Adiponectin Is a Candidate Biomarker of Lower Extremity Bone Density in Men With Chronic Spinal Cord Injury

J Bone Miner Res, 2014 · DOI: 10.1002/jbmr.2020 · Published: January 1, 2014

Endocrinology Rehabilitation Musculoskeletal Medicine

Simple Explanation

This study explores the relationship between fat tissue hormones (adipokines), bone density, and walking ability in men with long-term spinal cord injuries. The research found that in men who use wheelchairs, a hormone called adiponectin was linked to lower bone density, regardless of their body composition. However, this connection wasn't seen in men who could walk, suggesting that walking might counteract the bone-thinning effect of adiponectin in people with spinal cord injuries.

Study Duration

August 2009 and January 2011

Participants

149 men with chronic spinal cord injury (SCI)

Evidence Level

Not specified

Key Findings

1
There was a significant inverse association between adiponectin and BMD in wheelchair users independent of body composition.
2
No association was found between adiponectin and BMD in walkers.
3
Wheelchair users had lower BMD at the knees and hips, were more likely to have osteoporosis at the hip, and were more likely to report a history of osteoporotic fracture compared to those who walk.

Research Summary

The study examined the association between circulating adiponectin or leptin levels and BMD based on the ability to walk in chronic SCI. The findings suggest that for subjects with chronic SCI, walking may mitigate the effect of adiponectin mediated bone loss. For wheelchair users, adipose-derived adiponectin may contribute to SCI-induced osteoporosis because the osteoprotective benefits of obesity appear to require mechanical loading during ambulation.

Practical Implications

Biomarker Identification

Adiponectin may serve as a biomarker for bone loss in men with SCI who use wheelchairs.

Targeted Interventions

Interventions aimed at reducing adiponectin levels or promoting bone health may be beneficial for wheelchair users with SCI.

Importance of Weight-Bearing Exercise

The study highlights the importance of mechanical loading (e.g., walking) for maintaining bone density, particularly in individuals with SCI.

Study Limitations

1
Associations have been reported between adiponectin and lumbar spine BMD,(23) a site that we did not study because spinal instrumentation or arthritic changes are common after SCI, making reliable spine imaging difficult.
2
Other studies in the general population included a much larger numbers of subjects.
3
In this study ambulatory status is closely related to the severity of neurological injury.

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