BODY COMPOSITION, BONE MASS AND ADIPOKINES IN POSTMENOPAUSAL WOMEN WITH DIFFERENT CARDIOVASCULAR RISK (SCORE)

Cover Page

Abstract


Women after menopause have an increased risk of cardiovascular disease associated with atherosclerosis (CVD-AS), and osteoporosis. Low body weight is an independent risk factor for osteoporosis and related fractures. At the same time, osteoporosis occurs in people with overweight and is associated with a high risk of death from cardiovascular disease. As the link of overweight with CVD-AS was proved long ago, the impact of obesity on bone status is not sufficiently investigated. Purpose: To study the relationship between bone, fat, lean mass and adipokines in postmenopausal women with low and high risk of cardiovascular disease. Materials and Methods: The cross-sectional study included 100 women aged 45-65 years. Assessment of cardiovascular risk was carried out using an electronic version of the scale of SCORE. Measurement of bone mineral density (BMD), the amount of bone, fat and lean mass was performed using dual energy x-ray absorptiometry. We investigated the concentration of leptin and adiponectin in serum. Results: The increased cardiovascular risk, and low BMD was associated with duration of menopause. Women with an increased risk of CVD-AS more common had obesity and osteoporosis. Osteopenia and osteoporosis were found in 63% of patients, among whom 49% were overweight and 27% obese. To assess the distribution of fat and lean body mass in the ratio have been introduced «fat mass in the trunk (kg)/fat mass in the limbs (kg)» (TF/LF) and «lean mass in the trunk (kg) / lean mass in the limbs (kg) «(TL/LL). The ratio TF/LF, was associated with the presence or absence of abdominal obesity, directly correlated with an increased cardiovascular risk, and BMD at the proximal femur, and TL/LL directly correlated with BMD of the proximal femur and spine. In a linear regression analysis confirmed the connection of the BMD only with the lean mass. Leptin was directly correlated with % fat in the body, spine and BMD of the proximal femur, in the regression analysis the relationship of leptin and BMD remained highly significant. The inverse correlation of BMD in the proximal femoral neck and adiponectin after regression analysis was not confirmed. Conclusions: Low bone mass is associated with increased cardiovascular risk. Fat mass does not have neither protective, nor deleterious effect on BMD. Lean body mass and leptin may claim to be independent prognostic factors for bone mass.

About the authors

P. A. Ptichkina

Email: pptichka@yandex.ru
aspirant otdela profilaktiki osteoporoza

I. A. Skripnikova

d.m.n., rukovoditel' otdela profilaktiki osteoporoza

V. E. Novikov

nauchnyy sotrudnik otdela profilaktiki osteoporoza

V. A. Metelsky

d.m.n., professor, rukovoditel' otdela izucheniya biokhimicheskikh markerov khronicheskikh neinfektsionnykh zabolevaniy

