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Published in: Journal of Bone and Mineral Metabolism 5/2009

01-09-2009 | Original Article

Relationship between bone mineral density, leptin and insulin concentration in Brazilian obese adolescents

Authors: Wagner Luiz do Prado, Aline de Piano, Marise Lazaretti-Castro, Marco Túlio de Mello, Sérgio Garcia Stella, Sergio Tufik, Cláudia Maria Oller do Nascimento, Lila Missae Oyama, Mara Cristina Lofrano, Lian Tock, Danielle Arisa Caranti, Ana Raimunda Dâmaso

Published in: Journal of Bone and Mineral Metabolism | Issue 5/2009

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Abstract

Despite the epidemic of adolescent obesity, the effect of obesity and hormones on bone mineral accrual during growth is poorly understood. Studies using dual-energy X-ray to examine the effect of obesity on bone mass in children and adolescents have yielded conflicting results. The aim of this study was to explore the combined and independent contributions of body mass index, body composition, leptin, insulin, glucose levels and Homeostasis Model Assessment Insulin Resistance (HOMA-IR) to bone mineral density (BMD) and bone mineral content in a group of Brazilian obese adolescents. This study included 109 post-pubescent obese adolescents. A whole-body dual-energy X-ray absorptiometry scan was performed,using a HOLOGIC QDR4200, to determine whole-body BMD and body composition. Blood samples were collected in the outpatient clinic after an overnight fast, and evaluated for fasting blood glucose and immunoreactive insulin. Leptin levels were assessed with a radioimmunoassay kit. Insulin resistance was assessed by HOMA-IR and the quantitative insulin sensitivity check index. Our results showed that insulin levels and HOMA-IR correlated negatively with BMD and a linear regression analysis showed that serum leptin is inversely associated to BMD adjusted for body mass. In conclusion, our data support the hypothesis that leptin, insulin and HOMA-IR are inversely associated with BMD and play a significant direct role in bone metabolism.
Literature
1.
go back to reference Morberg CM, Tetehs I, Black E, Toubro S, Soerensen TIA, Pedersen O, Astrup A (2003) Leptin and bone mineral density: a cross-sectional study in obese and nonobese men. J Clin Endocrinol Metab 88:5795–5800PubMedCrossRef Morberg CM, Tetehs I, Black E, Toubro S, Soerensen TIA, Pedersen O, Astrup A (2003) Leptin and bone mineral density: a cross-sectional study in obese and nonobese men. J Clin Endocrinol Metab 88:5795–5800PubMedCrossRef
2.
go back to reference Siris ES, Miller PD, Barrett-Connor E, Faulkner KG, Wehren LE, Abbott TA, Berger ML, Santora AC, Sherwood LM (2001) Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. JAMA 286:2815–2822PubMedCrossRef Siris ES, Miller PD, Barrett-Connor E, Faulkner KG, Wehren LE, Abbott TA, Berger ML, Santora AC, Sherwood LM (2001) Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. JAMA 286:2815–2822PubMedCrossRef
3.
go back to reference Kirchengast S, Knogler W, Hauser G (2002) Protective effect of moderate overweight on bony density of the hip joint in elderly and old Austrians. Anthropol Anz 60:187–197PubMed Kirchengast S, Knogler W, Hauser G (2002) Protective effect of moderate overweight on bony density of the hip joint in elderly and old Austrians. Anthropol Anz 60:187–197PubMed
4.
go back to reference Rico H, Arribas I, Casanova FJ, Duce AM, Hernadez ER, Cortez-Prieto J (2002) Bone mass, bone metabolism gonadal status and body mass index. Osteoporos Int 13:187–379CrossRef Rico H, Arribas I, Casanova FJ, Duce AM, Hernadez ER, Cortez-Prieto J (2002) Bone mass, bone metabolism gonadal status and body mass index. Osteoporos Int 13:187–379CrossRef
5.
go back to reference Krakauer JC, McKenna MJ, Buderer NF, Rao DS, Whitehouse FW, Parfitt AM (1995) Bone loss and bone turnover in diabetes. Diabetes 44:775–782PubMedCrossRef Krakauer JC, McKenna MJ, Buderer NF, Rao DS, Whitehouse FW, Parfitt AM (1995) Bone loss and bone turnover in diabetes. Diabetes 44:775–782PubMedCrossRef
6.
