Armaiz-Flores Sara A, Kelly Nichole R, Galescu Ovidiu A, Demidowich Andrew P, Altschul Anne M, Brady Sheila M, Hubbard Van S, Pickworth Courtney K, Tanofsky-Kraff Marian, Shomaker Lauren B, Reynolds James C, Yanovski Jack A
Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), Bethesda, Maryland, USA.
Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA.
Horm Res Paediatr. 2017;87(4):233-243. doi: 10.1159/000459623. Epub 2017 Mar 30.
BACKGROUND/AIMS: Animal studies suggest that leptin may adversely affect bone mineral density (BMD). Clinical studies have yielded conflicting results. We therefore investigated associations between leptin and bone parameters in children.
830 healthy children (age = 11.4 ± 3.1 years; 75% female; BMI standard deviation score [BMIz] = 1.5 ± 1.1) had fasting serum leptin measured with ELISA and body composition by dual-energy X-ray absorptiometry. The main effects for leptin and BMIz plus leptin's interactions with sex and BMIz were examined using hierarchical linear regressions for appendicular, pelvis, and lumbar spine BMD as well as bone mineral content (BMC), and bone area (BA).
Accounting for demographic, pubertal development, and anthropometric variables, leptin was negatively and independently associated with lumbar spine BMC and BA, pelvis BA, and leg BA (p < 0.05 for all). Sex, but not BMIz, moderated the associations of leptin with bone parameters. In boys, leptin was negatively correlated with leg and arm BMD, BMC at all bone sites, and BA at the subtotal and lumbar spine (p < 0.01 for all). In girls, leptin was positively correlated with leg and arm BMD (p < 0.05 for both).
CONCLUSION: Independent of body size, leptin is negatively associated with bone measures; however, these associations are moderated by sex: boys, but not girls, have a negative independent association between leptin and BMD. .
背景/目的：动物研究表明，瘦素可能对骨密度（BMD）产生不利影响。临床研究结果相互矛盾。因此，我们调查了儿童瘦素与骨骼参数之间的关联。
830名健康儿童（年龄=11.4±3.1岁；75%为女性；BMI标准差评分[BMIz]=1.5±1.1）采用酶联免疫吸附测定法（ELISA）测量空腹血清瘦素，并通过双能X线吸收法测量身体成分。使用分层线性回归分析瘦素和BMIz的主要效应以及瘦素与性别和BMIz的相互作用，分析上肢、骨盆和腰椎的骨密度（BMD）、骨矿物质含量（BMC）和骨面积（BA）。
在考虑人口统计学、青春期发育和人体测量学变量后，瘦素与腰椎BMC和BA、骨盆BA以及腿部BA呈负相关且具有独立性（所有p<0.05）。性别而非BMIz调节了瘦素与骨骼参数之间的关联。在男孩中，瘦素与腿部和手臂的BMD、所有骨部位的BMC以及全身和腰椎BA呈负相关（所有p<0.01）。在女孩中，瘦素与腿部和手臂的BMD呈正相关（两者p<0.05）。
独立于体型之外，瘦素与骨骼测量值呈负相关；然而，这些关联受性别调节：男孩中瘦素与BMD之间存在负向独立关联，而女孩中不存在。
