脂联素与女性身体成分和骨密度的研究进展

脂联素是参与调节糖脂代谢、能量消耗、炎症反应、免疫应答、心血管功能和生殖的内分泌因子。除此之外，脂联素还可以促进成骨细胞的增殖和分化，同时抑制破骨细胞的形成，对骨骼的发育以及维持具有积极作用。该文系统描述了从出生到更年期女性的血清脂联素波动情况及其分泌模式，讨论了脂联素在女性身体成分和骨密度方面发挥的调节作用。胎儿时期，脂联素通过母胎界面，以自分泌/旁分泌的方式在胎盘和脂肪组织中发挥作用，并促进葡萄糖代谢和胎儿发育。新生儿时期，脐带血清脂联素水平是成人的2～3倍，体重与血清脂联素水平呈正相关。幼儿时期，血清脂联素水平与体脂率呈负相关；骨量和骨密度也随体重增加而增加，与脂联素呈负相关。青年时期，血清脂联素水平似乎与雌激素分泌调节无必然关系；内脏脂肪是肥胖女性骨密度的负预测因子，与血清脂联素水平呈负相关。中年期，血清脂联素水平与体重呈负相关，肥胖的个体表现出血清脂联素水平下降，血清脂联素水平与骨密度亦呈负相关。绝经后，随着雌激素水平的降低，女性血清脂联素水平升高。总之，一生中不断增加的体脂肪总量似乎影响了女性脂联素的分泌，与雌激素水平的下降协同，导致女性老年时期发生骨质疏松的风险增加。

Research progress in the relationship between aidponectin and the body composition and bone mineral density in women

Adiponectin is an endocrine factor involving regulation of glucose and lipid metabolism, energy consumption, inflammatory response, immune response, cardiovascular function, and reproduction. In addition, adiponectin also promotes the proliferation and differentiation of osteoblasts and inhibits the formation of osteoclasts, which plays a positive role in the development and maintenance of bone. This review systematically introduces the fluctuation and secretion pattern of serum adiponectin in women from the fetal stage to post-menopause. It discusses the role of adiponectin in the regulation of female body composition and bone mineral density. At the maternal-fetal interface, adiponectin roles in the placenta and adipose tissue by autocrine/paracrine manner and promotes glucose metabolism and fetal development during the fetal stage. At the neonatal stage, the level of umbilical cord serum adiponectin is 2-3 times as much as adults. Serum adiponectin level is positively correlated with the body weight. In the whole period of childhood, serum adiponectin level is, on the contrary, negatively correlated with body fat percentage. Bone mass and bone density also increase with body weight and are negatively correlated with adiponectin. During puberty, serum adiponectin level does not necessarily relate to the level of estrogen in the body. Visceral fat was a negative predictor of bone mineral density and negatively correlated with serum adiponectin level in obese women. In adulthood, serum adiponectin level is negatively correlated with body weight. Female obesity shows a decrease in serum adiponectin level and a negative correlation with bone mineral density. In post-menopause, while estrogen level decreases, serum adiponectin levels in women arise. In summary, increasing body fat percentage affects serum adiponectin level in the whole life of women. Low serum adiponectin level accompanied with the decrease of estrogen level causes an increased risk of developing osteoporosis.