Yilmazi Murat, Keleş Işik, Aydin Gülümser, Orkun Sevim, Bayram Merih, Sevinc F Ceylan, Kisa Uçler, Yetkin Ilhan
Department of Endocrinology and Metabolism, Kirikkale University, Ivedik Caddesi 33, Sokak 48/3, 06200 Ozevler, Ankara, Turkey.
Endocr Res. 2005;31(2):133-8. doi: 10.1080/07435800500229276.
Osteoporosis is less common in obese individuals with increased bone mineral density (BMD) and plasma leptin concentrations. The aim of this study was to determine the correlation between leptin levels and BMD in postmenopausal women. The study consisted of 90 postmenopausal women with a mean age of 53.45 +/- 0.87 years who visited our outpatient clinic for the evaluation of BMD. Thirty-six post-menopausal women with osteoporosis (mean age: 54.52 +/- 1.41 years and mean body mass index (BMI, kg/m2) 29.33 +/- 0.66), 30 age- and BMI-matched postmenopausal women with normal BMD, and 24 postmenopausal women (mean age: 52.79 +/- 1.48 years and mean BMI: 29.45 +/- 0.89) with osteopenic BMD were included in the study. Plasma concentrations of leptin after an overnight fast were measured by radioimmunoassay. BMD values were measured by dual-energy X-ray absorptiometry (DEXA) at the L2-L4 lumbar spine and femoral neck. The median spine BMD value in the patient group (0.67 +/- 0.08 g/cm2, mean +/- SEM) was significantly lower than that in the control group (1.02 +/- 0.25 g/cm2, mean +/- SEM) and osteopenic group (0.87 +/- 0.05 g/cm2, mean +/- SEM) (p < 0.005). The mean spine BMD value (T score -3.63 +/- 0.25, mean +/- SEM) and the mean femur neck BMD value (T score -2.55 +/- 0.18, mean +/- SEM) of the osteoporosis group were significantly lower than that in the normal BMD group (+ 0.33 +/- 0.14 and + 0.27 +/- 0.18, P < 0.001) and in the osteopenia group (-1.74 +/- 0,1 and -1.18 +/- 0.05, p < 0.005). The mean plasma leptin concentration in the osteoporotic group (17.03 +/- 1.40 ng/ml) was not significantly different from that in the normal BMD group and the osteopenia group (16.55 +/- 1.50 ng/ml; 16.16 +/- 1.60, respectively, p > 0.150). Plasma leptin concentrations were correlated with BMI in three groups (r(s) = 0.450, p = 0.025 in normal BMD group and r(s) = 0.4254, P = 0.009 in the osteoporotic group, and r(s) = 395, p = 0.015 in the osteopenia group. There was no correlation between plasma leptin concentrations and BMD values in three groups (r(s) = -0.89 in normal BMD group, r(s) = -0.124 in osteopenia group, and r(s) = -0.195 in osteoporosis group). From this study we conclude that circulating plasma leptin does not have a significant direct influence on bone mass in postmenopausal women.
骨质疏松症在骨矿物质密度（BMD）和血浆瘦素浓度升高的肥胖个体中不太常见。本研究的目的是确定绝经后女性瘦素水平与骨密度之间的相关性。该研究包括90名平均年龄为53.45±0.87岁的绝经后女性，她们因评估骨密度前来我们的门诊就诊。36名患有骨质疏松症的绝经后女性（平均年龄：54.52±1.41岁，平均体重指数（BMI，kg/m²）29.33±0.66）、30名年龄和BMI匹配且骨密度正常的绝经后女性以及24名骨密度低的绝经后女性（平均年龄：52.79±1.48岁，平均BMI：29.45±0.89）被纳入该研究。通过放射免疫分析法测量过夜禁食后的血浆瘦素浓度。使用双能X线吸收法（DEXA）测量L2-L4腰椎和股骨颈的骨密度值。患者组的脊柱骨密度中位数（0.67±0.08 g/cm²，平均值±标准误）显著低于对照组（1.02±0.25 g/cm²，平均值±标准误）和骨量减少组（0.87±0.05 g/cm²，平均值±标准误）（p<0.005）。骨质疏松症组的脊柱骨密度平均值（T值-3.******3±0.25，平均值±标准误）和股骨颈骨密度平均值（T值-2.55±0.18，平均值±标准误）显著低于骨密度正常组（+0.33±0.14和+0.27±0.18，P<0.001）和骨量减少组（-1.74±0.1和-1.18±0.05，p<0.005）。骨质疏松症组的平均血浆瘦素浓度（17.03±1.40 ng/ml）与骨密度正常组和骨量减少组（分别为16.55±1.50 ng/ml；16.16±1.60）无显著差异（p>0.150）。三组中血浆瘦素浓度均与BMI相关（骨密度正常组r(s)=0.450，p=0.025；骨质疏松症组r(s)=0.4254，P=0.009；骨量减少组r(s)=0.395，p=0.015）。三组中血浆瘦素浓度与骨密度值均无相关性（骨密度正常组r(s)=-0.89；骨量减少组r(s)=-0.124；骨质疏松症组r(s)=-0.195）。从本研究我们得出结论，循环血浆瘦素对绝经后女性的骨量没有显著的直接影响。
