绝经后妇女血清脂联素、瘦素水平与骨密度关系

目的：探讨绝经后妇女血清脂联素（adiponectin）、瘦素（leptin）水平与骨密度（BMD）的关系。方法：用酶联免疫吸附试验测定363名40~80岁健康绝经后女性血清脂联素、雌二醇、睾酮、25-羟维生素D、甲状旁腺激素;用双能X线骨密度扫描仪测定总体、腰椎正位、总髋部BMD以及体脂、瘦体质量;并分析它们之间的关系。结果：脂联素与总体BMD、腰椎BMD、髋部总体BMD、前臂BMD均呈负相关（分别r=-0.181, r=-0.208, r=-0.228, r=-0.203, P＜0.05）,校正年龄和体脂后,相关性依然存在（分别r=-0.131, r=-0.140, r=-0.159, r=-0.172, P＜0.05）。瘦素与髋部总体BMD、前臂BMD均呈正相关（分别r=0.162, r=0.210, P＜0.05）;瘦素与总体BMD、腰椎BMD不相关;校正年龄和体脂后,瘦素与前臂BMD相关性存在（r=0.157, P＜0.05）,而与髋部总体BMD相关性消失。逐步多元线性回归分析显示,绝经年限、瘦体质量、脂联素、雌二醇是总体、髋部与前臂BMD的独立影响因素。绝经年限、瘦体质量、BMI、脂联素、雌二醇是腰椎BMD的独立影响因素。结论： 脂联素是BMD的独立影响因素。     

男性血清脂联素、瘦素水平与骨密度关系

目的:探讨男性血清脂联素(adiponectin)、瘦素(leptin)水平与骨密度(BMD)的关系. 方法:采用酶联免疫吸附实验(ELISA)测定232名20~80岁健康男性血清adiponectin和leptin水平;用双能X线吸收法(DXA)骨密度仪测定总体、腰椎正位、总髋部BMD,全身扫描测定体脂、瘦体质量.结果:Leptin与体脂呈正相关,校正年龄与体质量指数后,相关性仍存在.Adiponectin与体脂呈负相关,校正年龄与体质量指数后,相关性消失.Adiponectin与总体、腰椎正位、总髋部BMD呈负相关,校正年龄与体脂后,相关性存在.Leptin与总体、腰椎正位、总髋部BMD无相关性.多元线性回归分析显示adiponetin是男性各部位BMD的独立影响因素.结论:Leptin与男性各部位BMD无相关性,adiponetin与各部位BMD呈负相关,是男性各部位BMD的独立影响因素.     

体成分对不同糖耐量水平男性骨密度的影响

目的：观察体成分对正常糖耐量（NGT）及2型糖尿病(T2DM) 男性骨密度的影响及差异。方法：选择87例门诊及体检中心成年男性就诊者,其中57例为2型糖尿病（T2DM组）,30例为糖耐量正常（NGT组）,年龄35～64岁。采用双能X线骨密度仪测定腰椎前后位（AP）腰1至腰4、左侧股骨颈（FN）、左髋部总体（T hip）及全身骨密度(T BMD),同时测定体成分,计算出瘦体质量(LTM)、体脂量(FTM)、躯干体脂比(Tru fat%)及总体脂比(Fat%)。分析体成分对2组研究对象骨密度的影响。结果：NGT组瘦体质量与股骨颈BMD正相关（r=0.411,P=0.024）,T2DM组两者不相关;T2DM组体脂比与腰椎BMD负相关（r=-0.311,P=0.023）,而NGT组两者无关。两组的体脂比均与全身BMD显著负相关。NGT组LTM是腰椎、股骨颈及髋部总体BMD的唯一独立影响因素（依次b=0.509,0.411,0.585,P＜0.01或0.05, R2=0.169～0.342）;T2DM组,LTM是腰椎（b=0.330,P＜0.05,R2=0.109）和髋部BMD（b=0.462,P＜0.01,R2=0.213）的唯一预测因素,而非股骨颈BMD的预测因素。结论：相对于正常糖耐量男性,2型糖尿病男性患者的瘦体质量对骨密度的保护作用减弱。无论糖耐量正常与否,成年男性体脂比例的增加不利于骨量的保护。     

