Increasing Adiposity Is Associated With Higher Adipokine Levels and Lower Bone Mineral Density in Obese Older Adults
Increasing Adiposity Is Associated With Higher Adipokine Levels and Lower Bone Mineral Density in Obese Older Adults
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DOI：
10.1210/jc.2013-3200
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发表时间：
2014-09-01
影响因子：
5.8
通讯作者：
Armamento-Villareal, Reina
中科院分区：
文献类型：
--
作者：
Aguirre, Lina;Napoli, Nicola;Armamento-Villareal, Reina
内容：虽然肥胖与高骨量有关，但最近的报告表明肥胖患者骨折的发病率增加。目的：本研究的目的是评估增加的体脂对骨矿物质密度（BMD）的影响，并确定不同脂肪因子对虚弱肥胖老年患者BMD的影响。设计和设置：这是一项在大学环境中进行的老年肥胖患者基线特征的横断面研究，这些患者参与了饮食结合或不结合运动的生活方式疗法。173岁，老年人（>= 65岁），肥胖（体重指数>= 30 kg/m2），大多数是虚弱的人参加了这项研究。BMD、体脂百分比、去脂体重百分比、瘦体重百分比、体重指数、脂联素、瘦素、IL-6、骨转换标志物（骨钙素和C-端肽），高敏C-反应蛋白，游离雌二醇，25-羟维生素Dmeasured.Results：较高的三分位数的体脂百分比和较低的瘦体重与较低的BMD。高敏C反应蛋白水平在女性最高脂肪三分位数中最高（第三，5.5 +/- 5.4 vs第一，1.5 +/- 1.3 mg/L，P < .05），而IL-6水平在男性最高脂肪三分位数中最高（第三，3.5 +/- 3.1 vs第一，1.7 +/- 0.8 pg/mL，P < .05）。两种性别的瘦素都随着脂肪三分位数的增加而增加（P <0.05），而脂联素只在男性中随着脂肪三分位数的增加而增加（P <0.05）。多变量分析显示脂联素是脂肪量对BMD影响的重要介质。骨钙素水平在女性最高脂肪三分位数中最高，但在男性中不是。身体功能测试分数下降，增加脂肪三分位数的妇女（P <0.05），但不是在mes.Conclusions：增加肥胖与减少瘦体重与较低的骨密度，较高的脂肪因子水平，并在老年肥胖成年人的脆弱性恶化。
Context: Although obesity is associated with high bone mass, recent reports suggest an increase in the incidence of fractures in obese patients.Objectives: The objectives of the study were to evaluate the influence of increasing body fat on bone mineral density (BMD) and to determine the influence of the different adipokines on BMD in frail obese elderly patients.Design and Setting: This is a cross-sectional study of baseline characteristics of elderly obese patients participating in a lifestyle therapy with diet with or without exercise and conducted in a university setting.Patients: One hundred seventy-three, elderly (>= 65 y old), obese (body mass index of >= 30 kg/m(2)) who were mostly frail participated in the study.Outcome Measures: BMD, percentage of total body fat, percentage of fat-free mass, percentage of lean mass, body mass index, adiponectin, leptin, IL-6, bone turnover markers (osteocalcin and C-telopeptide), high-sensitivity C-reactive protein, free estradiol, and 25-hydroxyvitamin D were measured.Results: Higher tertiles of percentage body fat and lower lean mass were associated with a lower BMD. High-sensitivity C-reactive protein levels were highest in the highest fat tertile (third, 5.5 +/- 5.4 vs first, 1.5 +/- 1.3 mg/L, P < .05) for women, whereas IL-6 levels were highest in the highest tertile in men(third, 3.5 +/- 3.1 vs first, 1.7 +/- 0.8 pg/mL, P < .05). Leptin increased with increasing fat tertiles in both genders (P < .05), whereas adiponectin increased with increasing fat tertiles only in men(P < .05). A multivariate analysis revealed adiponectin as an important mediator of the effect of fat mass on BMD. Osteocalcin levels were highest in the highest fat tertile in women but not in men. Physical function test scores decreased with increasing fat tertiles in women (P < .05) but not in men.Conclusions: Increasing adiposity together with decreasing lean mass is associated with lower BMD, higher adipokine levels, and worsening frailty in elderly obese adults.