老年人血浆游离脂肪酸浓度、血糖水平与肥胖的关系

目的 研究老年人血浆游离脂肪酸(FFA)浓度、空腹血糖水平与超重及肥胖的关系.方法 对154例年龄≥60岁的志愿者,依据体重指数(BMI)分为肥胖组(41名)、超重组(39名)和正常体重组(74名),抽取空腹静脉血,检测血糖、胰岛素、血游离脂肪酸.结果 肥胖组、超重组FFA均显著高于正常体重组(P＜0.01).肥胖组空腹血糖高于超重组、正常体重组(P＜0.01),超重组空腹血糖高于正常体重组(P＜0.01).正常体重组、超重组FFA均与空腹血糖正相关(r:0.588、0.680,P均＜0.05),与胰岛素敏感指数(ISI)负相关(r=:-0.387、-0.354,P均＜0.05);肥胖组FFA与空腹血糖正相关(r =0.340,P＜0.05),与胰岛素敏感指数(ISI)无相关(P＞0.05).在以FFA为应变量的多元回归方程中,空腹血糖、ISI进入方程(R2 =0.451,P＜0.01).结论 血游离脂肪酸浓度与血糖水平相互影响,并与老年超重、肥胖密切相关.     

肥胖对排卵正常患者促排卵卵巢反应性的影响

目的探讨肥胖对排卵正常患者IVF-ET促排卵过程中卵巢反应性的影响。方法回顾性分析首都医科大学附属北京妇产医院2009年1月~2015年12月接受IVF-ET的、排卵正常的943例患者的所有统计学资料。按照BMI将受试者分为四组:低体重组(BMI18.5kg/m2),正常体重组(BMI在18.5~23.9kg/m2之间),超重组(BMI在24.0~27.9kg/m2之间)和肥胖组(BMI≥28.0kg/m2),并比较各组间基线数据和卵巢反应性数据。结果 943例排卵正常患者中,低体重组患者70例,正常体重组640例,超重组192例,肥胖组41例。四组间比较,结果提示不孕年限和用药量组间差异存在统计学差异(P0.05);组间两两比较,可见肥胖组不孕年限明显高于低体重组、正常体重组和超重组,肥胖组的用药量明显高于低体重组和正常体重组,组间差异均存在统计学意义(P0.05)。b FSH、用药天数、获卵数和受精率组间差异均未见统计学意义(P0.05)。结论对于排卵正常的病人而言,肥胖使其促排卵过程中用药量增加,但对其卵巢反应性没有明显影响。     

腹膜透析患者体重指数与预后的关系

目的初步探讨体重指数(BMI)对腹膜透析(PD)患者预后的影响。方法119例1999年1月起始行PD治疗患者,按BMI分为低体重组(BMI<20kg/m2)、正常体重组(20≤BMI<25kg/m2)及超重肥胖组(BMI≥25kg/m2)。采集这些患者的年龄、性别、RRF、Kt/V、血清白蛋白(SA)、Hb、CRP、心血管并发症以及转归等,并进行回顾性分析。结果与正常体重的PD患者相比,低体重者死亡率较高(42.11%对21.67%,P<0.05),而超重肥胖患者预后更差(52.5%对21.67%,P<0.01)。超重肥胖的PD患者心血管并发症的死亡率明显高于正常体重者(P<0.01)。Pearson相关分析发现,这些PD患者的BMI与其CRP(r=0.79,P<0.01),SA(r=0.58,P<0.01),Hb(r=0.32,P<0.05)呈正相关,而与其Kt/V(r=-0.36,P<0.05)负相关。Cox比例风险模型显示,BMI≥25kg/m2与PD患者死亡率独立相关(风险比例,1.31;95%可信限,1.20￣1.54;P<0.05)。结论低体重、尤其是超重肥胖PD患者预后不佳,BMI≥25kg/m2是值得关注的死亡危险因素。     

