Department of Clinical Chemistry and Metabolic Medicine, St Thomas' Hospital, 5th Floor, North Wing, London, SE1 7EH, UK.
Osteoporosis Unit, Guy's Hospital, London, UK.
J Endocrinol Invest. 2017 Dec;40(12):1345-1353. doi: 10.1007/s40618-017-0711-1. Epub 2017 Jun 23.
To explore the relationship between circulating adiponectin, leptin and vaspin with bone mineral density (BMD), arterial stiffness and vascular calcification in post-menopausal women. We hypothesised that adipokines produced by adipose tissue may be mediators of bone and cardiovascular disease (CVD) and explain, in part, the observed association between osteoporosis and CVD.
We studied 386 ambulant community dwelling postmenopausal women aged (mean [SD] 61 [6.4] years). BMD at the lumbar spine, femoral neck (FN), and total hip (TH), body composition; fat mass (FM) and lean mass (LM) as well as abdominal aortic calcification (AAC) were determined by dual energy X-ray absorptiometry. Pulse wave velocity (PWV) and augmentation index, markers of arterial stiffness were measured. Fasting adiponectin, leptin and vaspin were quantified in serum.
A positive independent association was observed between vaspin and BMD at the FN (p = 0.009), TH (p = 0.037) in the whole study population adjusted for confounders including age, FM, LM and lifestyle variables. Using the same model, a negative association was seen between adiponectin and BMD at the FN in women with osteoporosis (p = 0.043). Serum adiponectin was significantly higher in women with fractures (20.8 [9.3] µg/ml compared to those without (18.5 [8.6] µg/ml, p = 0.018) and associated with a significant increased risk of fracture (HR 1.032, 95% CI 1.003-1.063, p = 0.032). Leptin was not associated with BMD or fracture risk after adjustment. Adiponectin was independently associated with AAC (p = 0.007) and significantly higher in women with AAC scores > 1; (19.2[9.2]) compared to those with no or low AAC scores (<1); 16.8 [8.0], p = 0.018). In adjusted analyses, PWV velocity was positively associated with circulating vaspin (p = 0.039) and AI was negatively associated with serum leptin (p = 0.002).
Adiponectin, leptin, vaspin are related to markers of bone and vascular health and may contribute to the observed association between osteoporosis and CVD.
探讨循环脂联素、瘦素和内脂素与绝经后妇女的骨密度（BMD）、动脉僵硬度和血管钙化之间的关系。我们假设脂肪组织产生的脂肪因子可能是骨和心血管疾病（CVD）的介质，并部分解释了观察到的骨质疏松症和 CVD 之间的关联。
我们研究了 386 名年龄在（平均[标准差]61[6.4]岁）的社区活动的绝经后妇女。腰椎、股骨颈（FN）和总髋（TH）的 BMD、身体成分；脂肪量（FM）和瘦体量（LM）以及腹主动脉钙化（AAC）通过双能 X 射线吸收法确定。脉搏波速度（PWV）和增强指数，动脉僵硬度的标志物，进行了测量。空腹脂联素、瘦素和内脂素在血清中被定量。
在整个研究人群中，在调整年龄、FM、LM 和生活方式变量等混杂因素后，内脂素与 FN（p=0.009）和 TH（p=0.037）的 BMD 呈正相关。使用相同的模型，发现脂联素与骨质疏松症妇女 FN 的 BMD 呈负相关（p=0.043）。骨折组妇女的血清脂联素明显高于无骨折组（20.8[9.3]µg/ml 与 18.5[8.6]µg/ml，p=0.018），骨折风险显著增加（HR 1.032，95%CI 1.003-1.063，p=0.032）。瘦素在调整后与 BMD 或骨折风险无关。脂联素与 AAC（p=0.007）独立相关，在 AAC 评分>1 的妇女中明显更高（19.2[9.2]）与 AAC 评分<1 的妇女（16.8[8.0]，p=0.018）。在调整分析中，PWV 速度与循环内脂素呈正相关（p=0.039），AI 与血清瘦素呈负相关（p=0.002）。
脂联素、瘦素、内脂素与骨和血管健康的标志物相关，可能有助于解释观察到的骨质疏松症和 CVD 之间的关联。