go back to reference Afghani A, Cruz ML, Goran MI (2005) Impaired glucose tolerance and bone mineral content in overweight latino children with a family history of type 2 diabetes. Diabetes Care 28:372–378PubMedCrossRef Afghani A, Cruz ML, Goran MI (2005) Impaired glucose tolerance and bone mineral content in overweight latino children with a family history of type 2 diabetes. Diabetes Care 28:372–378PubMedCrossRef
7.
go back to reference Ducy P, Amling M, Takeda S, Priemel M, Schilling AF, Beil FT, Shen J, Vinson C, Rueger JM, Karsenty G (2000) Leptin inhibits bone formation through a hypothalamic relay: a central control of bone mass. Cell 100:197–207PubMedCrossRef Ducy P, Amling M, Takeda S, Priemel M, Schilling AF, Beil FT, Shen J, Vinson C, Rueger JM, Karsenty G (2000) Leptin inhibits bone formation through a hypothalamic relay: a central control of bone mass. Cell 100:197–207PubMedCrossRef
8.
go back to reference Takeda S, Elefteriou F, Levasseur R, Liu X, Zhao L, Parker KL, Armstrong D, Ducy P, Karsenty G (2002) Leptin regulates bone formation via the sympathetic nervous system. Cell 111:305–317PubMedCrossRef Takeda S, Elefteriou F, Levasseur R, Liu X, Zhao L, Parker KL, Armstrong D, Ducy P, Karsenty G (2002) Leptin regulates bone formation via the sympathetic nervous system. Cell 111:305–317PubMedCrossRef
9.
go back to reference Zhang Y, Proença R, Maffei M, Baroni M, Lori L, Friedman JM (1994) Positional cloning of the mouse obese gene and its human homologue. Nature 372:425–432PubMedCrossRef Zhang Y, Proença R, Maffei M, Baroni M, Lori L, Friedman JM (1994) Positional cloning of the mouse obese gene and its human homologue. Nature 372:425–432PubMedCrossRef
10.
go back to reference Thomas T, Gori F, Khosla S, Jensen MD, Burguera B, Riggs BL (1999) Leptin acts on human marrow stromal cells to enhance differentiation to osteoblasts and to inhibit differentiation to adipocytes. Endocrinology 140:1630–1938PubMedCrossRef Thomas T, Gori F, Khosla S, Jensen MD, Burguera B, Riggs BL (1999) Leptin acts on human marrow stromal cells to enhance differentiation to osteoblasts and to inhibit differentiation to adipocytes. Endocrinology 140:1630–1938PubMedCrossRef
11.
go back to reference Sun AJ, Jing T, Heymsfield SB, Philips GB (2003) Relationship of leptin and sex hormones to bone mineral density in men. Acta Diabetol 40:S101–S105PubMedCrossRef Sun AJ, Jing T, Heymsfield SB, Philips GB (2003) Relationship of leptin and sex hormones to bone mineral density in men. Acta Diabetol 40:S101–S105PubMedCrossRef
12.
go back to reference Zoico E, Zamboni M, Adami S, Vettor R, Mazzali G, Tosoni P, Bissoli L, Bosello O (2003) Relationship between leptin levels and bone mineral density in the elderly. Clin Endocrinol 59:97–103CrossRef Zoico E, Zamboni M, Adami S, Vettor R, Mazzali G, Tosoni P, Bissoli L, Bosello O (2003) Relationship between leptin levels and bone mineral density in the elderly. Clin Endocrinol 59:97–103CrossRef
13.
go back to reference Hamrick MW, Pennington C, Newton D, Xie D, Isales C (2004) Leptin deficiency produces contrasting phenotypes in bones of the limb and spine. Bone 34:376–383PubMedCrossRef Hamrick MW, Pennington C, Newton D, Xie D, Isales C (2004) Leptin deficiency produces contrasting phenotypes in bones of the limb and spine. Bone 34:376–383PubMedCrossRef
14.
go back to reference Leonard MB, Shults J, Wilson BA, Tershakovec AM, Zemel BS (2004) Obesity during childhood and adolescence augments bone mass and bone dimensions. Am J Clin Nutr 80:514–523PubMed Leonard MB, Shults J, Wilson BA, Tershakovec AM, Zemel BS (2004) Obesity during childhood and adolescence augments bone mass and bone dimensions. Am J Clin Nutr 80:514–523PubMed
15.