不同甲状腺功能绝经前女性血清饥饿素与全身骨量、肌肉量、体重的相关分析

目的:探讨不同甲状腺功能的绝经前女性血清饥饿素(ghrelin)水平与其身体成份骨量(BMC)、脂肪量(FM)、肌肉量(LM)的相互关系。方法:采用放射免疫分析法检测71例不同甲状腺功能的绝经前女性其中包括甲状腺机能亢进(甲亢)组33例、甲状腺机能减低(甲减)组18例、正常对照组20例的血清饥饿素水平,同时采用化学发光快速检测法检测其血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、灵敏促甲状腺激素(sTSH);并采用双能X线吸收法(DXA)测定其全身身体成份(骨量、脂肪量、肌肉量),同时记录体重(BW)。结果:(1)甲亢组血清饥饿素水平明显低于正常对照组(P0.01)和甲减组(P0.01),甲减组血清饥饿素水平与正常对照组之间无显著差别(P0.05)。血清饥饿素与其FT3(r=-0.318,P0.01)、FT4(r=-0.350,P0.01)呈负相关,与sTSH(r=0.281,P0.05)呈正相关。(2)血清饥饿素与全身骨量(r=0.284,P0.05)、肌肉量(r=0.259,P0.05)、体重(r=0.279,P0.05)存在正相关;与脂肪量不存在相关(P0.05)。结论:不同甲状腺功能的绝经前女性血清饥饿素可能影响其全身骨量、肌肉量、体重。     

超重、肥胖患者心脏结构、功能变化及影响因素研究

用超声心动图评价超重、肥胖患者心脏结构、功能变化,并探究心功能影响因素。本文将受试者分为正常组、超重组及肥胖组,各纳入34人,运用组织多普勒成像(TDI)、二维斑点追踪技术(2D-STI)及三维斑点追踪技术(3D-STI)分析比较三组心脏结构、功能变化。结果显示:与正常组比较,超重、肥胖组患者整体纵向峰值应变(GLS)、圆周峰值应变(GCS)、面积峰值应变(GAS)及径向峰值应变(GRS)递减,差异有统计学意义(P0.05);二尖瓣舒张早期前向血流速度与左室整体舒张早期峰值应变率之比(E/e′sr)(r=0.466,P0.001)以及GLS(r=0.502,P0.001)、GCS(r=0.426,P0.001)、GAS(r=0.535,P0.001)、GRS(r=-0.554,P0.001)等均与体重指数(BMI)相关;E/e′sr(r=0.37,P=0.003)、GLS(r=0.455,P0.001)、GCS(r=0.282,P=0.02)、GAS(r=0.412,P0.001)及GRS(r=-0.471,P0.001)均与游离脂肪酸(FFA)相关;stepwise逐步回归分析发现BMI与E/e′sr、GLS、GCS、GAS及GRS独立相关,腰臀比(WHR)与GLS、GCS、GAS及GRS独立相关,FFA与E/e′sr独立相关(P0.05)。研究表明超重、肥胖患者存在心脏结构改变及左室整体收缩、舒张功能受损,BMI、WHR、FFA可能是超重、肥胖患者心功能的独立影响因素。     

肥胖患者外周脂肪组织中瘦素受体水平的研究

通过对肥胖患者外周脂肪组织中瘦素(leptin)受体表达的研究,进一步探讨肥胖发生发展的机制.用放射配基竞争试验的方法,对71例受检者(其中肥胖32例,超重19例,正常人20名)外周脂肪组织leptin受体的密度进行检测.结果显示,随着体重指数(BMI)的增加,瘦素受体密度肥胖组和超重组与正常组比较差异十分显著(P＜0.01),肥胖组与超重组比较有显著性差异(P＜0.01);而受体与瘦素结合的能力没有显著性差异(P＞0.05).三组间的解离常数(Kd)值无差异,表明瘦素受体与配基结合的能力与BMI无关.从散点分布图可以看出,体重指数越大leptin受体的密度就越小,BMI与Bmax呈显著负相关(r=-0.76,P＜0.01).结论:肥胖患者外周脂肪组织中leptin受体的表达减少与BMI密切相关,这提示体内存在着leptin受体水平下调而造成leptin耐受,继而形成肥胖.     

