Leptin is Negatively Associated with Femoral Bone Mineral Density in Postmenopausal Women with Type 2 Diabetes Mellitus

Abstract

Background: Serum leptin level and bone mineral density (BMD) are widely assumed to be positively associated with body fat mass. Numerous attempts have been made to document the relationship between leptin and BMD, but the results are inconsistent, especially in diabetic patients. Methods:A total of 60 Korean postmenopausal women with type 2 diabetes mellitus were included in the present study. The BMDs of lumbar spines (L1 to L4) and proximal femurs (trochanter, neck, and total) were measured by dual-energy X-ray absorptiometry (DXA), and biochemical markers including leptin, HbA1c, C-peptide and urine albumin-creatinine ratio (ACR) were measured for each patient. Results:Negative associations between leptin and BMD of femoral neck, trochanter, and total femur in postmenopausal women with type 2 diabetes mellitus were documented in a model adjusted for age, body fat mass, and fasting insulin level (r = -0.308, P = 0.020 and r = -0.303, P = 0.025 and r = -0.290, P = 0.032 respectively). Multiple linear regression analysis was performed revealing negative associations between leptin and BMD of the femoral neck (β = -0.369), trochanter (β = -0.324), and total femur (β = -0.317). Conclusion

Evaluation of bone mineral density in type 2 diabetes mellitus patients before and after treatment

“…18 However, calcium, phosphorus, and ALP showed no correlation to BMD in multivariate analysis, which have also been observed by others. 24,25 Total cholesterol, LDL cholesterol and triglycerides were positively correlated with BMD at spine also been reported earlier. 19,20 Haemoglobin A 1c showed no correlation to BMD in the present study, which has been seen by investigators from India.…”

“…21,22 A significant association between BMD and C-peptide levels has been reported. 24,25 C-peptide has been shown to stimulate proliferation of chondrocytes thereby implying that the peptide has growth factor activity. 26 Since, sulphonylurea increase endo genous C-peptide and proinsulin levels it is prudent to expect BMD to increase with therapy, whereas exogenous insulin will inhibit C-peptide release hence may have adverse impact.…”