男性脊髓損傷患者骨質疏鬆與血清瘦素及激素之關係(2/2)
Date Issued
2003-07-31
Date
2003-07-31
Author(s)
王顏和
DOI
912314B002317
Abstract
Osteoporosis is the most common metabolic disease of bone with increased structural
fragility and fracture risk. SCI is associated with the development of a rapid and severe
osteoporosis clinically. Bone mineral density (BMD) is an important tool in the prevention,
diagnosis and management of osteoporosis. Dual energy X-ray absorptiometry has become
the most widespread method of monitoring BMD. Immobilization, disuse, vascular changes
and hormonal changes maybe responsible for the bone mineral loss after SCI. BMD of the
lumbar spine was within the range of normal values and the BMD of femoral neck, shaft and
proximal tibia was lower than normal values. Increased bone turnover is a sequel of SCI and a
marked increase in bone resorption and modest changes in bone formation occur after SCI.
II
Leptin is a small polypeptide hormone secreted primarily by the adipocytes. It controls body
weight and gonadal function following its binding to a specific receptor located in the
hypothalamus. Serum leptin was significantly higher in the group of SCI. A linear correlation
was found between serum leptin and bone mass index and serum cortisol correlated
significantly with serum leptin level in SCI patients. Sympathetic denervation and possible
central neurotransmission alternations after SCI may contribute to the elevation of serum
leptin.
In this two-year study, we investigated the relationship among osteoporosis, serum leptin,
and various hormone levels in men with SCI. A dual energy X-ray absorptiometry is used to
measure the BMD in the area of 6th to 8th thoracic vertebrae, 2nd to 4th lumbar vertebrae and
left hip. Various baseline hormone levels, including serum leptin, will be measured by RIA.
We found the BMD of thoracic vertebrae in tetraplegic patients is significant lower than that
of paraplegic patients. There are no significant difference of various baseline hormone levels,
including bone-ALP, IL-6, CRP, ICTP, leptin, cortisol, IGF-1, ACTH, T4, T3, TSH, prolactin,
testosterone, GH between tetraplegic and paraplegic patients. It seems that weight-bearing is
the important factor in affecting the BMD. The effect of various hormones or factors must be
further analyzed and investigated.
Subjects
spinal cord injury
osteoporosis
hypothalamus-pituitary-endocrine axes
leptin
Publisher
臺北市：國立臺灣大學醫學院復健科
Type
other
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