汉族成人膝关节软骨厚度变化规律的研究

目的借助软骨磁共振成像技术研究我国20～40岁成年人膝关节软骨厚度变化规律及其与年龄、体质量和性别等与骨关节炎有关的主要临床因素的相关性。方法对200例20～40岁间汉族正常志愿者进行磁共振(MR)膝关节软骨成像,序列包括:快速自旋回波加权(FSE T2W)、三维脂肪抑制扰相梯度回波(3D-FS-SPGR)和脂肪抑制质子加权(FS-PD)。分别记录股骨内侧髁、外侧髁、胫骨内侧平台、外侧平台和髌骨区5个区域软骨最大厚度。同时分别记录关节胫股角、身高、体质量并计算体质指数(BMI)。分析不同性别、BMI正常和超质量组、不同年龄段(以5岁年龄差为一年龄组)的膝关节各区域之间软骨厚度差异;采用多元方差分析不同年龄组软骨厚度总体差异;采用Sperman分析法对年龄、BMI、性别与软骨厚度的相关性进行分析。结果样本胫股角平均值为4.6°,不同组间差异无统计学意义(F=14.683,P=0.094);不同年龄组在股骨内侧髁和胫骨内、外侧平台软骨厚度方面存在显著性差异,以上区域软骨随年龄增大而变薄的趋势明显(F=2 968.790,P<0.001);软骨厚度与年龄具有较为明显的负相关性(r外侧平台=-0.352,r内侧平台=-0.475,r股骨内侧髁=-0.363)。不同性别间软骨平均厚度差异无统计学意义(t=0.4235,P=0.672)。超质量与体质量正常组间软骨平均厚度无显著差异(t=0.798,P=0.425);成年人股骨外侧髁软骨厚度与BMI负相关(r=-0.162,P=0.022),其余部位与BMI无相关性。结论在我国20～40岁正常成年人中,膝关节不同区域的软骨厚度差异显著且随年龄变化明显。该年龄段正常人膝关节软骨厚度与性别、体质量无相关性。     

正常成年人促甲状腺素水平调查及其影响因素分析

目的 调查正常成年人血清促甲状腺素(TSH)水平,并分析性别、年龄、BMI、季节对TSH水平的影响.方法 2018年在解放军总医院第一医学中心进行健康体检的成年人检验资料20081例.95％分位数法调查中青年(18～60岁)及老年人(>60岁)TSH水平.分析不同性别、年龄(每10岁为1组)、BMI(低体重、正常、偏胖、肥胖)、采血季节(春夏秋冬)TSH水平差异,探索各因素对TSH水平的影响.结果 中青年TSH水平为2.10(0.74,5.66)mIU/L,老年人为2.19(0.69,6.48)mIU/L,老年人群水平高于中青年人水平(P=0.000).各年龄组、BMI组、季节组中女性TSH水平高于男性.肥胖组TSH水平高于体重正常组(男性P=0.004,女性P=0.022).四个季节中,男性和女性均为秋季TSH水平最低,女性在冬季达到TSH最高水平.结论 调查初步建立了中青年及老年人群TSH参考区间;TSH水平女性高于男性,肥胖人群高于体重正常人群,冬季高于秋季.     

