건강한 폐경 전 여성에서 골밀도와 혈청 렙틴 농도와의 관련성
Leptin and Bone density in Healthy Premenopausal Women
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연구배경 : 체지방량이 골밀도의 중요한 결정인자이지만 어떠한 기전으로 작용하는지에 대해서는 아직 확실하지 않다. 지방세포에서 생산되는 호르몬인 렙틴은 체내 에너지 대사 뿐만 아니라 최근에는 골대사에도 관여하는 것으로 알려져 있다. 건강한 폐경 전 여성에서 골밀도와 혈청 렙틴 농도와의 관련성을 알아보고자 하였다. 방 법 : 대전 시내 소재 일개대학병원 종합검진센터에서 건강검진을 시행한 건강한 폐경 전 여성 51명을 대상으로 단면 조사 연구를 시행하였다. 골밀도는 이중방사선에너지 흡수법을, 혈청 렙틴 농도는 방사면역측정법을 이용하여 측정하였다. 결 과 : 요추부위의 골밀도는 체중, 제지방량과 각각 유의한 양의 상관관계를 보였으며, 체중에 대해 보정한 후 시행한 편상관관계 분석에서는 혈청 렙틴 농도만이 유의한 음의 상관관계를 보였다. 혈청 렙틴 농도는 체중, 체지방량, 체지방률, 체질량지수와 각각 유의한 양의 상관관계를 보였으며, 체중에 대해 보정한 후 시행한 편상관관계 분석에서는 제지방량, 요추부위의 골밀도와 유의한 음의 상관관계를 보였다. 다중회귀분석에서는 혈청 렙틴 농도, 체중, 체지방량이 연령, 혈청 인슐린 농도에 독립적으로 요추부위 골밀도에 영향을 미치는 것으로 나타났다. 결 론 : 건강한 폐경 전 여성에서 혈청 렙틴 농도는 골밀도와 유의한 음의 상관관계를 가지며 연령, 혈청 인슐린 농도, 체중 또는 체지방량과 독립적으로 골밀도에 영향을 미치는 인자이다.
Abstract
Background : Fat mass is an important determinant of bone density, but the mechanism involved in this relation is uncertain. A recent study demonstrated that leptin, the hormone produced in adipocytes, acts on bone metabolism. This study was performed to investigate the relationship between leptin and bone density in healthy premenopausal Korean women. Methods : We conducted a cross-sectional study in 51 healthy premenopausal women who were randomly selected from a routine health check-up. Bone density was measured by dual-energy x-ray absorptiometry and serum leptin level by a radioimmunoassay. Results :L-spine bone density showed a significant positive correlation with body weight, lean mass, and after adjustin for body weight, showed a significant negative correlation with leptin. Leptin level showed a significant positive correlation with body weight, fat mass, fat percent, body mass index, and after adjusting for body weight, showed a significant negative correlation with lean mass, L-spine bone density. In multiple linear regression analyses, leptin, body weight and body fat mass were shown to be a significant predictor of L-spine bone density, independently of age, blood insulin level. The leptin level accounted for a variance in L-spine bone density of 19.7% in healthy premenopausal women. Conclusions :In our study, leptin level seems to have a significant negative correlation with bone density in healthy premenopausal women, and to be a significant predictor of L-spine bone density, independently of age, blood insulin level, body weight, fat mass.
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