go back to reference Rocher E, Chappard C, Jaffre C, Benhamou CL, Courteix D (2008) Bone mineral density in prepubertal obese and control children: relation to body weight, lean mass, and fat mass. J Bone Miner Metab 26:73–78PubMedCrossRef Rocher E, Chappard C, Jaffre C, Benhamou CL, Courteix D (2008) Bone mineral density in prepubertal obese and control children: relation to body weight, lean mass, and fat mass. J Bone Miner Metab 26:73–78PubMedCrossRef
16.
go back to reference da Silva HG, Mendonça LM, Conceição FL, Zahar SE, Farias ML (2007) Influence of obesity on bone density in postmenopausal women. Arq Bras Endocrinol Metabol 51:943–949PubMed da Silva HG, Mendonça LM, Conceição FL, Zahar SE, Farias ML (2007) Influence of obesity on bone density in postmenopausal women. Arq Bras Endocrinol Metabol 51:943–949PubMed
17.
go back to reference Stettler N, Berkowtiz RI, Cronquist JL, Shults J, Wadden TA, Zemel BS et al (2008) Observational study of bone accretion during successful weight loss in obese adolescents. Obesity 16:96–101PubMedCrossRef Stettler N, Berkowtiz RI, Cronquist JL, Shults J, Wadden TA, Zemel BS et al (2008) Observational study of bone accretion during successful weight loss in obese adolescents. Obesity 16:96–101PubMedCrossRef
18.
go back to reference Goulding A, Jones IE, Taylor RW, Williams SM, Manning PJ (2001) Bone mineral density and body composition in boys with distal forearm fractures: a dual-energy x-ray absorptiometry study. J Pediatr 139:509–515PubMedCrossRef Goulding A, Jones IE, Taylor RW, Williams SM, Manning PJ (2001) Bone mineral density and body composition in boys with distal forearm fractures: a dual-energy x-ray absorptiometry study. J Pediatr 139:509–515PubMedCrossRef
19.
go back to reference Goulding A, Taylor RW, Jones IE, McAuley KA, Manning PJ, Williams SM (2000) Overweight and obese children have low bone mass and area for their weight. Int J Obes Relat Metab Disord 24:627–632PubMedCrossRef Goulding A, Taylor RW, Jones IE, McAuley KA, Manning PJ, Williams SM (2000) Overweight and obese children have low bone mass and area for their weight. Int J Obes Relat Metab Disord 24:627–632PubMedCrossRef
20.
go back to reference Tanner JM, Whithouse RH (1976) Clinical longitudinal standards for height, weight velocity and stages of puberty. Arch Dis Child 51:170–179PubMedCrossRef Tanner JM, Whithouse RH (1976) Clinical longitudinal standards for height, weight velocity and stages of puberty. Arch Dis Child 51:170–179PubMedCrossRef
21.
go back to reference Gutin B, Ransey L, Barbeu P et al (1999) Plasma leptin concentrations in obese children: changes during 4-mo periods with and without physical training. Am J Clin Nutr 69:388–394PubMed Gutin B, Ransey L, Barbeu P et al (1999) Plasma leptin concentrations in obese children: changes during 4-mo periods with and without physical training. Am J Clin Nutr 69:388–394PubMed
22.
go back to reference Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostais model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419PubMedCrossRef Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC (1985) Homeostais model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 28:412–419PubMedCrossRef
23.
go back to reference Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G, Quon MJ (2000) Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab 85:2402–2410PubMedCrossRef Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G, Quon MJ (2000) Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab 85:2402–2410PubMedCrossRef
24.
go back to reference Schwimmer JB, Deutsch R, Rauch JB, Bahling C, Newbury R, Lavine JG (2003) Obesity, insulin resistance, and other clinicopathological correlates of pediatrics nonalcoholic fatty liver disease. J Pediatr 143:500–505PubMedCrossRef Schwimmer JB, Deutsch R, Rauch JB, Bahling C, Newbury R, Lavine JG (2003) Obesity, insulin resistance, and other clinicopathological correlates of pediatrics nonalcoholic fatty liver disease. J Pediatr 143:500–505PubMedCrossRef
25.