男性骨生化指标随年龄的变化及其与骨密度的关系

目的:探讨男性人群血清骨特异性碱性磷酸酶(BAP)和Ⅰ型胶原氨基末端肽(NTX)随年龄变化及其与骨密度(BMD)之间的关系.方法:用ELISA测定389例20～80岁健康男性BAP和NTX,用DXA仪测定腰椎及髋部BMD.结果:BAP和NTX与年龄呈负相关,随年龄的变化均以三次回归模型的拟合程度最佳,拟合曲线的决定系数(R2)为0.013～0.029(P＜0.05).2个生化指标的水平在20～29岁年龄段最高,随后随年龄的增长而降低;50～59岁段达最低值.60岁之后骨吸收指标轻度增加,而骨形成指标则保持相对稳定.校正年龄、身高、体质量、体质量指数及吸烟后的偏相关分析显示BAP与各部位BMD呈负相关,而NTX与腰椎及髋部总体BMD呈负相关.结论:BAP和NTX是反映中国男性随年龄变化的骨转换的敏感性、特异性较强的指标,监测这两个指标有助于早期防治骨质疏松症(OP).     

绝经后女性血清网膜素-1与骨密度的关系

目的:探讨绝经后女性血清网膜素-1浓度与骨密度的关系,进一步了解脂肪组织对骨密度的影响。方法:运用双能X线骨扫描仪(DEXA)测定此336名受试人群全身总体骨密度、腰椎正位、左侧前臂、髋部总体、左侧股骨颈、Ward’s三角区、左侧股骨大转子及转子内骨密度及体成份,运用酶联免疫吸附试验(ELISA)测定血清脂肪因子(网膜素,脂联素,瘦素,抵抗素,内脏脂肪素,apelin)浓度。结果:超重及肥胖组较正常体重组有更高的总髋、股骨颈、转子内骨密度;血清网膜素-1与腰椎、股骨颈、股骨大转子、转子内、总髋、Ward’s三角区BMD呈负相关(r=-0.159,-0.259,-0.233,-0.243,-0.247,-0.112),校正年龄、BMI及体脂后,网膜素-1与各部位BMD相关无显著性。逐步多元线性回归分析,总瘦重、绝经年限及雌激素是总体及各部位骨密度的独立相关因素,其变化分别可以解释12.2%~13.7%,6.9%~13.1%,0.9%~1.7%的变异。血清脂联素是腰椎、总髋及总体骨密度的独立相关因素。结论:绝经后女性血清网膜素-1与各部位及总体骨密度无显著相关;雌激素、绝经年限、瘦重是绝经后女性各部位及总体骨密度的独立预测因子。血清脂联素是腰椎、总髋及总体骨密度的独立预测因子。     

老年2型糖尿病瘦素、骨密度变化及相关因素的研究

目的 探讨老年2型糖尿病(T2DM)患者骨密度变化及其与瘦素、性激素及各种骨转换因子的相关关系.方法 采用单能定量CT(QCT)对53例2型糖尿病患者及40例健康老年人进行脊柱骨密度(BMD)测定,并分析受试者的骨密度与体质量指数(BMI)、腰臀比(WHR)、血清瘦素(leptin)、性激素、骨钙素(BGP)、骨特异性碱性磷酸酶(B-ALP)、抗酒石酸酸性磷酸酶-5b(TRACP-5b)等指标间的关系.结果 ①T2DM组脊柱BMD均值显著低于对照组(P＜0.05),T2DM组血浆瘦素浓度较对照组显著升高(P＜0.05).②相关性研究显示,T2DM组瘦素水平与L1椎体及脊柱BMD均值呈显著负相关(r=-0.443,r=-0.373,P＜0.05).③多元线性回归分析表明,T2DM组中瘦素、E2、T分别是BMD变化的独立相关因素.结论 老年2型糖尿病患者存在不同程度的骨密度下降.瘦素是老年T2DM患者骨量减少的影响因素,但不是直接因素.     

绝经后女性血清网膜素-1与骨密度的关系

目的：探讨绝经后女性血清网膜素-1浓度与骨密度的关系,进一步了解脂肪组织对骨密度的影响。方
法：运用双能X线骨扫描仪(DEXA)测定此336名受试人群全身总体骨密度、腰椎正位、左侧前臂、髋部总体、左侧
股骨颈、Ward’s三角区、左侧股骨大转子及转子内骨密度及体成份,运用酶联免疫吸附试验(ELISA)测定血清脂肪
因子(网膜素,脂联素,瘦素,抵抗素,内脏脂肪素,apelin)浓度。结果：超重及肥胖组较正常体重组有更高的总
髋、股骨颈、转子内骨密度;血清网膜素-1与腰椎、股骨颈、股骨大转子、转子内、总髋、Ward’s三角区BMD呈负
相关(r=-0.159,-0.259,-0.233,-0.243,-0.247,-0.112),校正年龄、BMI及体脂后,网膜素-1与各部位BMD相关
无显著性。逐步多元线性回归分析,总瘦重、绝经年限及雌激素是总体及各部位骨密度的独立相关因素,其变化分
别可以解释12.2%~13.7%,6.9%~13.1%,0.9%~1.7%的变异。血清脂联素是腰椎、总髋及总体骨密度的独立相关因素。
结论：绝经后女性血清网膜素-1与各部位及总体骨密度无显著相关;雌激素、绝经年限、瘦重是绝经后女性各部位
及总体骨密度的独立预测因子。血清脂联素是腰椎、总髋及总体骨密度的独立预测因子。     

