Visceral Fat Is a Negative Predictor of Bone Density Measures in Obese Adolescent Girls
Visceral Fat Is a Negative Predictor of Bone Density Measures in Obese Adolescent Girls
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DOI：
10.1210/jc.2009-1475
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发表时间：
2010-03-01
影响因子：
5.8
通讯作者：
Misra, Madhusmita
中科院分区：
文献类型：
--
作者：
Russell, Melissa;Mendes, Nara;Misra, Madhusmita
背景：局部脂肪越来越被认为是骨矿物质密度（BMD）的决定因素，这种关联可能由脂肪因子介导，如脂联素和瘦素，以及炎症性脂肪产物。慢性炎症对骨骼有害，内脏脂肪组织（VAT）预测炎症标志物，如可溶性细胞间粘附分子-1和e-选择素，而sc脂肪组织（SAT）和VAT预测青少年的IL-6。目的：我们的目的是确定区域脂肪量和脂肪因子与骨密度的关系。我们假设VAT相对于SAT较高的女孩骨密度较低，骨密度由炎症细胞因子、脂联素和瘦素介导。设计：这是一项横断面研究。环境：本研究在临床研究中心进行。受试者：受试者包括30名12-18岁的女孩（15名肥胖，15名正常体重），年龄（骨龄）、种族和民族相匹配。结果测量：我们使用磁共振成像评估局部脂肪（SAT， VAT），使用双能x线吸收仪评估总脂肪和骨密度。获得空腹瘦素、脂联素、IL-6、可溶性细胞间粘附分子-1和e-选择素。结果：肥胖组平均体重指数SD评分为3.7 +/- 1.5，对照组为0.1 +/- 0.4 kg/m(2)。VAT是肥胖女孩脊柱骨密度和骨矿物质表观密度、全身骨密度和骨矿物质含量/身高以及在控制SAT后整个组的全身骨密度和骨矿物质含量/身高的负预测因子，VAT与SAT的比值也是如此。在包括VAT/SAT、脂肪因子和细胞因子的回归模型中，e-选择素和脂联素是骨密度的负预测因子，瘦素是正预测因子。结论：VAT是肥胖患者骨密度的一个独立的逆决定因素。这种关联可能是由脂肪因子和慢性炎症状态介导的。[J] .中华内分泌杂志，2010,31(5):557 - 557。
Context: Regional fat is increasingly recognized as a determinant of bone mineral density (BMD), an association that may be mediated by adipokines, such as adiponectin and leptin, and inflammatory fat products. Chronic inflammation is deleterious to bone, and visceral adipose tissue (VAT) predicts inflammatory markers such as soluble intercellular adhesion molecule-1 and E-selectin, whereas sc adipose tissue (SAT) and VAT predict IL-6 in adolescents.Objective: Our objective was to determine associations of regional fat mass and adipokines with BMD. We hypothesized that girls with greater VAT relative to SAT would have lower bone density mediated by inflammatory cytokines, adiponectin, and leptin.Design: This was a cross-sectional study.Setting: The study was conducted at a clinical research center.Subjects: Subjects included 30 girls (15 obese, 15 normal weight) 12-18 yr old, matched for maturity (bone age), race, and ethnicity.Outcome Measures: We assessed regional fat (SAT, VAT) using magnetic resonance imaging, total fat, and BMD using dual-energy x-ray absorptiometry. Fasting leptin, adiponectin, IL-6, soluble intercellular adhesion molecule-1, and E-selectin were obtained.Results: Mean body mass index SD score was 3.7 +/- 1.5 in obese subjects and 0.1 +/- 0.4 kg/m(2) in controls. VAT was a negative predictor of spine BMD and bone mineral apparent density, whole-body BMD and bone mineral content/height in obese girls and whole-body BMD and bone mineral content/height for the group as a whole after controlling for SAT, as was the ratio of VAT to SAT. In a regression model that included VAT/SAT, adipokines, and cytokines, E-selectin and adiponectin were negative predictors of BMD and leptin a positive predictor.Conclusion: VAT is an independent inverse determinant of bone density in obesity. This association may be mediated by adipokines and a chronic inflammatory state. (J Clin Endocrinol Metab 95: 1247-1255, 2010)