go back to reference Black E, Petersen L, Kreutzer M, Toubro S, Sorensen TI, Astrup A (2002) Fat mass measured by DXA varies with scan mode. Obes Res 10:69–77PubMedCrossRef Black E, Petersen L, Kreutzer M, Toubro S, Sorensen TI, Astrup A (2002) Fat mass measured by DXA varies with scan mode. Obes Res 10:69–77PubMedCrossRef
26.
go back to reference Lorentzon M, Lorentzon R, Bäckström T, Nordstöm P (1999) Estrogen receptor gene polymorphism, but not estradiol levels, is related to bone density in health adolescent boys: a cross-sectional and longitudinal study. J Clin Endocrinol Metab 84:4597–4601PubMedCrossRef Lorentzon M, Lorentzon R, Bäckström T, Nordstöm P (1999) Estrogen receptor gene polymorphism, but not estradiol levels, is related to bone density in health adolescent boys: a cross-sectional and longitudinal study. J Clin Endocrinol Metab 84:4597–4601PubMedCrossRef
27.
go back to reference Janz K (2002) Physical activity and bone development during childhood and adolescence. Implications for the prevention of osteoporosis. Minerva Pediatr 54:93–104PubMed Janz K (2002) Physical activity and bone development during childhood and adolescence. Implications for the prevention of osteoporosis. Minerva Pediatr 54:93–104PubMed
28.
go back to reference Jüremäe T, Sööt T, Jüremäe J (2005) Relationship of anthropometrical and body composition with bone mineral content or density in young women with different levels of physical activity. J Physiol Anthropol Appl Human Sci 24:579–587CrossRef Jüremäe T, Sööt T, Jüremäe J (2005) Relationship of anthropometrical and body composition with bone mineral content or density in young women with different levels of physical activity. J Physiol Anthropol Appl Human Sci 24:579–587CrossRef
29.
go back to reference Holbrook TL, Barret-Connor E (1993) The association of lifetime weight and height control patterns with bone mineral density in an adult community. Bone Miner 20:141–142PubMedCrossRef Holbrook TL, Barret-Connor E (1993) The association of lifetime weight and height control patterns with bone mineral density in an adult community. Bone Miner 20:141–142PubMedCrossRef
30.
go back to reference Ackerman A, Thornton JC, Wang J, Pierson RN Jr, Horlick M (2006) Sex difference in the effect of puberty on the relationship between fat mass and bone mass in 926 healthy subjects, 6 to 18 years old. Obesity 14:819–825PubMedCrossRef Ackerman A, Thornton JC, Wang J, Pierson RN Jr, Horlick M (2006) Sex difference in the effect of puberty on the relationship between fat mass and bone mass in 926 healthy subjects, 6 to 18 years old. Obesity 14:819–825PubMedCrossRef
31.
go back to reference Thomas DM, Ng KW, Best JD (1997) Insulin and bone: a clinical and scientific review. Endocrinol Metab 4:5–17 Thomas DM, Ng KW, Best JD (1997) Insulin and bone: a clinical and scientific review. Endocrinol Metab 4:5–17
32.
go back to reference Abrahamsen B, Rohold A, Henriksen JE, Beck-Nielsen H (2000) Correlations between insulin sensitivity and bone mineral density in non-diabetic men. Diabet Med 17:124–129PubMedCrossRef Abrahamsen B, Rohold A, Henriksen JE, Beck-Nielsen H (2000) Correlations between insulin sensitivity and bone mineral density in non-diabetic men. Diabet Med 17:124–129PubMedCrossRef
33.
go back to reference Abou Samra R, Baba NH, Torbay N, Dib L, Fuleihan GEH (2005) High plasma leptin levels is not associated with higher bone mineral density in insulin-resistance premenopausal obese women. J Clin Nedocrinol Metab 90:2588–2594CrossRef Abou Samra R, Baba NH, Torbay N, Dib L, Fuleihan GEH (2005) High plasma leptin levels is not associated with higher bone mineral density in insulin-resistance premenopausal obese women. J Clin Nedocrinol Metab 90:2588–2594CrossRef
34.
go back to reference Caranti DA, Lazzer S, Dâmaso AR, Agosti F, Zennaro R, de Mello MT, Tufik S, Sartorio A (2008) Prevalence and risk factors of metabolic syndrome in Brazilian and Italian obese adolescents: a comparison study. Int J Clin Pract 62:1526–1532PubMedCrossRef Caranti DA, Lazzer S, Dâmaso AR, Agosti F, Zennaro R, de Mello MT, Tufik S, Sartorio A (2008) Prevalence and risk factors of metabolic syndrome in Brazilian and Italian obese adolescents: a comparison study. Int J Clin Pract 62:1526–1532PubMedCrossRef
35.