血清瘦素水平与绝经后妇女骨密度关系的研究

目的　研究血清瘦素水平和绝经后妇女骨密度 (BMD)之间的关系。方法　测定 14 0名上海地区健康绝经后妇女的体重指数 (BMI)、腰臀比值 (WHR)、体脂 (FM )、体脂百分比 (Fat% )、空腹瘦素以及腰椎(L2～ 4)和股骨颈 (FN)BMD。结果　由于血清瘦素呈非正态分析 ,故将其转换为自然对数 (Inleptin)。Inleptin与体重、BMI、WHR、Fat%和FM均呈显著正相关 (r =0 .2 6～ 0 .75 ,P值均 <0 .0 1)。L2～ 4、FNBMD与Fat%和Inleptin呈显著正相关 (r =0 .2 9～ 0 .34,P值均 <0 .0 1)。校正年龄、体重和Fat%影响后 ,Inleptin与L2～ 4BMD间仍存在正相关关系 (r =0 .2 0 ,P =0 .0 3) ,而Fat%与L2～ 4、FNBMD的正相关关系经校正年龄、体重后消失。多元逐步回归分析显示 ,Inleptin和年龄是影响L2～ 4BMD的独立决定因素 (R2 =0 .174 ,P =0 .0 0 0 ) ,体重和年龄是影响FNBMD的独立决定因素 (R2 =0 .2 6 4 ,P =0 .0 0 0 )。结论　血清瘦素水平与绝经后妇女腰椎BMD之间的正相关关系不受年龄、体重和Fat%的影响 ,提示血清瘦素可能是绝经后妇女腰椎BMD的独立预测因子。     

绝经后女性类风湿关节炎患者骨密度与生化免疫指标相关性的研究

  目的 寻找血生化免疫指标中与类风湿关节炎（RA）患者骨密度（BMD）相关的参数。 方法 选择32例绝经后女性RA患者,测定其血沉(ESR)、C-反应蛋白(CRP)、类风湿因子（RF）、纤维蛋白原(Fib)、血小板(PLT)、血红蛋白(HB)、碱性磷酸酶（ALP）、钠（Na+）、钙（Ca2+）、免疫球蛋白（IgG,IgA,IgM）及补体（C3,C4）值;采用双能X射线骨密度检测仪测量患者的腰椎（L1~L4）及髋部BMD。 结果 绝经后女性RA患者腰椎和髋部BMD与年龄呈显著负相关(腰椎r=-0.505,P＜0.01;右髋部r=-0.424,P＜0.05;左髋部r=-0.487,P＜0.01);多元线性回归分析显示髋部BMD与ALP、RF及Na+关系密切,前两者与BMD呈负相关,后者与BMD呈正相关。 结论 绝经后女性RA患者的BMD随年龄增长呈下降趋势,ALP、RF及Na+与髋部BMD关系密切。     

运动和营养对青年女子骨密度影响研究

目的:研究大学一年级女生骨密度状况,分析影响青年女性峰值骨密度(BMD)的因素.方法:应用DEXA测定84名大学一年级女生骨密度和体成分,通过问卷调查了解受试对象每日牛奶摄入情况.结果:研究对象中普通组和运动组的BMI分别为(19.2±2.4) kg/m2和(19.8±2.3) kg/m2;瘦体重(38.4±3.6) kg和(39.7±4.5) kg;体脂百分比(26.2±3.3)％和(25.4±2.7)％;运动组的瘦体重、体脂百分比以及各部位骨密度与普通组之间均呈显著性差异(P＜0.05).各组受试对象腰椎、髋部骨密度与体重、BMI、瘦体重和体脂百分比均呈正相关(P＜0.01),牛奶摄入量≥250mL/d者骨密度高于不足250mL/d者,但无显著差异(P＞0.05).结论:运动、体重、BMI和体脂百分比是骨密度的主要影响因素,单纯牛奶摄入对于骨密度的影响不明显.     

