M.P.H., BUL 457, Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
J Clin Endocrinol Metab. 2010 Mar;95(3):1247-55. doi: 10.1210/jc.2009-1475. Epub 2010 Jan 15.
Regional fat is increasingly recognized as a determinant of bone mineral density (BMD), an association that may be mediated by adipokines, such as adiponectin and leptin, and inflammatory fat products. Chronic inflammation is deleterious to bone, and visceral adipose tissue (VAT) predicts inflammatory markers such as soluble intercellular adhesion molecule-1 and E-selectin, whereas sc adipose tissue (SAT) and VAT predict IL-6 in adolescents.
Our objective was to determine associations of regional fat mass and adipokines with BMD. We hypothesized that girls with greater VAT relative to SAT would have lower bone density mediated by inflammatory cytokines, adiponectin, and leptin.
This was a cross-sectional study.
The study was conducted at a clinical research center.
SUBJECTS included 30 girls (15 obese, 15 normal weight) 12-18 yr old, matched for maturity (bone age), race, and ethnicity.
We assessed regional fat (SAT, VAT) using magnetic resonance imaging, total fat, and BMD using dual-energy x-ray absorptiometry. Fasting leptin, adiponectin, IL-6, soluble intercellular adhesion molecule-1, and E-selectin were obtained.
Mean body mass index sd score was 3.7 +/- 1.5 in obese subjects and 0.1 +/- 0.4 kg/m(2) in controls. VAT was a negative predictor of spine BMD and bone mineral apparent density, whole-body BMD and bone mineral content/height in obese girls and whole-body BMD and bone mineral content/height for the group as a whole after controlling for SAT, as was the ratio of VAT to SAT. In a regression model that included VAT/SAT, adipokines, and cytokines, E-selectin and adiponectin were negative predictors of BMD and leptin a positive predictor.
VAT is an independent inverse determinant of bone density in obesity. This association may be mediated by adipokines and a chronic inflammatory state.
越来越多的人认识到区域性脂肪是骨密度（BMD）的决定因素，这种关联可能是由脂联素和瘦素等脂肪因子以及炎症性脂肪产物介导的。慢性炎症对骨骼有害，内脏脂肪组织（VAT）可预测可溶性细胞间黏附分子-1 和 E-选择素等炎症标志物，而皮下脂肪组织（SAT）和 VAT 可预测青少年的 IL-6。
我们的目的是确定区域性脂肪量和脂肪因子与 BMD 的关系。我们假设，相对于 SAT，VAT 较大的女孩的骨密度较低，这是由炎症细胞因子、脂联素和瘦素介导的。
这是一项横断面研究。
该研究在一个临床研究中心进行。
研究对象包括 30 名 12-18 岁的女孩（15 名肥胖，15 名正常体重），按成熟度（骨龄）、种族和民族相匹配。
我们使用磁共振成像评估区域性脂肪（SAT、VAT），使用双能 X 射线吸收法评估总脂肪和 BMD。抽取空腹瘦素、脂联素、IL-6、可溶性细胞间黏附分子-1 和 E-选择素。
肥胖组的平均体重指数标准差为 3.7 ± 1.5，对照组为 0.1 ± 0.4 kg/m2。VAT 是肥胖女孩脊柱 BMD 和骨矿物质表观密度、全身 BMD 和骨矿物质含量/身高的负预测因子，在控制 SAT 后，肥胖组全身 BMD 和骨矿物质含量/身高也是如此，VAT 与 SAT 的比值也是如此。在包括 VAT/SAT、脂联素和细胞因子的回归模型中，E-选择素和脂联素是 BMD 的负预测因子，瘦素是正预测因子。
VAT 是肥胖症中骨密度的独立负相关因素。这种关联可能是由脂肪因子和慢性炎症状态介导的。