go back to reference Dâmaso AR, do Prado WL, de Piano A, Tock L, Caranti DA, Lofrano MC, Carnier J, Cristofalo DJ, Lederman H, Tufik S, de Mello MT (2008) Relationship between nonalcoholic fatty liver disease prevalence and visceral fat in obese adolescents. Dig Liver Dis 40:132–139PubMedCrossRef Dâmaso AR, do Prado WL, de Piano A, Tock L, Caranti DA, Lofrano MC, Carnier J, Cristofalo DJ, Lederman H, Tufik S, de Mello MT (2008) Relationship between nonalcoholic fatty liver disease prevalence and visceral fat in obese adolescents. Dig Liver Dis 40:132–139PubMedCrossRef
36.
go back to reference Nagasaki K, Kikuchi T, Hiura M, Uchiyama M (2004) Obese Japanese children have low bone mineral density after puberty. J Bone Miner Metab 22:376–381PubMedCrossRef Nagasaki K, Kikuchi T, Hiura M, Uchiyama M (2004) Obese Japanese children have low bone mineral density after puberty. J Bone Miner Metab 22:376–381PubMedCrossRef
37.
go back to reference Maccario M, Ramunni J, Oleandri SE, Procopio M, Grottoli S, Rossetto R, Savio P, Aimaretti G, Camanni F, Ghigo E (1999) Relationships between IGF-I and age, gender, body mass, fat distribution, metabolic and hormonal variables in obese patients. Int J Obes Relat Metab Disord 23:612–618PubMedCrossRef Maccario M, Ramunni J, Oleandri SE, Procopio M, Grottoli S, Rossetto R, Savio P, Aimaretti G, Camanni F, Ghigo E (1999) Relationships between IGF-I and age, gender, body mass, fat distribution, metabolic and hormonal variables in obese patients. Int J Obes Relat Metab Disord 23:612–618PubMedCrossRef
38.
go back to reference Radetti G, Bozzola M, Pasquino B, Paganini C, Aglialoro A, Livieri C, Barreca A (1998) Growth hormone bioactivity, insulin-like growth factors (IGFs), and IGF binding proteins in obese children. Metabolism 47:1490–1493PubMedCrossRef Radetti G, Bozzola M, Pasquino B, Paganini C, Aglialoro A, Livieri C, Barreca A (1998) Growth hormone bioactivity, insulin-like growth factors (IGFs), and IGF binding proteins in obese children. Metabolism 47:1490–1493PubMedCrossRef
39.
go back to reference Argente J, Caballo N, Barrios V, Pozo J, Muñoz MT, Chowen JA, Hernández M (1997) Multiple endocrine abnormalities of the growth hormone and insulin-like growth factor axis in prepubertal children with exogenous obesity: effect of short- and long-term weight reduction. J Clin Endocrinol Metab 82:2076–2083PubMedCrossRef Argente J, Caballo N, Barrios V, Pozo J, Muñoz MT, Chowen JA, Hernández M (1997) Multiple endocrine abnormalities of the growth hormone and insulin-like growth factor axis in prepubertal children with exogenous obesity: effect of short- and long-term weight reduction. J Clin Endocrinol Metab 82:2076–2083PubMedCrossRef
40.
go back to reference Nam SY, Lee EJ, Kim KR, Cha BS, Song YD, Lim SK, Lee HC, Huh KB (1997) Effect of obesity on total and free insulin-like growth factor (IGF)-1, and their relationship to IGF-binding protein (BP)-1, IGFBP-2, IGFBP-3, insulin, and growth hormone. Int J Obes Relat Metab Disord 21:355–359PubMedCrossRef Nam SY, Lee EJ, Kim KR, Cha BS, Song YD, Lim SK, Lee HC, Huh KB (1997) Effect of obesity on total and free insulin-like growth factor (IGF)-1, and their relationship to IGF-binding protein (BP)-1, IGFBP-2, IGFBP-3, insulin, and growth hormone. Int J Obes Relat Metab Disord 21:355–359PubMedCrossRef
41.
