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Adiponectin is associated with bone strength and fracture history in paralyzed men with spinal cord injury

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Abstract

Summary

We explored the association between adiponectin levels and bone strength in paralyzed men with spinal cord injury. We found that bone strength was inversely associated with circulating adiponectin levels. Thus, strength estimates and adiponectin levels may improve fracture risk prediction and detection of response to osteogenic therapies following spinal cord injury.

Purpose

Previous research has demonstrated an inverse relationship between circulating adiponectin and bone mineral density, suggesting that adiponectin may be used as a biomarker for bone health. However, this relationship may reflect indirect effects on bone metabolism via adipose-mediated mechanical pathways rather than the direct effects of adipokines on bone metabolism. Thus, we explored the association between circulating adiponectin levels and bone strength in 27 men with spinal cord injury.

Methods

Plasma adiponectin levels were quantified by ELISA assay. Axial stiffness and maximal load to fracture of the distal femur were quantified via finite element analysis using reconstructed 3D models of volumetric CT scans. We also collected information on timing, location, and cause of previous fractures.

Results

Axial stiffness and maximal load were inversely associated with circulating adiponectin levels (R 2 = 0.44, p = 0.01; R 2 = 0.58, p = 0.05) after adjusting for injury duration and lower extremity lean mass. In individuals with post-SCI osteoporotic fractures, distal femur stiffness (p = 0.01) and maximal load (p = 0.005) were lower, and adiponectin was higher (p = 0.04) than those with no fracture history.

Conclusions

Based on these findings, strength estimates may improve fracture risk prediction and detection of response to osteogenic therapies following spinal cord injury. Furthermore, our findings suggest that circulating adiponectin may indeed be a feasible biomarker for bone health and osteoporotic fracture risk in paralyzed individuals with spinal cord injury.

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Acknowledgments

We thank Sam Davis, clinical research coordinator and technician, Boston VA Healthcare System, for assisting with bone density scans; and Rachael Burns and Kara Loo, research assistants, Boston VA Healthcare System, for collection of anthropometric data. This study received support from the Department of Defense (W81XWH-10-1-1043), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (1R01AR059270-01), and the Department of Education, National Institute on Disability and Rehabilitation Research (H133N110010).

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Authors and Affiliations

  1. Spaulding-Harvard SCI Model System, Spaulding Rehabilitation Hospital, Boston, MA, USA

    C. O. Tan, A. L. Doherty, R. Zafonte & L. R. Morse

  2. Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA

    C. O. Tan, R. Zafonte & L. R. Morse

  3. The Forsyth Institute, Cambridge, MA, USA

    R. A. Battaglino & L. R. Morse

  4. Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA

    R. A. Battaglino

  5. Department of Radiology, Massachusetts General Hospital, Boston, MA, USA

    R. Gupta

  6. Primary Care and Rheumatology Sections, VA Boston Healthcare System, Boston University School of Medicine, Boston, MA, USA

    A. A. Lazzari

  7. Pulmonary and Critical Care Medicine Section, Medical Service, VA Boston Healthcare System, Boston, MA, USA

    E. Garshick

  8. Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    E. Garshick

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  1. C. O. Tan
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  2. R. A. Battaglino
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  3. A. L. Doherty
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  7. R. Zafonte
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  8. L. R. Morse
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Correspondence to L. R. Morse.

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Tan, C.O., Battaglino, R.A., Doherty, A.L. et al. Adiponectin is associated with bone strength and fracture history in paralyzed men with spinal cord injury. Osteoporos Int 25, 2599–2607 (2014). https://doi.org/10.1007/s00198-014-2786-2

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  • DOI: https://doi.org/10.1007/s00198-014-2786-2

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