Skip to main content
Log in

Fat body mass, leptin and femur bone mineral density in hip-fractured women

  • Original Article
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Fat body mass (FBM) is a strong predictor of both bone mineral density (BMD) and risk of hip fracture, but the mechanisms responsible are not completely understood. We addressed whether leptin is the link between FBM and BMD in hip-fractured women. Sixty-two of 74 women with hip fractures were evaluated. Serum leptin was measured by radioimmunoassay, 23.4±9.1 days (mean±SD) after fracture occurrence. BMD and body composition were assessed by dual-energy X-ray absorptiometry (DXA). As expected, a positive linear correlation was found between FBM and both leptin (r=0.782; p<0.001) and femur BMD measured at five sites (r value ranging from 0.293 to 0.498 depending on the site of the femur BMD assessment, p<0.05). A positive correlation between leptin and BMD measured at the intertrochanteric area (r=0.259; p<0.05) but not at the other four sites was shown. At linear multiple regression [dependent variable = femur BMD; independent variables = age, weight, height, body mass index, fracture type, term fracture-DXA, Barthel index score, FBM, lean body mass, serum PTH, serum 25(OH)vitamin D and leptin], FBM was positively associated with BMD measured at all the five sites. The association between leptin and BMD was inverse and it was significant at four of the five sites of the BMD assessment. In conclusion, in a sample of hip-fractured women, the positive association between FBM and femur BMD was not explained by serum leptin. On the contrary, after adjustment for FBM and other confounding variables, an inverse association between leptin and BMD was found.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ensrud KE, Lipschutz RC, Cauley JA, et al. S. Body size and hip fracture risk in older women: a prospective study. Study of the Osteoporotic Research Group. Am J Med 1997, 103: 274–80.

    Article  PubMed  CAS  Google Scholar 

  2. Galvard H, Elmstahl S, Elmstahl B, Samuelsson M, Robertsson E. Differences in body composition between female geriatric hip fracture patients and healthy controls: body fat mass is more important as an explanatory factor for the fracture than body weight and lean body mass. Aging Clin Exp Res 1996, 8: 282–6.

    Article  CAS  Google Scholar 

  3. Schott AM, Cormier C, Hans D, et al. How hip and whole-body bone mineral density predict hip fracture in elderly women: the EPIDOS Prospective Study. Osteoporos Int 1998, 8: 247–54.

    Article  PubMed  CAS  Google Scholar 

  4. Guerre-Millo M. Adipose tissue hormones. J Endocrino Invest 2002,25: 855–61.

    Article  CAS  Google Scholar 

  5. Thomas T, Burguera B. Is leptin the link between fat and bone mass? J Bone Miner Res 2002, 17: 1563–9.

    Article  PubMed  CAS  Google Scholar 

  6. Ruhl CE, Everhart JE. Relationship of serum leptin concentration with bone mineral density in the United States population. J Bone Miner Res 2002, 17: 1896–903.

    Article  PubMed  CAS  Google Scholar 

  7. Mahoney F, Barthel D. Functional evaluation: the Barthe index. Mar State Med J Rehabil 1965, 14: 61–65.

    CAS  Google Scholar 

  8. Pietrobelli A, Heymsfield SB. Establishing body composition in obesity. J Endocrinol Invest 2002, 25: 884–92.

    Article  PubMed  CAS  Google Scholar 

  9. Sato M, Takeda N, Sarui H, 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.

    Article  PubMed  CAS  Google Scholar 

  10. Thomas T, Burguera B, Melton LJ III, et al. Role of serum leptin, insulin, and estrogen levels as potential mediators of the relationship between fat mass and bone minera density in men versus women. Bone 2001, 29: 114–20.

    Article  PubMed  CAS  Google Scholar 

  11. Roemmich JN, Clark PA, Montzoros CS, Gurgol CM, Weltman A, Rogol AD. Relationship of leptin to bone mineralization in children and adolescents. J Clin Endocrino Metab 2003, 88: 599–604.

    Article  CAS  Google Scholar 

  12. Goulding A, Taylor RW. Plasma leptin values in relation to bone mass and density and to dynamic biochemical markers of bone resorption and formation in postmenopausa women. Calcif Tissue Int 1998; 63: 456–8.

    Article  PubMed  CAS  Google Scholar 

  13. 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 2001, 55: 341–7.