体质成分及脂肪因子对青春前期女孩骨密度的影响

目的探讨体质成分及脂肪因子与骨密度的关系,并评价体质成分、瘦素及脂联素对青春前期女孩骨密度的影响。方法入选60例体检的青春前期女孩,根据体质量指数分为肥胖组(n=36)和正常对照组(n=24)。用酶联免疫分析法测定血清瘦素、脂联素浓度,采用双能X线测量仪测量骨密度,应用生物电阻抗技术分析体质成分。结果肥胖组平均体质量、体质量指数、瘦素浓度、脂肪量及骨密度均显著高于对照组(P<0.05)。线性相关分析结果显示体质量、体质量指数、脂肪量、瘦体质量及瘦素浓度与股骨颈及脊骨的骨密度呈正相关;身高与脊骨骨密度呈正相关(r=0.627,P=0.012),而与股骨颈骨密度无相关(r=0.265,P=0.201)。多元线性回归分析显示,瘦体质量为股骨颈及脊骨骨密度的正性预测因子;血清瘦素浓度是股骨颈骨密度的正性预测因子,而脂肪量为股骨颈骨密度的负性预测因子。结论在青春前期女孩中,瘦体质量为股骨颈及脊骨骨密度的正性独立预测因子,对骨密度有着良性的作用。血清瘦素水平可能在骨的代谢调节中起着重要的生物学作用。     

Serum leptin concentration, adiposity, and body fat distribution in Mexican-Americans

BACKGROUND: Leptin is strongly associated with adiposity and few studies have investigated its role in Mexican-Americans. The aims of this study were to examine the association of serum leptin concentration with adiposity and body fat distribution in Mexican-Americans and to develop a predictive model of serum leptin concentration for this ethnic group. METHODS: Three hundred fifty-two college students (242 women, 110 men; age 18-30 years) were evaluated in this cross-sectional study. Body fat content was assessed using bioelectrical impedance analysis. Correlation between serum leptin levels and several markers of adiposity and body fat distribution were examined in both men and women. Multiple regression analysis was performed to create the predictive model. RESULTS: Women had higher serum leptin concentrations than men for the same levels of adiposity. After controlling for gender and body fat, only fat mass (FM) expressed in kg, was significantly correlated with serum leptin concentration in men (partial rho = 0.811, p <0.001), whereas body mass index (BMI), hip circumference (HC), and FM expressed in kg, were significantly correlated with serum leptin concentration in women (partial rho = 0.214, p <0.001; partial rho = 0.201, p <0.01; and partial rho = 0.818, p <0.001, respectively). Percent body fat (PBF) was the only significant predictor of serum leptin concentration among men, explaining 42% of the variance in serum leptin concentration. In addition to PBF, waist circumference (WC) and HC were significant predictors of serum leptin concentration among women explaining 65% of the variance in serum leptin concentration. CONCLUSIONS: Serum leptin concentration is a function of adiposity as determined by PBF in both Mexican-American men and women. HC and WC are associated with serum leptin concentration in Mexican-American women but not in men. BMI alone should not be used in evaluating the association of serum leptin concentration with body fatness in Mexican-Americans.     

Predictors of bone mass in healthy older men in the community

OBJECTIVES: To determine the predictors of bone mass (in lumbar spine and femoral neck) in healthy older men living in the community. DESIGN: Cross-sectional study. Bone mineral density (BMD) was measured and known predictors of bone mass and bone turnover were assessed. SUBJECTS AND SETTING: 113 independent, healthy men (70 years and over), not taking glucocorticoid therapy and without medical conditions known to affect bone mass and bone turnover, were recruited from recreational and sports clubs in southern Sydney in April/May 1997. MAIN OUTCOME MEASURES: BMD (measured by dual-energy x-ray absorptiometry); known predictors of bone mass (height; weight; body mass index; calcium level; serum 25-hydroxyvitamin D and free testosterone levels); and markers of bone turnover (serum bone Gla protein and procollagen-1 concentrations, and urinary deoxypyridinoline excretion rates). RESULTS: The mean age of the men was 76.6 years (range, 70-92 years). Mean (SE) BMD of the lumbar spine was 1.143 (0.019) g/cm2 and that of the femoral neck was 0.897 (0.013) g/cm2. BMD values indicating osteoporosis were found in the lumbar spine in 13 men (11.5%) and in the femoral neck in 35 men (31%). The best predictor of lumbar spine BMD was weight (R = 0.37; P = 0.001), and weight- and age-predicted femoral-neck BMD (R = 0.49; P < 0.001). The study group was analysed in two groups with BMD higher or lower than median bone mass corrected for age. Men with lower femoral-neck BMD for age had significantly lower weight, lower lean mass and higher bone Gla protein concentrations. In addition, men with lower lumbar spine BMD for age also had significantly lower fat mass. CONCLUSIONS: These data indicate that measures of body composition, such as weight and lean mass, are the main predictors of bone mass in healthy, community-dwelling older men.     

