脂联素与脊髓损伤瘫痪男性的骨强度和骨折史相关。
Adiponectin is associated with bone strength and fracture history in paralyzed men with spinal cord injury.
作者信息
Tan C O, Battaglino R A, Doherty A L, Gupta R, Lazzari A A, Garshick E, Zafonte R, Morse L R
机构信息
Spaulding-Harvard SCI Model System, Spaulding Rehabilitation Hospital, Boston, MA, USA.
出版信息
Osteoporos Int. 2014 Nov;25(11):2599-607. doi: 10.1007/s00198-014-2786-2. Epub 2014 Jul 1.
UNLABELLED
We explored the association between adiponectin levels and bone strength in paralyzed men with spinal cord injury. We found that bone strength was inversely associated with circulating adiponectin levels. Thus, strength estimates and adiponectin levels may improve fracture risk prediction and detection of response to osteogenic therapies following spinal cord injury.
PURPOSE
Previous research has demonstrated an inverse relationship between circulating adiponectin and bone mineral density, suggesting that adiponectin may be used as a biomarker for bone health. However, this relationship may reflect indirect effects on bone metabolism via adipose-mediated mechanical pathways rather than the direct effects of adipokines on bone metabolism. Thus, we explored the association between circulating adiponectin levels and bone strength in 27 men with spinal cord injury.
METHODS
Plasma adiponectin levels were quantified by ELISA assay. Axial stiffness and maximal load to fracture of the distal femur were quantified via finite element analysis using reconstructed 3D models of volumetric CT scans. We also collected information on timing, location, and cause of previous fractures.
RESULTS
Axial stiffness and maximal load were inversely associated with circulating adiponectin levels (R (2) = 0.44, p = 0.01; R (2) = 0.58, p = 0.05) after adjusting for injury duration and lower extremity lean mass. In individuals with post-SCI osteoporotic fractures, distal femur stiffness (p = 0.01) and maximal load (p = 0.005) were lower, and adiponectin was higher (p = 0.04) than those with no fracture history.
CONCLUSIONS
Based on these findings, strength estimates may improve fracture risk prediction and detection of response to osteogenic therapies following spinal cord injury. Furthermore, our findings suggest that circulating adiponectin may indeed be a feasible biomarker for bone health and osteoporotic fracture risk in paralyzed individuals with spinal cord injury.
未标注
我们探究了脊髓损伤致瘫男性中脂联素水平与骨强度之间的关联。我们发现骨强度与循环脂联素水平呈负相关。因此，强度评估和脂联素水平可能会改善脊髓损伤后骨折风险预测以及对成骨治疗反应的检测。
目的
先前的研究表明循环脂联素与骨矿物质密度之间存在负相关，这表明脂联素可用作骨健康的生物标志物。然而，这种关系可能反映了通过脂肪介导的机械途径对骨代谢的间接影响，而非脂肪因子对骨代谢的直接影响。因此，我们探究了27例脊髓损伤男性中循环脂联素水平与骨强度之间的关联。
方法
采用酶联免疫吸附测定法（ELISA）对血浆脂联素水平进行定量。通过使用容积CT扫描重建的3D模型进行有限元分析，对股骨远端的轴向刚度和最大骨折负荷进行定量。我们还收集了既往骨折的时间、部位和原因等信息。
结果
在调整损伤持续时间和下肢瘦体重后，轴向刚度和最大负荷与循环脂联素水平呈负相关（R² = 0.44，p = 0.01；R² = 0.58，p = 0.05）。在脊髓损伤后发生骨质疏松性骨折的个体中，股骨远端刚度（p = 0.01）和最大负荷（p = 0.005）较低，而脂联素水平较高（p = 0.04），高于无骨折病史的个体。
结论
基于这些发现，强度评估可能会改善脊髓损伤后骨折风险预测以及对成骨治疗反应的检测。此外，我们的研究结果表明，循环脂联素可能确实是脊髓损伤致瘫个体骨健康和骨质疏松性骨折风险的可行生物标志物。
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