osteoporosis in obese and non-obese people.Type 2 diabetes is associated with increased BMD and lower bone turnover

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