老年男性骨质疏松症与血清痩素水平关系的研究

目的 探讨瘦素和老年男性骨质疏松的关系.方法 选择86例老年男性原发骨质疏松患者和50例正常对照者,采用放免法检测血清瘦素(Lep)浓度,骨钙素(BGP)、I型胶原前胶原氨基端前肽(PINP),采用双能X线吸收法测定腰椎及髋部骨密度,同时计算体重指数(body mass index, BMI),并分析瘦素与其他各项指标的关系.结果 老年男性骨质疏松组血清瘦素水平(4.137±2.439 μg/L)明显低于正常对照组(5.142±2.869 μg/L),两组有显著性差异,P<0.05.血清瘦素水平与BMI显著正相关(Pearsons 相关系数r=0.470, P<0.001),亦与L_(1-2), L_4的BMD 及BGP正相关(r分别为0.356,0.315,0.307,0.241, P<0.05),但在校正BMI后,瘦素与L_2的BMD及BGP的正相关关系消失,与L_1(r=0.193,P<0.05)和L_4(r=0.212, P<0.05)BMD的正相关关系亦有所减弱.结论 老年男性骨质疏松患者血清瘦素水平下降,推测瘦素可能通过外周局部作用影响骨代谢.

Investigation of the relationship of serum leptin level and osteoporosis in old men

Objective This study was performed to investigate the relationship of serum leptin level and osteoporosis in old men. Methods Select 86 older male patients with osteoporosis and 50 health persons of control group were selected. Serum leptin,osteocalcin(BGP) and collagen type I N-terminal propeptide(PINP) were determined by radioimmunoassay. BMD of their lumbar spine and hip were measured by dual-energy X-ray absorptiometry (DEXA). The correlations between leptin and other parameters were analyzed. Results Serum leptin concentrations of osteoporosis group (4.137±2.439 μg/L) was significantly lower than that in the control group (5.142±2.869 μg/L), P<0.05. Serum leptin level was strongly correlated with BMI(Pearsons correlation coefficient r=0.470, P<0.001). Serum leptin correlated positively with BMD of L_(1-2), L_4 and BGP (r=0.356,0.315,0.307,0.241, P<0.05). But after adjustment for BMI, there was no significant relationship between serum leptin level and L_2 and BGP. And the association between serum leptin and BMD of L_1(r=0.193,P<0.05) and L_4(r=0.212, P<0.05), was decreased after adjustment for BMI. Conclusion Serum leptin concentrations of osteoporosis in old men was significantly lower. Leptin may affect bone-metamolism through local action in periphery.