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青少年特发性脊柱侧弯女孩循环瘦素水平降低及其与身体和骨量的关系。

Decreased circulating leptin level and its association with body and bone mass in girls with adolescent idiopathic scoliosis.

作者信息

Qiu Yong, Sun Xu, Qiu Xusheng, Li Weiguo, Zhu Zezhang, Zhu Feng, Wang Bin, Yu Yang, Qian Bangping

机构信息

Spine Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.

出版信息

Spine (Phila Pa 1976). 2007 Nov 15;32(24):2703-10. doi: 10.1097/BRS.0b013e31815a59e5.

Abstract

STUDY DESIGN

A prospective study was designed to investigate the circulating leptin level in girls with adolescent idiopathic scoliosis (AIS).

OBJECTIVE

To determine the circulating leptin levels in AIS girls, and to investigate its associations with body mass and bone mass.

SUMMARY OF BACKGROUND DATA

Abnormal growth pattern and osteopenia have been well documented in AIS patients throughout the peripubertal growth period. Leptin has been shown to regulate the growth of the whole body and bone particularly during childhood and adolescence. However, the circulating level of leptin, the relationships between leptin and lower body mass, and the relationships between leptin and lower bone mass in AIS patients remain unclear.

METHODS

One hundred twenty AIS girls and 80 healthy controls were recruited in this study. Measurements of anthropometry and circulating leptin were performed both in AIS and non-AIS girls. Evaluations of curve severity and measurements of bone mineral content/density (BMC/BMD) were performed only in AIS girls. The anthropometric data and circulating leptin levels were compared between older AIS girls and controls. The relationships between leptin and age, menstrual status, body weight, height, body mass index (BMI), Risser sign, curve magnitude, and BMC/BMD were analyzed in AIS girls.

RESULTS

Compared with healthy controls, an abnormal growth pattern (higher corrected height, lower weight, and lower BMI), and a marked decrease of circulating leptin were found in AIS girls, even after the adjustment for age and menstrual status. Positive correlations were found between leptin and age, menstrual status, body weight, height, BMI, and Risser sign. No significant correlation was found between leptin and curve magnitude. There was no significant difference in age at menarche between menstruating AIS and non-AIS girls, though an inverse correlation was observed between leptin and the age at menarche. The relationship between leptin and BMC/BMD remained significantly positive after controlling for age and menstrual status, although it was not independent of body weight or BMI.

CONCLUSION

A marked decrease of circulating leptin was observed in the current study. There was an association between leptin and body weight, BMI, other growth parameters, and BMC/BMD. This correlation suggests that leptin might play an important role in the lower body and bone mass in AIS girls.

摘要

研究设计

本研究为前瞻性研究,旨在调查青少年特发性脊柱侧凸(AIS)女孩的循环瘦素水平。

目的

测定AIS女孩的循环瘦素水平,并研究其与体重和骨量的关系。

背景数据总结

在整个青春期前生长阶段,AIS患者的生长模式异常和骨质减少已有充分记录。瘦素已被证明可调节全身尤其是儿童期和青春期的骨骼生长。然而,AIS患者的循环瘦素水平、瘦素与较低体重之间的关系以及瘦素与较低骨量之间的关系仍不明确。

方法

本研究招募了120名AIS女孩和80名健康对照。对AIS女孩和非AIS女孩均进行人体测量和循环瘦素测量。仅对AIS女孩进行曲线严重程度评估和骨矿物质含量/密度(BMC/BMD)测量。比较年龄较大的AIS女孩和对照之间的人体测量数据和循环瘦素水平。分析AIS女孩中瘦素与年龄、月经状态、体重、身高体重指数(BMI)、Risser征、曲线严重程度以及BMC/BMD之间关系。

结果

与健康对照相比,即使在调整年龄和月经状态后,AIS女孩仍存在生长模式异常(矫正身高较高、体重较低和BMI较低)以及循环瘦素显著降低。瘦素与年龄、月经状态、体重、身高、BMI和Risser征呈正相关。瘦素与曲线严重程度之间无显著相关性。月经初潮的AIS女孩和非AIS女孩月经初潮年龄无显著差异,尽管瘦素与月经初潮年龄呈负相关。在控制年龄和月经状态后,瘦素与BMC/BMD之间的关系仍显著为正,尽管它并非独立于体重或BMI。

结论

本研究观察到循环瘦素显著降低。瘦素与体重、BMI、其他生长参数以及BMC/BMD之间存在关联。这种相关性表明瘦素可能在AIS女孩的较低体重和骨量中起重要作用。

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