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Negative association between trunk fat, insulin resistance and skeleton in obese women

World Journal of Diabetes 2013年第2期4卷 31-39页

作者： Emanuela A Greco Davide Francomano rachele fornari Chiara Marocco Carla Lubrano Vincenza Papa Francesca Wannenes Luigi Di Luigi Lorenzo M Donini Andrea Lenzi Antonio Aversa Silvia Migliaccio Department of Experimental Medicine Section of Medical Pathophysiology Endocrinology and Nutrition University "Sapienza"of Rome Department of Experimental Medicine Section of Medical Pathophysiology Endocrinology and Nutrition University "Sapienza" of Rome Unit of Endocrinology Department of Health Sciences University "Foro Italico" of Rome

AIM: To evaluate the potential interference of trunk fat (TF) mass on metabolic and skeletal metabolism. METHODS: In this cross-sectional study, 340 obese women (mean age: 44.8 ± 14 years; body mass index: 36.0 ± 5.9 kg/m 2 ) were included. Patients were evaluated for serum vitamin D, osteocalcin (OSCA), inflammatory markers, lipids, glucose and insulin (homeostasis model assessment of insulin resistance, HOMA-IR) levels, and hormones profile. Moreover, all patients underwent measurements of bone mineral density (BMD;at lumbar and hip site) and body composition (lean mass, total and trunk fat mass) by dual-energy X-ray absorptiometry. RESULTS: Data showed that: (1) high TF mass was inversely correlated with low BMD both at lumbar (P < 0.001) and hip (P < 0.01) sites and with serum vitamin D (P < 0.0005), OSCA (P < 0.0001) and insulin-like growth factor-1 (IGF-1; P < 0.0001) levels; (2) a positive correlation was found between TF and HOMA-IR (P < 0.01), fibrinogen (P < 0.0001) and erythrocyte sedimentation rate (P < 0.0001); (3) vitamin D levels were directly correlated with IGF-1 (P < 0.0005), lumbar (P < 0.006) and hip (P < 0.01) BMD; and (4) inversely with HOMA-IR (P < 0.001) and fibrinogen (P < 0.0005). Multivariate analysis demonstrated that only vitamin D was independent of TF variable. CONCLUSION: In obese women, TF negatively correlates with BMD independently from vitamin D levels. Reduced IGF-1 and increased inflammatory markers might be some important determinants that account for this relationship.

关键词： Obesity Skeleton Vitamin D Osteocalcin Insulin resistance Trunk fat Inflammation

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