    Article  CAS  Google Scholar 

  14. Martini G, Valenti R, Giovani S, Franci B, Campagna S, Nuti R. Influence of insulin-like growth factor-1 and leptin on bone mass in healthy postmenopausal women. Bone 2001, 28: 113–7.

    Article  PubMed  CAS  Google Scholar 

  15. Pasco JA, Henry MJ, Kotowicz MA, et al. Serum leptin levels are associated with bone mass in nonobese women. J Clin Endocrinol Metab 2001, 86: 1884–7.

    PubMed  CAS  Google Scholar 

  16. Blain H, Vuillemin A, Guillemin F, et al. Serum leptin leve is a predictor of bone mineral density in postmenopausa women. J Clin Endocrinol Metab 2002, 87: 1030–5.

    Article  PubMed  CAS  Google Scholar 

  17. Odabasi E, Ozata M, Turan M, et al. Plasma leptin concentrations in postmenopausal women with osteoporosis. Eur J Endocrinol 2000, 142: 170–3.

    Article  PubMed  CAS  Google Scholar 

  18. Sahin G, Polat G, Baethis S, et al. Body composition, bone mineral density and circulating leptin levels in postmenopausal Turkish women. Rheumatol Int 2003, 23: 87–91.

    PubMed  CAS  Google Scholar 

  19. Shaarawy M, Abassi AF, Hassan H, Salem ME. Relationship between serum leptin concentrations and bone minera density as well as biochemical markers of bone turnover in women with postmenopausal osteoporosis. Fertil Steri 2003, 79: 919–24.

    Article  Google Scholar 

  20. Simha I, Zerwekh JE, Sakhaee K, Garg A. Effect of subcutaneous leptin replacement therapy on bone metabolism in patients with generalized lipodystrophy. J Clin Endocrinol Metab 2002, 87: 4942–5.

    Article  PubMed  CAS  Google Scholar 

  21. Blum M, Harris SS, Must A, et al. Leptin, body composition and bone mineral density in premenopausal women. Calcif Tissue Int 2003, 73: 27–32.

    Article  PubMed  CAS  Google Scholar 

  22. Bonjour J, Schurch M, Rizzoli R. Nutritional aspects of hip fractures. Bone 1996, 18: 139s–44s.

    Article  PubMed  CAS  Google Scholar 

  23. Ducy P, Amling M, Takeda S. Leptin inhibits bone formation through a hypothalamic relay: a central control of bone mass. Cell 2000, 100: 197–207.

    Article  PubMed  CAS  Google Scholar 

  24. Burguera B, Hofbauer L, Thomas T, et al. Leptin reduces ovariectomy-induced bone loss in rats. Endocrinology 2001, 142: 3546–53.

    Article  PubMed  CAS  Google Scholar 

  25. Reseland JE, Syversen U, Bakke I, et al. Leptin is expressed in and secreted from primary cultures of human osteoblasts and promotes bone mineralization. J Bone Miner Res 2001, 16: 1426–33.

    Article  PubMed  CAS  Google Scholar 

  26. Holloway WR, Collier FM, Aitken CJ, et al. Leptin inhibits osteoclast generation. J Bone Miner Res 2002, 17: 200–9.

    Article  PubMed  CAS  Google Scholar 

  27. Meier CA, Bobbioni E, Gabay C, Assimacopoulos-Jeannet F, Goaly A, Dayer JM. IL-1 receptor antagonist serum levels are increased in human obesity: a possible link to the resistance to leptin? J Clin Endocrinol Metab 2002, 87: 1184–8.

    Article  PubMed  CAS  Google Scholar 

  28. Di Monaco M, Vallero F, Di Monaco R, Mautino F, Cavanna A. Functional recovery and length of stay after hip fracture in patients with neurologic impairment. Am J Phys Med Rehabil 2003, 82: 143–8.

    Article  PubMed  Google Scholar 

  29. Fox KM, Magaziner J, Hawkes WG, et al. Loss of bone density and lean body mass after hip fracture. Osteoporos Int 2000, 11: 31–5.

    Article  PubMed  CAS  Google Scholar 

  30. Di Monaco M, Di Monaco R, Mautino F, Cavanna A. Femur bone mineral density, age and fracture type in 300 hip-fractured women. Aging Clin Exp Res 2002, 14: 47–51.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Di Monaco, M., Vallero, F., Di Monaco, R. et al. Fat body mass, leptin and femur bone mineral density in hip-fractured women. J Endocrinol Invest 26, 1180–1185 (2003). https://doi.org/10.1007/BF03349154

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03349154

Key-words

Navigation