V. A. Vygodina

k.m.n., vedushchiy nauchnyy sotrudnik otdela biostatistiki

E. A. Zhabina

m.n.s. laboratorii farmakologicheskikh issledovaniy

References

  1. Скрипникова И.А. взаимосвязь сердечно-сосудистых заболеваний, обусловленных атеросклерозом, и генерализованного остеопороза у женщин в постменопаузальном периоде: Автореф. дис.. д-ра мед. наук. М 2008; 109.
  2. Premaor M.O., Pilbrow L., Tonkin C. et al. Obesity and fractures in postmenopausal women. J Bone Miner Res.,2010 Feb;25(2):292-7
  3. Noroozi M., Rastegari Z., Paknahad Z. Type of body fat distribution in postmenopausal women and its related factors. Iran J Nurs Midwifery Res. 2010 Winter; 15(1): 27-31.
  4. Genazzani A.R., Gambacciani M. Effect of climacteric transition and hormone replacement therapy on body weight and body fat distribution. Gynecol Endocrinol. 2006 Mar; 22(3): 145-50.
  5. Douchi T., Yamamoto S., Yoshimitsu N. et al. Relative contribution of aging and menopause to changes in lean and fat mass in segmental regions. Maturitas. 2002 Aug 30; 42(4): 301-6.
  6. Линдсей Р. Дефицит эстрогенов // Риге Б.Л., Мелтон Л.Д. III. Остеопороз: этиология, диагностика, лечение. - М.: БИНОМ, 2000. - С. 157-160.
  7. Hamerman D. Osteoporosis and atherosclerosis: biological linkages and the emergence of dual-purpose therapies. QJM. 2005 Jul; 98(7): 467-84.
  8. Reid I.R. Fat and bone. Arch Biochem Biophys. 2010 Nov 1; 503(1): 20-7.
  9. Papakitsou E.F., Margioris A.N., Dretakis K.E. et al. Body mass index (BMI) and parameters of bone formation and resorption in postmenopausal women. Maturitas 2004; 47(3): 185-93.
  10. Bakker I., Twisk J.W., Van Mechelen W. et al. Fat-free body mass is the most important body composition determinant of 10-yr longitudinal development of lumbar bone in adult men and women. J Clin Endocrinol Metab. 2003 Jun; 88(6): 2607-13.
  11. Capozza R.F., Cure-Cure C., Cointry G.R. et al. Association between low lean body mass and osteoporotic fractures after menopause. Menopause 2008; 15: 5: 905—913.
  12. Reid I.R., Ames R., Evans M.C. et al. Determinants of total body and regional bone mineral density in normal postmenopausal women-a key role for fat mass. J Clin Endocrinol Metab. 1992 Jul; 75(1): 45-51.
  13. Ho-Pham L.T., Nguyen N.D., Lai T.Q. et.al. Contributions of lean mass and fat mass to bone mineral density: a study in postmenopausal women. BMC Musculoskelet Disord. 2010 Mar 26; 11: 59.
  14. Gilsanz V., Chalfant J., Mo A.O. et al. Reciprocal relations of subcutaneous and visceral fat to bone structure and strength. J Clin Endocrinol Metab. 2009 Sep; 94(9): 3387-93.
  15. Von der Recke P., Hansen M.A., Hassager C. The association between low bone mass at the menopause and cardiovascular mortality. Am J Med. 1999 Mar; 106(3): 273-8.
  16. Kim C.J., Oh K.W., Rhee E.J. Relationship between body composition and bone mineral density (BMD) in perimenopausal Korean women. Clin Endocrinol (Oxf) 2009 Jul; 71(1): 18-26.
  17. Park J.H., Song Y.M., Sung J. et al. The association between fat and lean mass and bone mineral density: The Healthy Twin Study. Bone. 2012 Apr; 50(4): 1006-11.
  18. Thomas T., Burguera B., Melton L.J. et al. Role of serum leptin, insulin, and estrogen levels as potential mediators of the relationship between fat mass and bone mineral density in men versus women. Bone 2001; 29: 2: 114-120.
  19. Yamauchi M., Sugimoto T., Yamaguchi T. et al. Plasma leptin concentrations are associated with bone mineral density and the presence of vertebral fractures in postmenopausal women. Clin Endocrinol (Oxf) 2001; 55: 3: 341-347.
  20. Blain H., Vuillemin A., Guillemin F. et al. Serum leptin level is a predictor of bone mineral density in postmenopausal women. J Clin Endocrinol Metab. 2002; 87: 3: 1030-1035.
  21. Elefteriou F., Karsenty G. Bone mass regulation by leptin: a hypothalamic control of bone formation. Pathol Biol 2004; 52: 3: 148—153.
  22. Morberg C.M., Tetens I., Black E. et al. Leptin and bone mineral density: a cross-sectional study in obese and nonobese men. J Clin Endocrinol Metab. 2003 Dec; 88(12): 5795-800.
  23. Hipmair G., Bohler N., Maschek W. et al. Serum leptin is correlated to high turnover in osteoporosis. Neuro Endocrinol Lett 2010; 31: 1: 155—160.
  24. Jürimäe J., Jürimäe T., Leppik A. et al. The influence of ghrelin, adiponectin, and leptin on bone mineral density in healthy postmenopausal women. J Bone Miner Metab. 2008; 26(6): 618-23.
  25. Richards J.B., Valdes A.M., Burling K. et al. Serum adiponectin and bone mineral density in women. J Clin Endocrinol Metab. 2007 Apr; 92(4): 1517-23. Epub 2007 Jan 30.
  26. Lei X., Peng X., Wu N. et al. Serum adiponectin, leptin level, and bone mineral density in postmenopausal women. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2009; 34: 6: 559-562.
  27. Ozkurt B., Ozkurt Z.N., Altay M. et al. The relationship between serum adiponectin level and anthropometry, bone mass, osteoporotic fracture risk in postmenopausal women. Eklem Hastalik Cerrahisi. 2009; 20(2): 78-84.
  28. Chanprasertyothin S., Saetung S., Payattikul P. et al. Relationship of body composition and circulatory adiponectin to bone mineral density in young premenopausal women. J Med Assoc Thai. 2006 Oct; 89(10): 1579-83.

Statistics

Views

Abstract - 821

PDF (Russian) - 551

Cited-By


PlumX

Dimensions


Copyright (c) 2012 Ptichkina P.A., Skripnikova I.A., Novikov V.E., Metelsky V.A., Vygodina V.A., Zhabina E.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies