Adiponectin is associated with bone strength and fracture history in paralyzed men with spinal cord injury.
Adiponectin is associated with bone strength and fracture history in paralyzed men with spinal cord injury.
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DOI：
10.1007/s00198-014-2786-2
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发表时间：
2014-11
期刊：
影响因子：
--
通讯作者：
Morse LR
中科院分区：
文献类型：
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作者：
Tan CO;Battaglino RA;Doherty AL;Gupta R;Lazzari AA;Garshick E;Zafonte R;Morse LR
我们探讨了瘫痪男性脊髓损伤患者的脂联素水平与骨强度之间的关系。我们发现骨强度与循环脂联素水平呈负相关。因此，强度评估和脂联素水平可能会改善对脊髓损伤后成骨治疗反应的骨折风险预测和检测。以前的研究已经证明，循环脂联素与骨密度之间存在负相关关系，提示脂联素可能被用作骨健康的生物标志物。然而，这种关系可能反映了通过脂肪介导的机械途径对骨代谢的间接影响，而不是脂肪因子对骨代谢的直接影响。因此，我们在27名男性脊髓损伤患者中探讨了循环脂联素水平与骨强度之间的关系。用双抗体夹心法测定血浆脂联素水平。利用重建的三维CT扫描模型，通过有限元分析来量化股骨远端的轴向刚度和最大骨折载荷。我们还收集了有关以前骨折的时间、位置和原因的信息。调整损伤时间和下肢瘦质量后，轴向僵硬和最大负荷与循环脂联素水平呈负相关(R2=0.44，p=0.01；R2=0.58，p=0.05)。在有脊髓损伤后骨质疏松性骨折的患者中，股骨远端硬度(p=0.005)和最大载荷(p=0.04)低于无骨折病史的患者，而脂联素(p=0.04)高于无骨折病史的患者。基于这些发现，强度评估可能会改善对脊髓损伤后骨折风险的预测和对成骨治疗反应的检测。此外，我们的研究结果表明，循环脂联素可能确实是瘫痪脊髓损伤患者的骨骼健康和骨质疏松性骨折风险的一个可行的生物标志物。
We explored the association between adiponectin levels and bone strength in paralyzed men with spinal cord injury. We found that bone strength was inversely associated with circulating adiponectin levels. Thus, strength estimates and adiponectin levels may improve fracture risk prediction and detection of response to osteogenic therapies following spinal cord injury. Previous research has demonstrated an inverse relationship between circulating adiponectin and bone mineral density, suggesting that adiponectin may be used as a biomarker for bone health. However, this relationship may reflect indirect effects on bone metabolism via adipose-mediated mechanical pathways rather than the direct effects of adipokines on bone metabolism. Thus, we explored the association between circulating adiponectin levels and bone strength in 27 men with spinal cord injury. Plasma adiponectin levels were quantified by ELISA assay. Axial stiffness and maximal load to fracture of the distal femur were quantified via finite element analysis using reconstructed 3D models of volumetric CT scans. We also collected information on timing, location, and cause of previous fractures. Axial stiffness and maximal load were inversely associated with circulating adiponectin levels (R2=0.44, p= 0.01; R2=0.58, p=0.05) after adjusting for injury duration and lower extremity lean mass. In individuals with post-SCI osteoporotic fractures, distal femur stiffness (p=0.01) and maximal load (p=0.005) were lower, and adiponectin was higher (p=0.04) than those with no fracture history. Based on these findings, strength estimates may improve fracture risk prediction and detection of response to osteogenic therapies following spinal cord injury. Furthermore, our findings suggest that circulating adiponectin may indeed be a feasible biomarker for bone health and osteoporotic fracture risk in paralyzed individuals with spinal cord injury.