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血清瘦素浓度对绝经前后女性通过定量超声测定法评估的骨量的影响。

The influence of serum leptin concentration on bone mass assessed by quantitative ultrasonometry in pre and postmenopausal women.

作者信息

Hadji P, Bock K, Gotschalk M, Hars O, Backhus J, Emons G, Schulz K-D

机构信息

Department of Gynecology, Gynecological Oncology and Endocrinology, Philipps University Marburg, Pilgrimstein 3, D-35037, Marburg, Germany.

出版信息

Maturitas. 2003 Feb 25;44(2):141-8. doi: 10.1016/s0378-5122(02)00324-9.

Abstract

OBJECTIVE

the aim of this study was to evaluate the influence of serum leptin concentration on bone mass assessed by quantitative ultrasound (QUS) in a large sample of healthy pre and postmenopausal women.

DESIGN

555 healthy pre and postmenopausal (n=261 and n=294) women (mean age, 49.5+/-17.2 years) not on hormone replacement therapy were recruited on the occasion of a routine gynecological visit. Before entry to the study, all women had answered a detailed questionnaire on important risk factors and gave written informed consent. Speed of sound (SOS), broadband ultrasound attenuation (BUA) and stiffness index (SI) of the os Calcis were measured using the Achilles ultrasonometer (GE/lunar). We systematically investigated the relation of menopause, BMI and leptin on bone mass by allocating women into the following groups: (a) premenopausal women BMI<25 kg/m(2) (N=178); (b) premenopausal women BMI>25 kg/m(2) (N=83); (c) postmenopausal women BMI<25 kg/m(2) (N=125); and (d) postmenopausal women BMI>25 kg/m(2) (N=169). Additionally we investigated the relation of serum leptin concentrations, age and BMI on ultrasonometry variables by performing a multiple linear regression analyses.

RESULTS

in the initial analyses premenopausal women showed a significantly (P<0.001) lower mean age, weight, BMI, follicle stimulating hormone (FSH) and leptin concentration, a higher mean height, serum estradiol and ultrasonometry variables in comparison to postmenopausal women. Irrespective of the menopausal status, women with a BMI>25 kg/m(2) had significantly higher leptin concentrations (P<0.001) and BUA (P<0.05) whereas SOS and SI was not significant different, compared to women with a BMI<25 kg/m(2). The multiple linear regression analyses showed that only BMI but not Leptin was related to higher ultrasonometry variables, whereas increasing age was associated with a decrease in ultrasonometry variables. Furthermore, the multiple linear regression analyses confirmed that age and BMI were the only statistically significant independent predictor for ultrasonometry variables. There was no significant influence of leptin on ultrasonometry variables even after controlling for BMI or age, or BMI and age.

CONCLUSIONS

serum leptin concentrations are significantly higher in pre and postmenopausal obese women, compared with normal weight controls. Ultrasonometry variables are influenced by age and BMI but not by serum leptin concentrations.

摘要

目的

本研究旨在评估血清瘦素浓度对大量健康绝经前和绝经后女性通过定量超声(QUS)评估的骨量的影响。

设计

在一次常规妇科检查中招募了555名未接受激素替代治疗的健康绝经前和绝经后女性(n = 261和n = 294)(平均年龄49.5±17.2岁)。在进入研究之前,所有女性都回答了一份关于重要风险因素的详细问卷,并签署了书面知情同意书。使用跟腱超声仪(GE/通用电气公司)测量跟骨的声速(SOS)、宽带超声衰减(BUA)和硬度指数(SI)。我们通过将女性分为以下几组,系统地研究了绝经、体重指数(BMI)和瘦素与骨量的关系:(a)绝经前BMI<25 kg/m²的女性(N = 178);(b)绝经前BMI>25 kg/m²的女性(N = 83);(c)绝经后BMI<25 kg/m²的女性(N = 125);以及(d)绝经后BMI>25 kg/m²的女性(N = 169)。此外,我们通过进行多元线性回归分析,研究了血清瘦素浓度、年龄和BMI与超声测量变量之间的关系。

结果

在初始分析中,与绝经后女性相比,绝经前女性的平均年龄、体重、BMI、促卵泡激素(FSH)和瘦素浓度显著更低(P<0.001),平均身高、血清雌二醇和超声测量变量更高。无论绝经状态如何,与BMI<25 kg/m²的女性相比,BMI>25 kg/m²的女性瘦素浓度显著更高(P<0.001),BUA也显著更高(P<0.05),而SOS和SI无显著差异。多元线性回归分析表明,只有BMI而非瘦素与更高的超声测量变量相关,而年龄增加与超声测量变量降低相关。此外,多元线性回归分析证实,年龄和BMI是超声测量变量仅有的具有统计学意义的独立预测因素。即使在控制了BMI或年龄,或BMI和年龄之后,瘦素对超声测量变量也没有显著影响。

结论

与正常体重对照组相比,绝经前和绝经后肥胖女性的血清瘦素浓度显著更高。超声测量变量受年龄和BMI影响,但不受血清瘦素浓度影响。

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