Endocrinology Division, Hospital Universitario San Cecilio, Granada, Spain.
Menopause. 2012 Feb;19(2):172-7. doi: 10.1097/gme.0b013e31822815c0.
Clinical studies evaluating the role of leptin and adiponectin on bone metabolism had shown conflicting results, and data about the effect of anticatabolic drugs on these adipokines are scarce. Our aims were to determine adiponectin and leptin levels in osteoporotic postmenopausal women and their relationship with bone mass and bone turnover and to analyze changes on adiponectin and leptin levels after treatment with raloxifene or alendronate.
We selected 53 women (mean ± SD age, 63 ± 7 y) with postmenopausal osteoporosis divided into two treatment groups: raloxifene (60 mg/d; n = 20) or alendronate (70 mg/wk; n = 33) during a period of 1 year. Bone mineral density by dual-energy x-ray absorptiometry and serum levels of leptin, adiponectin, and bone turnovers markers were determined at baseline and at 1 year after treatment.
Baseline levels of leptin were correlated to body mass index (r = 0.47; P < 0.01), waist circumference (r = 0.38, P = 0.01), and estradiol (r = 0.4, P = 0.003). Adiponectin was inversely related to bone-specific alkaline phosphatase (r = -0.41, P < 0.01) and serum crosslaps (r = -0.35; P < 0.01). There was no correlation between bone mineral density, leptin, and adiponectin. After 12 months, no changes were observed in leptin and adiponectin in the alendronate group; however, a significant increase in leptin levels (973.5 ± 637.4 pM/mL vs 1,305.7 ± 793.5 pM/mL; P = 0.031) was detected in the raloxifene group, whereas adiponectin levels showed no significant changes (P = 0.46).
In postmenopausal women with osteoporosis, raloxifene induces a significant increase in leptin levels without significant changes in adiponectin serum levels. The antiresorptive effect of raloxifene and alendronate is not substantially influenced by changes in leptin or adiponectin levels.
评估瘦素和脂联素在骨代谢中的作用的临床研究结果相互矛盾，关于抗分解代谢药物对这些脂肪因子影响的数据也很少。我们的目的是确定骨质疏松绝经后妇女的脂联素和瘦素水平及其与骨量和骨转换的关系，并分析用雷洛昔芬或阿仑膦酸钠治疗后脂联素和瘦素水平的变化。
我们选择了 53 名绝经后骨质疏松症女性（平均年龄 ± 标准差为 63 ± 7 岁），分为两组：雷洛昔芬（60mg/d；n = 20）或阿仑膦酸钠（70mg/wk；n = 33），治疗 1 年。在治疗前和治疗 1 年后通过双能 X 线吸收仪测定骨矿物质密度和血清瘦素、脂联素和骨转换标志物水平。
基线时瘦素水平与体重指数（r = 0.47；P < 0.01）、腰围（r = 0.38，P = 0.01）和雌二醇（r = 0.4，P = 0.003）呈正相关。脂联素与骨特异性碱性磷酸酶（r = -0.41，P < 0.01）和血清交联 C 端肽（r = -0.35；P < 0.01）呈负相关。骨矿物质密度、瘦素和脂联素之间无相关性。阿仑膦酸钠组治疗 12 个月后，瘦素和脂联素无变化；然而，雷洛昔芬组瘦素水平显著升高（973.5 ± 637.4 pM/mL 比 1305.7 ± 793.5 pM/mL；P = 0.031），脂联素水平无显著变化（P = 0.46）。
在绝经后骨质疏松症妇女中，雷洛昔芬可显著升高瘦素水平，而脂联素血清水平无显著变化。雷洛昔芬和阿仑膦酸钠的抗吸收作用不受瘦素或脂联素水平变化的显著影响。