慢性阻塞性肺疾病患者年龄及体质量指数与肺功能的关系

目的：揭示慢性阻塞性肺疾病发作期患者体质量指数（body mass index,BMI）、年龄与肺功能的关系。方法：选择慢性阻塞性肺疾病患者,测量其体质量及身高并检测其肺功能。比较营养不良组（BMI＜18.5）、正常组（18.5≤BMI＜24）、超重组（24≤BMI＜28）、肥胖组（BMI≥28）患者肺功能之间的关系;同时将患者分为老年组（年龄≥65岁）和非老年组（年龄≤64岁）,同样方法比较这两组患者的肺功能状态;检测BMI和年龄与肺功能之间的相关性。结果：营养不良组和正常组、超重组、肥胖组相比,第1秒用力呼气量占预计值的百分比（forced expiratory volume in on second, FEV1%）均存在统计学意义（P＜0.01）;正常组和超重组、肥胖组相比,FEV1%差异无统计学意义（P＞0.05）;超重组和肥胖组相比,差异无统计学意义（P＞0.05）。营养不良组与超重组、肥胖组相比,FEV1/用力肺活量（forced vital capacity, FVC）的比值差异均存在统计学意义（P＜0.01）;正常组和超重组、肥胖组相比,FEV1/FVC的差异有统计学意义（P＜0.05）。FEV1%老年组与非老年组相比,差异有统计学意义（P＞0.05）,而FEV1/FVC老年组与非老年组相比,差异有统计学意义（P＜0.05）;FEV1%和BMI呈正相关（r=0.22, P＜0.01）、FEV1/FVC和BMI呈正相关（r=0.29,P＜0.01）,年龄和FEV1%无显著相关性（r=-0.12,P＞0.05）,而年龄和FEV1/FVC呈负相关（r=-0.17, P＜0.05）。结论：慢性阻塞性肺疾病患者FEV1/FVC与患者的体质量指数和年龄均存在相关性,而体质量指数对FEV1%的影响不及对FEV1/FVC的影响,年龄对FEV1%的影响不大。     

695名0～12岁儿童维生素D及骨营养状况分析研究

目的了解0~12岁儿童维生素D及骨营养的状况,并探讨维生素D的含量对儿童骨营养的影响。方法儿童保健门诊2013年1月-2014年1月来我院儿保门诊健康体检695名0~12岁儿童,采用酶联免疫法进行血清25-(OH)D检测,采用定量超声技术(QUS)测定超声速度值(SOS),根据同年龄、同性别SOS标准值的百分位数划成低骨强度和正常骨强度。结果 25-(OH)D的平均浓度为(64.15±31.69nmol/L),男性与女性25-(OH)D水平差异无统计学意义(t=1.631,P0.05);维生素D缺乏组的低骨密度发生率大于维生素D正常组,前者骨的SOS值小于后者,两者统计学具有显著差异(P0.05)。结论维生素D缺乏会影响儿童骨营养的状况乃至骨的发育,应重视3~12岁儿童维生素D的补充,增强少年儿童的身体素质。     

GH, IGFBP-1, and IGFBP-3 response to oral glucose tolerance test in perimenopausal women: no influence of body mass index

OBJECTIVES: an increasing interest is being focused on the role of the somatotropic axis in the modulation of body weight and fat distribution, particularly in climacteric women. The influence of the glycometabolic state on the somatotropic axis in postmenopausal and in obese subjects has not been investigated. The aim of the present study is to evaluate whether menopause and body mass index (BMI) affect the response of growth hormone (GH), insulin-like growth factor-binding protein-1 (IGFBP-1) and -3 (IGFBP-3) to the oral glucose tolerance test (OGTT). METHODS: the study included 24 women, aged 45-55 years, categorized into 4 groups, premenopausal pre-obese (BMI = 28.5 +/- 0.8 Kg/m2) and normal body weight (BMI = 22.2 +/-1.1 Kg/m2), and postmenopausal pre-obese and normal body weight. All women underwent: (1) a biophysical evaluation with determination of waist/hip ratio; (2) an assessment of fat and lean tissue mass and body fat distribution by total body DEXA; and to (3) an OGTT. RESULTS: in response to OGTT plasma GH levels significantly decreased in all groups, but the relative decrease was more prominent in the lean subjects. A significant decrease of IGFBP-1 levels in response to OGTT was observed in all women, regardless of menopausal age and BMI, while IGFBP-3 levels did not significantly change in either group. CONCLUSIONS: in conclusion, the impact of both BMI and menopausal condition on GH, IGFBP-1, and -3 response to OGTT is limited to a blunted GH response in overweight women compared with normally-weighing ones. These findings appear to rule out the hypothesis that a common glycometabolic derangement may affect both the modifications of body weight and of the somatotropic axis observed in perimenopausal women.     

