Association between serum leptin level and osteoporosis in patients with type 2 diabetes mellitus

Yıl 2010, Cilt: 1 Sayı: 2, 31 - 38, 05.04.2013

Tuncer Demir Sefa Gulturk , Ercan Özdemir Şafak Şahin Bahattin Aydın

https://doi.org/10.12808/bcs.v1i2.7

Öz

Abstract

Aim: As osteoporosis and diabetes mellitus are widespread diseases, it is an important question whether leptin plays a role in bone physiology or not. In this study, we aimed to investigate the relationship between serum leptin level, diabetes and osteoporosis. Methods: The present study was conducted on 49 healthy individuals and 77 patients with type 2 Diabetes mellitus (DM), a total of 126 individuals, between 40 and 60 of ages. Between 08-10 hours in the morning, venous blood samples of 15 mL were drawn from forearm veins of the individuals and transferred into concerned test tubes. After blood samples were taken, Bioelectrical Impedance Analysis (BIA) was performed. Bone mineral density (BMD) was measured by DEXA (Dual energy X-ray absorptiometry) at L_1-4 (anterior-posterior) and femur. Student t test and correlation analysis were used for the statistical analysis in the study. Results: Leptin level of women in both groups were significantly higher than those of men in both groups (p<0.05). BMD values of men in patient group was significantly lower compared to those of men in control group (p<0.05). Similarly, BMD values of women in patient group was significantly lower compared to those of women in control group (p<0.05). A positive correlation was found between femur neck bone mineral density and leptin of men in both groups (p<0.05). Conclusions: In terms of bone mineral density, femur neck measurements of women were more sensitive than L_1-L4 measurements. Finding a positive correlation between femur neck bone mineral density and leptin levels in all men and having no such correlation in women may be related to more effective function of leptin hormone in men.

Keywords: Leptin, osteoporosis, type 2 diabetes mellitus

Özet

Tip 2 diabetes mellitus hastalarında leptin düzeyi ile osteoporoz arasındaki ilişki

Amaç: Osteoporoz ve diyabet çok yaygın hastalıklar olduğu için, leptinin insan kemik fizyolojisinde herhangi bir rolü olup olmadığı önemli bir sorudur. Bu çalışmada, serum leptin konsantrasyonu ile diyabet ve osteoporoz arasındaki ilişkinin araştırılmasını amaçladık. Yöntem: Çalışma yaşları 40 ile 60 arasında değişen, tip 2 diabetes mellituslu (DM) 77 hasta ve 49 sağlıklı olmak üzere toplam 126 birey üzerinde yapılmıştır. Sabah saat 08:00-10:00 arası bireylerin ön kol venasından girilip yaklaşık 15 mL venöz kan örneği alınarak yapılacak testlerle ilgili deney tüplerine aktarıldı. Kan örnekleri alındıktan sonra tüm olgulara Biyoelektriksel İmpedans Analizi (BİA) uygulandı. Kemik mineral yoğunluğu (KMY) ise DEXA (Dual enerji X-ray absorptiometri) yöntemi ile L_1-4 (ön-arka) ve femurdan ölçüldü. Çalışmanın istatistiksel analizinde student t testi ve korelasyon analizi kullanıldı. Bulgular: Kontrol ve hasta gruplarında kadınların leptin düzeylerinde görülen artış, erkeklerinkine göre anlamlı bulunmuştur (p<0.05). Hasta erkek grubu kontrol grubu ile karşılaştırıldığında, KMY değeri anlamlı olarak düşük bulunmuştur (p<0.05). Kadın hasta grubundaki KMY değerinde azalma kontrol gurubuna göre anlamlıydı (p<0.05). Tüm erkeklerde femur boynu KMY değerleri ile leptin arasında pozitif bir korelasyon bulunmuştur (p<0.05). Sonuçlar: Kadınlar KMY'ye göre değerlendirildiğinde femur boynu ölçümleri, L_1-L4 ile karşılaştırıldığında daha hassasiyet göstermektedir. Tüm erkeklerde femur boynu KMY değerleri ile leptin arasında pozitif bir korelasyon bulunurken kadınlarda bulunmaması erkeklerde leptin hormonunun daha etkili olmasından kaynaklanabilir.