go back to reference Kinjo M, Setoguchi S, Solomon DH (2007) Bone mineral density in adults with the metabolic syndrome: analysis in a population-based U.S. sample. J Clin Endocrinol Metab 92:4161–4164PubMedCrossRef Kinjo M, Setoguchi S, Solomon DH (2007) Bone mineral density in adults with the metabolic syndrome: analysis in a population-based U.S. sample. J Clin Endocrinol Metab 92:4161–4164PubMedCrossRef
42.
go back to reference Zhong N, Wu XP, Xu ZR, Wang AH, Luo XH, Cao XZ, Xie H, Shan PF, Liao EY (2005) Relationship of serum leptin with age, body mass index, and bone mineral density in healthy mainland Chinese women. Clin Chim Acta 351:161–168PubMedCrossRef Zhong N, Wu XP, Xu ZR, Wang AH, Luo XH, Cao XZ, Xie H, Shan PF, Liao EY (2005) Relationship of serum leptin with age, body mass index, and bone mineral density in healthy mainland Chinese women. Clin Chim Acta 351:161–168PubMedCrossRef
43.
go back to reference Iwamoto I, Douchi T, Kosha S, Murakami M, Pujino T, Nagata Y (2000) Relationship between serum leptin levels and regional bone mineral density, bone metabolic markers in healthy women. Acta Obstet Gynecol Scand 79:1060–1064PubMedCrossRef Iwamoto I, Douchi T, Kosha S, Murakami M, Pujino T, Nagata Y (2000) Relationship between serum leptin levels and regional bone mineral density, bone metabolic markers in healthy women. Acta Obstet Gynecol Scand 79:1060–1064PubMedCrossRef
44.
go back to reference Odabasi E, Azata M, Turan M, Bingol N, Yonem A, Cakir B, Kutlu M, Oxdemir IC (2000) Plasma leptin concentrations in postmenopausal women with osteoporosis. Eur J Endocrinol 142:170–174PubMedCrossRef Odabasi E, Azata M, Turan M, Bingol N, Yonem A, Cakir B, Kutlu M, Oxdemir IC (2000) Plasma leptin concentrations in postmenopausal women with osteoporosis. Eur J Endocrinol 142:170–174PubMedCrossRef
45.
go back to reference Blum M, Harris SS, Must A, Naumova EN, Phillips SM, Rand WM, Dawson-Hughes B (2003) Leptin, body composition and bone mineral density in premenopausal women. Calcif Tissue Int 73:27–32PubMedCrossRef Blum M, Harris SS, Must A, Naumova EN, Phillips SM, Rand WM, Dawson-Hughes B (2003) Leptin, body composition and bone mineral density in premenopausal women. Calcif Tissue Int 73:27–32PubMedCrossRef
46.
go back to reference Reid IR, Comish J (2004) Direct actions of leptin on bone remodeling. Calcif Tissue Int 74:313–316PubMedCrossRef Reid IR, Comish J (2004) Direct actions of leptin on bone remodeling. Calcif Tissue Int 74:313–316PubMedCrossRef
47.
go back to reference Thomas T, Burguera B, Melton LJ, Atkinson EJ, O′Fallon WM, Riggs BL, Khosla S (2001) Role of serum leptin and estrogen levels as potential mediators of the relationship between fat mass and bone mineral density in men versus women. Bone 29:114–120PubMedCrossRef Thomas T, Burguera B, Melton LJ, Atkinson EJ, O′Fallon WM, Riggs BL, Khosla S (2001) Role of serum leptin and estrogen levels as potential mediators of the relationship between fat mass and bone mineral density in men versus women. Bone 29:114–120PubMedCrossRef
Metadata
Title
Relationship between bone mineral density, leptin and insulin concentration in Brazilian obese adolescents
Authors
Wagner Luiz do Prado
Aline de Piano
Marise Lazaretti-Castro
Marco Túlio de Mello
Sérgio Garcia Stella
Sergio Tufik
Cláudia Maria Oller do Nascimento
Lila Missae Oyama
Mara Cristina Lofrano
Lian Tock
Danielle Arisa Caranti
Ana Raimunda Dâmaso
Publication date
01-09-2009
Publisher
Springer Japan
Published in
Journal of Bone and Mineral Metabolism / Issue 5/2009
Print ISSN: 0914-8779
Electronic ISSN: 1435-5604
DOI
https://doi.org/10.1007/s00774-009-0082-6

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