Quantitative ultrasound of the calcaneus in Arabian women: relation to anthropometric and lifestyle factors

OBJECTIVES: To determine factors influencing quantitative ultrasound (QUS) parameters of the calcaneus in a population-based sample of United Arab Emirates (UAE) women, and to compare QUS parameters of the calcaneus for healthy young UAE women with the manufacturer's reference ranges for other populations. METHODS: All subjects completed a questionnaire on reproductive and life style factors. Height and weight were measured, and body composition was determined by bioelectric impedence. Estimated bone mineral density (BMD), Speed of sound (SOS), broadband ultrasound attenuation (BUA) and quantitative ultrasound index (QUI) of the right calcaneus were determined by Sahara ultrasound. RESULTS: In premenopausal women (n=330), age, weight, body mass index (BMI), lean weight, fat weight, education, age at menarche, and number of pregnancies, correlated significantly with QUS parameters. Multiple regression analysis showed that age at menarche, number of pregnancies, and BMI, were the best predictors of QUS parameters although these factors explained only small amounts of the variance (R(2)=0.05). In postmenopausal women (n=81), age, BMI and physical activity were the best predictors of BUA (R(2)=0.35), SOS (R(2)=0.39), and QUI (R(2)=0.43). Mean estimated BMD, QUI and SOS for healthy young UAE women were significantly lower than the manufacturer's reference ranges for U.S. Caucasian, European Caucasian, and Chinese Asian healthy young women of the same age range (P<0.001 for all comparisons). Mean BUA was not significantly different, however. CONCLUSIONS: Menopausal status, age, BMI and physical activity are strong predictors of QUS parameters of the calcaneus in Arabian women. Healthy young Arabian women have lower estimated calcaneal BMD compared with the manufacturer's reference ranges for other populations.     

The influence of serum leptin concentration on bone mass assessed by quantitative ultrasonometry in pre and postmenopausal women

OBJECTIVE: the aim of this study was to evaluate the influence of serum leptin concentration on bone mass assessed by quantitative ultrasound (QUS) in a large sample of healthy pre and postmenopausal women. DESIGN: 555 healthy pre and postmenopausal (n=261 and n=294) women (mean age, 49.5+/-17.2 years) not on hormone replacement therapy were recruited on the occasion of a routine gynecological visit. Before entry to the study, all women had answered a detailed questionnaire on important risk factors and gave written informed consent. Speed of sound (SOS), broadband ultrasound attenuation (BUA) and stiffness index (SI) of the os Calcis were measured using the Achilles ultrasonometer (GE/lunar). We systematically investigated the relation of menopause, BMI and leptin on bone mass by allocating women into the following groups: (a) premenopausal women BMI<25 kg/m(2) (N=178); (b) premenopausal women BMI>25 kg/m(2) (N=83); (c) postmenopausal women BMI<25 kg/m(2) (N=125); and (d) postmenopausal women BMI>25 kg/m(2) (N=169). Additionally we investigated the relation of serum leptin concentrations, age and BMI on ultrasonometry variables by performing a multiple linear regression analyses. RESULTS: in the initial analyses premenopausal women showed a significantly (P<0.001) lower mean age, weight, BMI, follicle stimulating hormone (FSH) and leptin concentration, a higher mean height, serum estradiol and ultrasonometry variables in comparison to postmenopausal women. Irrespective of the menopausal status, women with a BMI>25 kg/m(2) had significantly higher leptin concentrations (P<0.001) and BUA (P<0.05) whereas SOS and SI was not significant different, compared to women with a BMI<25 kg/m(2). The multiple linear regression analyses showed that only BMI but not Leptin was related to higher ultrasonometry variables, whereas increasing age was associated with a decrease in ultrasonometry variables. Furthermore, the multiple linear regression analyses confirmed that age and BMI were the only statistically significant independent predictor for ultrasonometry variables. There was no significant influence of leptin on ultrasonometry variables even after controlling for BMI or age, or BMI and age. CONCLUSIONS: serum leptin concentrations are significantly higher in pre and postmenopausal obese women, compared with normal weight controls. Ultrasonometry variables are influenced by age and BMI but not by serum leptin concentrations.     

