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。

Serum adiponectin, leptin level, and bone mineral density in postmenopausal women

ObjectiveTo determine whether serum adipocytokines and leptin level are associated with bone mineral density (BMD) in postmenopausal women.MethodsSerum adiponectin and leptin level were measured by ELISA in 336 postmenopausal women. BMD was measured by dual energy X-ray absorptiometry (DXA) at the whole body, lumbar spine, hip, and forearm. Body compositions including lean tissue mass and body fat mass were measured by DXA, and their relationship was analyzed. ResultsSerum adiponectin levels were negatively related to BMD at the whole body, the lumbar spine, the hip, and the forearm (r=-0.181, r=-0.208, r=-0.228, r=-0.203, and P＜0.05, respectively). After adjustment for age and fat mass, the correlation with BMD still remained (r=-0.131, r=-0.140, r=-0.159, r=-0.172, and P＜0.05, respectively). Serum leptin levels were positively related to BMD was at the hip and the forearm (r=0.162, r=0.210, and P＜0.05, respectively). After adjustment for age and fat mass, the correlation with BMD at the forearm remained (r=0.157, P＜0.05), but the correlation with BMD at the hip disappeared. In the multiple linear stepwise regression analysis, year since menopause, lean mass, adiponectin, and estradiol were independent predictors of BMD at the body, the hip and the forearm; year since menopause, lean mass, body mass index, adiponectin, and extradiol were independent predictors of BMD at the lumbar spine.Conclusion Adiponectin is the independent predictor of BMD.