Anahtar sözcükler: Leptin, osteoporoz, tip 2 diabetes mellitus

Anahtar Kelimeler

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Kaynakça

• Friedman M, and Halaas JL. Leptin and the regulation of body weight in mammals. Nature 1998;395:763–70.
• Arner P. Insulin resistance in type 2 diabetes - role of the adipokines. Curr Mol Med 2005;5:333-9.
• Hampson G, Evans C, Petitt RJ et al. Bone mineral density, collagen type 1 α 1 genotypes and bone turnover in premenopausal women with diabetes mellitus. Diabetologia 1998;41:1314–20.
• Thomas T, Gori F, Khosla S, Jensen MD, Burguera B and Riggs BL. Leptin acts on human marrow stromal cells to enhance differentiation to osteoblasts and to inhibit differentiation to adipocytes. Endocrinology 1999;140:1630–8.
• Holloway WR, Collier FM, Aitken CJ, Myers DE, Hodge JM and Malakellis M et al. Leptin inhibits osteoclast generation. J Bone Miner Res 2002;17:200–9.
• Ducy P, Amling M, Takeda S, Priemel M, Schilling AF and Beil FT et al. Leptin inhibits bone formation through a hypothalamic relay: a central control of bone mass. Cell 2000;100:197–207.
• Odabasi E, Ozata M, Turan M, Bingol N, Yonem A, Cakir B, et al. Plasma leptin concentrations in postmenopausal women with osteoporosis. Eur J Endocrinol 2000;142:170-3.
• Rauch F, Blum WF, Klein K, Allolio B and Schonau E. Does leptin have an effect on bone in adult women. Calcif Tissue Int 1998;63:453–5.
• Pasco JA, Henry MJ, Kotowicz MA, Collier GR, Ball MJ and Ugoni AM et al. Serum leptin levels are associated with bone mass in nonobese women. J Clin Endocrinol Metab 2001,86:1884–7.
• Roux C, Arabi A, Porcher R and Garnero P. Serum leptin as a determinant of bone resorption in healthy postmenopausal women. Bone 2003;33:847–52.
• Ruhl CE and Everhart JE. Relationship of serum leptin concentration with bone mineral density in the United States population. J Bone Miner Res 2002;17:1896–903.
• Sato M, Takeda N, Sarui H, Takami R, Takami K and Hayashi M et al. Association between serum leptin concentrations and bone mineral density, and biochemical markers of bone turnover in adult men. J Clin Endocrinol Metab 2001;86:5273–6.
• Blum M, Harris SS, Must A, Naumova EN, Phillips SM and Rand WM. Leptin, body composition and bone mineral density in premenopausal women. Calcif Tissue Int 2003;73:27–32.
• Thomas T, Burguera B, Melton LJ, Atkinson EJ, O’Fallon WM and Riggs BL 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;29:114–20.
• Ellis KJ, Bell SJ, Chertow GM, Chumlea CW, Knox TA, Kotler PD, et al. Bioelectical impedance methods in clinical research: a follow-up to the NIH tecnology assesment confererence. Nutrition 1999;15:874-80.
• Mcardle WD, Katch F, Katch VC. Exercise Physiology. Mcmillian Publishing Company First Edition, Baltimore 1996;151-63.
• Haffner SM, Bauer LR. The association of obesity and glucose and insülin concentration with bone density in premenopausal and postmenopausal women. Metabolism 1993;42:735-8.
• Hyldstrup L, Andersen T, Mc Nair P. Bone metabolism in obesity: Changes related to severe overweight and dietary weight reduction. Acta Endocrinologica 1993;129:393-8.
• Gordeladze JO, Drevon CA, Syversen U, Reseland JE. Leptin Stimulates Human Osteoblastic Cell Proliferation, De Novo Collagen Synthesis, and Mineralization: Impact on Differentiation Markers, Apoptosis, and Osteoclastic Signaling. J Cell Biochem 2002;85:825-36.
• Holloway WR, Collier FM, Aitken CG, Malakellis M, Gough TJ, Myers DE, Collier GR, Nicholson GC. Leptin inhibits osteoclast generation. J Bone Miner Res 2000;15:S1;S174.
• Steppan CM, Crawford DT, Chidsey-Frink KL, et al. is a potent stimulator of bone growth in ob/ob mice. Regul Pept 2000;92:73-8.
• Castracane VD, Kraemer RR, Franken MA, Kraemer GR, Gimpel T. Serum leptin concentration in women: effects of age, obesity and estrogen administration. Fertil Steril 1998;70:472-7.
• Goulding A, Taylor RW. Plasma leptin values in relation to bone mass and density to dynamic biochemical markers of bone resorption and formation in postmenopausal women. Calcif Tissue Int 1998;63:456-8.
• Blain H, Vuillemin A, Guillemin F, Durant R, Hanesse B, Talance N et al. Serum leptin levels is a predictor of bone mineral density in postmenopausal women. J Clin Endocrinol Metab 2002;87:1030-5.
• Westvik J. Radiological features in generalised lipodystrophy. Acta Paediatr 1996;413:44-51.
• 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;55:341-7.