Effects of uncoupling protein 1 and beta3-adrenergic receptor gene polymorphisms on body size and serum lipid concentrations in Japanese women

OBJECTIVES: To investigate whether the -3826 A-G point mutation of the uncoupling protein 1 (UCP1) gene and the Trp64Arg mutation of the beta3-adrenergic receptor (beta3-AR) gene are associated with increased susceptibility to weight gain and hyperlipidemia in postmenopausal women. METHODS: We genotyped 312 Japanese women for UCP1 and beta3-AR gene polymorphisms, and investigated their effects on anthropometrical parameters, serum lipid concentrations, and their changes after 4 years. RESULTS: Although body mass index (BMI), serum triglyceride, total cholesterol, and low-density lipoprotein levels were significantly higher and high-density lipoprotein levels significantly lower in postmenopausal (n=182) than in premenopausal (n=99) women, there was no significant difference in these parameters between carriers and non-carriers of the G allele in the postmenopausal women. In the premenopausal women, BMI and the 4-year change in body weight (BW) of carriers of the G allele were significantly higher than those of non-carriers of the G allele (P=0.022 and 0.048, respectively). In the postmenopausal women, the 4-year change in the level of serum triglyceride of carriers of the G allele was significantly higher (P=0.049), and the change of high-density lipoprotein was significantly lower (P=0.020) than those of non-carriers of the G allele. The beta3-AR polymorphism showed no apparent affect on these parameters. CONCLUSIONS: The -3826 A-G polymorphism of the UCP1 gene is associated with an increase in BW of premenopausal women and with the 4-year changes in serum triglyceride and high-density lipoprotein levels in postmenopausal women.     

Relationship of single measures of cardiorespiratory fitness and obesity in young schoolchildren.

The purpose of this study was to examine differences of cardiorespiratory fitness (CRF) among weight groups, and the associations of CRF with obesity (body mass index) in a sample of young children. Anthropometric data (height, body mass, and two skinfolds) were collected for 255 healthy children aged 8-10 years (127 boys and 128 girls). Children were placed in three groups (nonobese, overweight, and obese), using body mass index (BMI) sex- and age-specific cutoff points. Cardiorespiratory fitness was assessed with a 1-mile run test. Participants were separated into two groups: fit and unfit, according to age- and sex-specific scores defined by FITNESSGRAM. The prevalence of overweight (30.5% vs. 29.1%) and obesity (13.2% vs. 12.6%) was at the same magnitude for boys and girls. Overall, 109 children (42.7%) were overweight and obese. Sums of skinfolds, weight, and BMI were significantly lower (P < 0.05) in lean boys and girls compared to their overweight and obese counterparts. Regarding height, no significant differences were found in girls, while in boys, significant differences were only found between nonobese and obese. No differences were found in obesity groups according to CRF in boys, while significant differences were found for girls (P < 0.01). Logistic regression analysis showed that girls who were overweight (odds ratio = 0.05, P = 0.000) or obese (odds ratio = 0.09, P = 0.001) were likely to be unfit. No significant results were found in boys. Overweight and obese children presented higher sums of skinfolds and weight compared with their lean counterparts. Increased BMI was significantly associated with lower CRF in girls. Thus, our data clearly showed potential gender differences of body composition in CRF, which would be of great clinical significance. Therefore, even at young ages, at least for girls, the beneficial impact of low BMI values on CRF is shown with important clinical and public health implications.     