绝经后女性血清睾酮与瘦体质量、体脂和骨密度的关系

目的:探讨绝经后女性人群血清睾酮与瘦体质量、体脂和骨密度的关系。方法:长沙地区各工作岗位的45~81岁绝经1年以上健康女性志愿者185例,每例受试者空腹抽血,放射免疫法测定血清睾酮浓度。采用美国Hologic QDR-4500A型扇形束DXA仪,测量每例受试者腰椎前后位腰1至腰4及髋部总体面积骨密度(BMD), 单位g/cm2。用美国Hologic QDR-4500A型扇形束DXA仪作全身扫描测出头部、躯干、肋骨、骨盆、脊椎、上肢、下肢及全身的骨矿物含量、BMD、体脂含量和肌肉组织质量,结合测得的指标,计算出体质量、瘦体质量和体脂百分比。所有资料均输入电脑,应用SPSS11.0软件包进行统计学分析。结果:血清睾酮含量与瘦体质量、总体脂及体脂百分比均不相关;血清睾酮含量与腰椎、髋部BMD正相关,校正年龄、绝经年限、体脂和瘦体质量后,相关性消失。瘦体质量与各个部位BMD呈显著正相关;总体脂含量与髋部BMD呈正相关,体脂百分比与全身BMD呈负相关。结论:保持一定量的瘦体质量有利于绝经后女性保持骨量,而补充雄激素尚需谨慎。     

Osteoporosis risk factors and association with somatotypes in males

BACKGROUND: Osteoporosis is a systemic and metabolic skeletal disease characterized by reduced bone mass, changes in microarchitecture, and consequential increased fracture risk. Previous reports described a relationship between bone content with fat mass and lean body mass. In this study, we assessed osteoporosis risk factors and the association with somatotypes in males aged 45-65 years. METHODS: Standard axial spine and proximal femur bone mineral density (BMD) were measured using dual x-ray (DXA) absorptiometry in 70 healthy men. Heath-Carter procedure was followed to assess individual's somatotype. RESULTS: All body types were grouped as endomorphy, mesomorphy, and ectomorphy. Moderate to weak correlations were found between lumbar BMD with endomorphy and mesomorphy. Negative correlation was found between lumbar BMD and ectomorphy. Total femur BMD correlated positively with endomorphy and mesomorphy and negatively correlated with ectomorphy. Body mass index correlated weakly with lumbar, femur neck, and total femur BMD. Multiple regression analysis revealed that endomorphy was significantly related to BMD measurements at lumbar spine (standardized coefficient, SC = 0.51, p = 0.001), femur neck (SC = 0.52, p = 0.001), and total femur BMD (SC = 0.41, p = 0.01). Lumbar BMD and age, hand grip strength, smoking, tea and coffee consumption, calorie expenditure, calcium intake, PTH, albumin, total protein, sex hormone-binding globulin, and testosterone were not significantly correlated. CONCLUSIONS: Endomorphy seems related to high BMD values at the lumbar spine and the proximal femur in middle-aged men. Somatotype together with daily calorie expenditure may be taken into account when assessing risk factors for male osteoporosis.     

青岛地区1560例正常汉族人骨密度调查

目的通过对青岛地区1560例正常汉族人骨密度（BMD）的调查,探讨青岛地区正常成年人的骨密度随年龄变化的规律,为诊断和预防骨质疏松提供科学依据。方法用双能X线骨密度仪（DXA）测量1560例参考人群的6个骨骼部位BMD。用8种回归模型拟合健康成年人群BMD随年龄的变化趋势,找出最佳拟合的方程建立数据库。结果①6个骨骼区域峰值骨密度（PBMD）年龄,男性在30-34岁;女性腰椎在25-29岁,髋部在40-44岁。②各骨骼区域在达到PBMD之后,均呈现随年龄增高BMD逐渐降低的趋势。③用三次回归模型拟合程度优于其他回归模型,拟合曲线的决定系数（R2）最大。结论青岛地区正常成年人的BMD呈现PBMD后随增龄而逐渐下降,男性下降趋势较平缓。女性在45岁以后骨丢失加速,应开始监测BMD。三次回归是建立BMD正常参考数据库的最佳模型。