铁蓄积与绝经后髋部骨质疏松性骨折的相关性分析
Correlation analysis of iron accumulation with osteoporotic hip fracture in postmenopausal women
目的 回顾性分析绝经后髋部骨折患者的临床资料,了解铁蓄积与骨密度、骨转换指标之间的相关性,进一步探讨铁蓄积在绝经后髋部骨质疏松性骨折中的作用和意义. 方法 按照入组条件收集2010年6月—2014年12月376例绝经后髋部骨折患者资料,年龄(74.1±9.6)岁(55 ~94岁).按骨密度T值分为三组,T值≥-1 SD为正常组(22例),-2.5~-1 SD为骨量减少组(189例),T值≤-2.5 SD为骨质疏松组(165例).观察体重指数、血常规指标、血生化指标、骨转换指标[Ⅰ型原胶原氨基端延长肽(PINP)、Ⅰ型胶原C端肽降解β产物(β-CTx)]、血清铁蛋白指标变化、骨密度指标并进行相关性分析. 结果 (1)骨密度T值不同的三组中,骨密度低的组则血清铁蛋白高;(2)与骨密度有关的因素有年龄、体重指数、血清铁蛋白、血红蛋白、C反应蛋白及转铁蛋白等,控制年龄、体重指数等影响因素后,血清铁蛋白与骨密度呈负相关(股骨颈r=-0.446,P<0.01;腰椎r=-0.349,P<0.01);(3)血清铁蛋白与β-CTx呈正相关(r=0.166,P<0.01),与PINP不相关(r=-0.013,P>0.05). 结论 在绝经后髋部骨质疏松性骨折患者中,血清铁蛋白升高可能是骨密度下降的一个独立危险因素;血清铁蛋白还与破骨细胞活性增加相关.
更多Objective To analyze the correlation between indices of iron accumulation,bone turnover and bone mineral density in postmenopausal women with osteoporotic hip fracture,and further determine the role and significance of iron accumulation in hip osteoporosis.Methods A total of 376 cases aged (74.1 ±9.6) years (range,55-94 years) hospitalized from June 2010 to December 2014 were collected.Of all,22 cases were detected with normal bone mineral density (T-score≥-1),189 cases with osteopenia (T-score <-1 and >2.5) and 165 cases with osteoporosis (T-score≤-2.5).Body mass index,blood routine index,blood biochemical index,bone turnover markers [procollagen type N-terminal propeptide (PINP) andβ-C-terminal telopeptides of type Ⅰ collagen (β-CTx)] and iron metabolism index were statistically analyzed.Results Cases of lower bone mineral density resulted in higher serum ferritin.Age,body mass index,serum ferritin,hemoglobin,C reactive protein and transferrin were the factors that affecting bone mineral density.With the control of age and body mass index,serum ferritin and bone mineral density were significantly negatively correlated (femoral neck:r =-0.446,P <0.O1;lumbar:r =-0.349,P < 0.01).Serum ferritin was positively correlated with β-CTx(r =0.166,P <0.01),but it was not associated with P1NP (r =-0.013,P >0.05).Conclusions Regarding osteoporotic hip fracture in postmenopausal women,increase of serum ferritin may be an independent risk factor of decreased bone mineral density.Serum ferritin also relates to increased osteoclast activity.
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