Early postmenopausal bone loss in hyperthyroidism.

OBJECTIVES: To evaluate the effect of hyperthyroidism on bone in relation to the menopausal state. METHODS: Fifty-nine hyperthyroid (HYPER), 40 hypothyroid (HYPO), and 51 control euthyroid (EUTH) women were studied. Bone mineral density (BMD) was assessed by dual X-rays absorptiometry (DXA) at the lumbar spine, and at the femoral neck. A multi-site QUS device evaluated speed of sound (SOS) at the radius (RAD), tibia (TIB), metatarsus (MTR), and phalanx (PLX). Bone markers used were serum bone specific alkaline phosphatase (BSAP) and urinary deoxypyridinoline (DPD). RESULTS: At all sites, SOS was lower in HYPER than in EUTH (RAD P<0.05, TIB P<0.01, MTR P<0.05, PLX P=0.01). The low SOS was only noted at the early postmenopausal period. BMD at the femoral neck but not at the lumbar spine was lower in HYPER as compared to EUTH (P<0.05). Both femoral neck and tibia were the sites with the highest odds ratio for being hyperthyroid (2.3 and 2.04, respectively). There was no correlation between BMD or SOS and FT(4), TT(3) or duration of hyperthyroidism. BSAP and DPD positively correlated with FT(4) and TT(3) (P<0.05). CONCLUSIONS: This study suggests that hyperthyroidism affects bone mineralization especially during the early postmenopausal period, and the effect is mainly at the cortical bone.     

Body mass index (BMI) and parameters of bone formation and resorption in postmenopausal women

OBJECTIVES: Aim of this study was to evaluate increased body mass index (BMI) as an anthropometric factor, predisposing to lower rates of bone turnover or changes in bone balance after menopause. MATERIAL AND METHODS: For this purpose, we calculated BMI, and measured spinal (BMD(SP)) and femoral bone mineral density (BMD(FN)) and biochemical markers of bone formation (serum osteocalcin (S-OC), serum procollagen type I C propeptide (S-PICP), serum bone-specific alkaline phosphatase (S-B-ALP)) and resorption (urine N- and C-terminal cross-linking telopeptide of type I collagen (U-NTX-I and U-CTX-I), pyridinoline (U-PYD) and deoxypyridinoline (U-DPD)) in 130 healthy postmenopausal women, aged 46-85 years. Bone balance indices were calculated by subtracting z-scores of resorption markers from z-scores of formation markers, to evaluate bone balance. RESULTS: S-PICP ( r = -0.297, P = 0.002), S-OC ( r = -0.173, P = 0.05) and bone balance indices (zPICP-zDPD) and (zPICP-zPYD) were negatively correlated with BMI (r = -0.25, P = 0.01 and r = -0.25, P = 0.01 and r = -0.21, P = 0.037) and with BMD(SP) (r = -0.196, P = 0.032 and r = -0.275 and P = 0.022). Women were grouped according to their BMI, in normals (BMI < 25 kg/m2), overweight (BMI = 25-30 kg/m2, and obese (BMI > 30 kg/m2). Overweight and obese women had approximately 30% lower levels of S-PICP compared to normals (68.11 +/- 24.85 and 66.41 ng/ml versus 97.47 +/- 23.36 ng/ml, respectively; P = 0.0001). zPICP-zDPD, zPICP-zCTX-I and zPICP-zPYD were significantly declined in obese women compared to normals (P = 0.0072, 0.02 and 0.0028). CONCLUSIONS: We conclude that in postmenopausal women, BMI is inversely associated with levels of collagen I formation marker, serum PICP. In obesity formation of collagen I was reduced, in favor of degradation, but since this finding is not followed by simultaneous decrease in bone mineral density, it seems that increased body weight may have different effects on mature estrogen-deficient bone and extraskeletal tissues containing collagen I.     

