Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
Metabolism. 2011 Sep;60(9):1222-6. doi: 10.1016/j.metabol.2011.02.010. Epub 2011 Apr 12.
The objective was to examine the effects of weight loss and leptin administration following weight loss on calciotropic hormones and bone turnover. This was a prospective, single-blinded study of 12 subjects (8 women, 4 men; 2 nonobese, 10 obese; age range, 19-46 years) who were studied on an inpatient basis while maintaining their usual weight [Wt(initial)] and during maintenance of 10% weight loss while receiving twice-daily injections of either a placebo [Wt(-10%P)] or replacement doses of leptin [Wt(-10%L)]. The main outcome measures were markers of bone formation (bone alkaline phosphatase and procollagen type 1 amino terminal propeptide) and resorption (N-telopeptide) as well as parathyroid hormone, calcium, and 25-hydroxy vitamin D measured from fasting morning serum. As expected, serum leptin declined with weight loss. Bone alkaline phosphatase decreased by 12.3% ± 3.9% between Wt(initial) and Wt(-10%P) and remained suppressed after leptin administration (both P < .01 compared with baseline). N-telopeptides increased by 37.2% ± 11.3% from Wt(initial) to Wt(-10%L) (P < .01). Procollagen type 1 amino terminal propeptide, parathyroid hormone, calcium, and 25-hydroxy vitamin D did not change. These results suggest that both decreased bone formation and increased bone resorption underlie bone loss associated with weight loss. Leptin administration did not prevent the uncoupling of bone remodeling that accompanies weight loss.
目的是研究减肥和减肥后瘦素给药对钙调节激素和骨转换的影响。这是一项前瞻性、单盲研究，共纳入 12 名受试者（8 名女性，4 名男性；2 名非肥胖者，10 名肥胖者；年龄范围 19-46 岁），他们在住院期间保持其原体重[Wt（初始）]，然后在保持 10%体重减轻的同时，接受每日两次的安慰剂[Wt（-10%P）]或瘦素替代剂量[Wt（-10%L）]注射，从而进行研究。主要观察指标是骨形成标志物（骨碱性磷酸酶和前胶原 1 型氨基端前肽）和骨吸收标志物（N-端肽），以及来自空腹晨血的甲状旁腺激素、钙和 25-羟维生素 D。如预期的那样，血清瘦素随体重减轻而下降。骨碱性磷酸酶在 Wt（初始）和 Wt（-10%P）之间下降了 12.3%±3.9%，并且在瘦素给药后仍受到抑制（与基线相比，两者均 P<.01）。N-端肽在 Wt（初始）至 Wt（-10%L）期间增加了 37.2%±11.3%（P<.01）。前胶原 1 型氨基端前肽、甲状旁腺激素、钙和 25-羟维生素 D 均无变化。这些结果表明，体重减轻相关的骨丢失是由骨形成减少和骨吸收增加共同引起的。瘦素给药并不能防止伴随体重减轻的骨重建脱偶联。
