Остеопороз и остеопатии (Apr 2012)
BODY COMPOSITION, BONE MASS AND ADIPOKINES IN POSTMENOPAUSAL WOMEN WITH DIFFERENT CARDIOVASCULAR RISK (SCORE)
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.
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