The influence of hormone replacement therapy (HRT) on serum leptin concentration in postmenopausal women

OBJECTIVE: This study aimed to evaluate the influence of hormone replacement therapy (HRT), the estradiol concentration and body mass index (BMI, kg/m(2)) on the serum leptin concentration in postmenopausal women. SUBJECTS AND METHODS: 352 healthy postmenopausal women (mean age, 60.9 +/- 8.5 years) participated in this comparative study. 71 (30%) women (mean age 55.9 +/- 8.3 years) had taken HRT, while 281 (70%) women (mean age, 59.1 +/- 10.6 years) had not. Baseline characteristics -age, weight, height, BMI (greater than or = 25 or <25), follicle stimulating hormone, estradiol, and leptin values-were compared in the two groups. In a second analysis to evaluate the influence of HRT, estradiol concentrations, and BMI on leptin concentrations, these data were analysed in women allocated to one of four groups: (a) postmenopausal women not on HRT with a BMI <25 (n = 130); (b) postmenopausal women not on HRT with a BMI greater than or = 25 (n = 151); (c) postmenopausal women on HRT with a BMI<25 (n = 48); and (d) postmenopausal women on HRT with a BMI greater than or = 25 (n = 23). Leptin concentrations were subsequently analysed in relation to BMI and age and BMI and estradiol concentrations to determine any independent effect of these variables. RESULTS: The women taking HRT had a significantly lower mean age, weight, BMI and follicle stimulating hormone concentration than those who were not taking HRT. Furthermore, they had a higher mean height and serum estradiol value, but a significantly lower serum leptin concentration. After controlling for BMI, neither the use of HRT nor the estradiol concentration was found to be related to the leptin value (group (a) versus (c) and group (b) versus (d)), but there were significant differences in leptin concentrations between HRT users with BMI greater than or = 25 and BMI <25 and between women not taking HRT with BMI greater than or = 25 and BMI <25 (groups (a) versus (b) and (c) versus (d)). Furthermore, women with a BMI greater than or = 25 had significantly higher leptin concentrations than women with a BMI<25, irrespective of the HRT use. CONCLUSIONS: Leptin concentrations are significantly higher in obese postmenopausal women than in their non-obese counterparts. Serum leptin concentrations are not influenced by HRT use or estradiol concentrations. Further studies are needed to elucidate the role of HRT and estrogen on serum leptin concentrations.     

Does Quantitative Tibial Ultrasound Predict Low Bone Mineral Density Defined by Dual Energy X-Ray Absorptiometry?

PURPOSE: Efforts for the early detection of bone loss and subsequent fracture risk by quantitative ultrasound (QUS), which is a non-invasive, radiation free, and cheaper method, seem rational to reduce the management costs. We aimed in this study to assess the probable correlation of speed of sound (SOS) values obtained by QUS with bone mineral density (BMD) as measured by the gold standard method, dual energy X-ray absorptiometry (DEXA), and to investigate the diagnostic value of QUS to define low BMD. MATERIALS AND METHODS: One hundred twenty-two postmenopausal women having prior standard DEXA measurements were included in the study. Spine and proximal femur (neck, trochanter and Ward's triangle) BMD were assessed in a standard protocol by DEXA. The middle point of the right tibia was chosen for SOS measurement by tibial QUS. RESULTS: The SOS values were observed to be significantly higher in the normal BMD (t score > -1) group at all measurement sites except for the lumbar region, when compared with the low BMD group (t score < -1). SOS was negatively correlated with age (r= -0.66) and month since menopause (r= -0.57). The sensitivity, specificity, and positive and negative predictive values for QUS t score to diagnose low BMD did not seem to be satisfactory at either of the measurement sites. CONCLUSION: Tibial SOS was correlated weakly with BMD values of femur and lumbar spine as measured by DEXA and its diagnostic value did not seem to be high for discriminating between normal and low BMD, at these sites.