胸腰椎骨质疏松性骨折患者椎体骨铁含量、血清铁蛋白与骨密度的相关性分析

Correlation analysis of vertebral bone iron content, serum ferritin and bone mineral density in patients with thoracolumbar osteoporotic fractures

目的分析胸、腰椎骨质疏松性骨折患者椎体骨铁含量、血清铁蛋白和骨密度之间的相关性。方法研究对象为我院2018年6月至2020年6月期间收治的120例手术治疗的胸、腰椎椎体骨折患者,对其临床资料进行回顾性分析,对其血清铁蛋白和骨代谢指标进行测定,并且根据其椎体骨密度检测值的不同将其分为甲乙两组,甲组为骨质疏松患者,乙组为骨量减少患者,在患者手术过程中采集适量椎体松质骨开展骨铁含量检测,分析其椎体骨铁含量、血清铁蛋白和骨密度之间的相关性。结果甲组患者的骨铁含量、血清铁蛋白含量以及骨代谢指标均显著高于乙组患者(P<0.05)。和股骨颈及L_(1-4)骨密度表现为负相关的变量依次为年龄、骨铁、血清铁蛋白、Ⅰ型原胶原氨基端延长肽以及Ⅰ型胶原C端肽β降解产物,表现为正相关的变量依次为体质量指数、转铁蛋白以及总铁结合力(P<0.05)。骨铁和血清铁蛋白可以进入股骨颈和腰椎骨密度的多元线性回归模型中,是影响患者骨密度的独立危险因子(P<0.05)。结论对于胸、腰椎骨质疏松性椎体骨折患者,椎体骨铁含量以及血清铁蛋白含量可能是导致其发生骨折的重要危险因素,患者的骨密度会随着椎体骨铁含量及血清铁蛋白含量的升高而降低。

Objective To analyze the correlation between vertebral bone iron content,serum ferritin and bone mineral density in patients with thoracic and lumbar osteoporotic fractures.Methods The subjects of the study were 120 patients with thoracic and lumbar vertebral body fractures treated in our hospital from June 2018 to June 2020.Their clinical data were retrospectively analyzed,and their serum ferritin and bone metabolism indexes were measured.They were divided into two groups according to their vertebral bone density test values.Group A was osteoporosis patients,and group B was osteopenia patients.Appropriate amount of vertebral cancellous bone is collected during the operation to detect Bone iron content.The correlation between vertebral bone iron content,serum ferritin and bone density was analyzed.Results The bone iron content,serum ferritin content and bone metabolism indexes of group A patients were significantly higher than those of group B patients(P<0.05).The variables negatively correlated with femoral neck and L1-4 bone mineral density were age,bone iron,serum ferritin,type I procollagen amino-terminal extension peptide and type I collagen C-terminal peptide β degradation products.Femoral neck and L1-4 bone mineral density which were positively correlated with the body mass index,transferrin,and total iron binding capacity(P<0.05).Bone iron and serum ferritin can enter the multiple linear regression model of femoral neck and lumbar spine bone mineral density,and are independent risk factors that affect the patient’s bone mineral density(P<0.05).Conclusion For patients with thoracic and lumbar osteoporotic vertebral fractures,the vertebral bone iron content and serum ferritin content may be important risk factors for fractures.The patient’s bone density will decrease with the increase of vertebral bone iron content and serum iron content.