Department of Internal Medicine 1, Shimane University Faculty of Medicine, Shimane 693-8501, Japan.
Metabolism. 2010 Sep;59(9):1252-6. doi: 10.1016/j.metabol.2009.11.017. Epub 2010 Jan 4.
Although recent clinical studies have shown that serum adiponectin level was negatively associated with bone mineral density (BMD), serum adiponectin action on bone metabolism in humans is still unclear. We investigated the relationships between serum levels of total and high-molecular weight (HMW) adiponectin and its ratio (HMW-total ratio) vs chronological changes in BMD at the lumbar spine, femoral neck (FN), and one third of the radius after 1-year treatment of type 2 diabetes mellitus in 32 Japanese patients. Serum total adiponectin, but not HMW adiponectin or HMW-total ratio, was significantly and positively correlated with percentage change in FN-BMD (r = 0.35, P < .05). Multiple regression analysis adjusted for age, duration of diabetes, sex, body height, body weight, waist circumference, serum creatinine, and hemoglobin A(1c) showed that serum total adiponectin was still significantly and positively correlated with percentage change in FN-BMD (r = 0.65, P < .01). On the other hand, no significant relationships were found between serum levels of hemoglobin A(1c), pentosidine, bone formation markers (bone-specific alkaline phosphatase and osteocalcin), or a bone resorption marker (urinary N-terminal cross-linked telopeptide of type-I collagen) vs percentage change in BMD at any site. These findings suggest that serum total adiponectin could be clinically useful for predicting BMD change during treatment of type 2 diabetes mellitus. Adiponectin might protect against BMD reduction in patients with type 2 diabetes mellitus.
尽管最近的临床研究表明血清脂联素水平与骨密度(BMD)呈负相关,但血清脂联素对人体骨代谢的作用仍不清楚。我们研究了 32 例日本 2 型糖尿病患者在接受 1 年治疗后,血清总脂联素和高分子量(HMW)脂联素及其比值(HMW-总比值)与腰椎、股骨颈(FN)和桡骨 1/3 处 BMD 随时间变化的关系。血清总脂联素与 FN-BMD 百分比变化呈显著正相关(r = 0.35,P <.05),但 HMW 脂联素或 HMW-总比值与 FN-BMD 百分比变化无显著相关性。调整年龄、糖尿病病程、性别、身高、体重、腰围、血清肌酐和血红蛋白 A1c 后进行多元回归分析显示,血清总脂联素仍与 FN-BMD 百分比变化呈显著正相关(r = 0.65,P <.01)。另一方面,血清血红蛋白 A1c、戊糖、骨形成标志物(骨碱性磷酸酶和骨钙素)或骨吸收标志物(I 型胶原 N 端交联肽)与任何部位 BMD 百分比变化之间均无显著相关性。这些发现表明,血清总脂联素可能对预测 2 型糖尿病治疗期间 BMD 变化具有临床意义。脂联素可能对 2 型糖尿病患者的 BMD 降低具有保护作用。