Bone Marrow Adipose Tissue in Relation to Bone and Energy Metabolism in Obesity and Type 2 Diabetes Mellitus

Interventional Study: Effect of Caloric Restriction on BMAT/BM-MSCs Phenotype Inclusion Criteria: * Premenopausal women and age-eligible men assigned to either the obese intervention group or the lean control group * Obese intervention group: * Body mass index (BMI) of 30-42 kg/m² * Fasting plasma glucose less than 6.4 mmol/L * Age 25-55 years * Lean control group: * BMI of 19-25 kg/m² * Fasting plasma glucose less than 6.4 mmol/L * Age 25-50 years Exclusion Criteria: * Diabetes mellitus * Secondary osteoporosis * History of severe neuropathic disease * Hyperparathyroidism * Hyperthyroidism * Immobilization * Alcoholism * Chronic gastrointestinal disease * Significant chronic renal impairment, including any of the following: * Chronic kidney disease * Serum creatinine greater than 110 µmol/L * Estimated glomerular filtration rate (eGFR) less than 1 mL/s/1.73 m² * Proteinuria * Diabetic nephropathy * Chronic hepatic impairment * Unstable cardiovascular disease * Uncontrolled hypertension * Current or recent use of any of the following medications: * Bisphosphonates * Estrogen * Denosumab * Gonadotropin-releasing hormone (GnRH) analogs * Glucocorticoids at a dose equivalent to at least 5 mg of prednisone daily for at least 1 month * Phenytoin * Thiazolidinediones * Insulin * Adrenal or anabolic steroids * Anticonvulsants * Anticoagulants * Pharmacological doses of vitamin D or vitamin A supplements * Contraindications to magnetic resonance imaging (MRI), including: * Pacemaker * Metallic implants incompatible with MRI * Claustrophobia