绝经女性血清雌激素及铁蛋白含量与骨密度的相关性研究

Study on the correlation between serum estrogen,ferritin contents and bone mineral density of postmenopausal women

目的探讨绝经女性血清雌激素及铁蛋白含量与骨密度的相关性。方法2015年1—9月收集绝经女性167例作为研究对象，年龄55～84岁，平均年龄（68．06±2．21）岁。按10岁为1个年龄段组，共分为4组，分别为≤60岁组57例、61～70岁组48例、71～80岁组37例和〉80岁组25例。所有研究对象均进行体格检查并抽取空腹静脉血，采用化学发光法检测血清雌激素、铁蛋白、Ⅰ型原胶原氨基段延长肽、Ⅰ型原胶原C段肽β降解产物及氨基酸中段骨钙素含量；采用免疫散射比浊法检测血清总铁结合力及转铁蛋白含量；采用双能X线骨密度测量仪检测股骨颈和腰椎正位（L1～L4）骨密度，并进行统计学分析。结果4组绝经女性血清雌激素、铁蛋白、转铁蛋白、总铁结合力、Ⅰ型原胶原氨基段延长肽、Ⅰ型原胶原C段肽B降解产物、氨基酸中段骨钙素、股骨颈骨密度及腰椎L1—T4骨密度组间比较，差异有统计学意义（P〈0．05或P〈0．01）。血清雌激素随着年龄增长而降低，血清铁蛋白随着年龄增长而增加，股骨颈和腰椎L1—L4骨密度随着年龄的增长而降低。多因素Logistic回归分析结果显示，血清雌激素与股骨颈及腰椎骨密度呈正相关，血清铁蛋白与股骨颈骨密度呈负相关，与腰椎骨密度无明显相关性。结论绝经女性血清雌激素及铁蛋白含量水平与骨代谢密切相关。随着年龄增长雌激素水平逐渐下降，而血清铁蛋白逐渐升高，骨密度则逐渐下降。血清雌激素降低和铁蛋白逐渐升高可能是绝经后骨质疏松症发生的独立危险因素。

Objective To explore the correlation between serum estrogen, ferritin contents and bone mineral density （BMD） of postmenopausal women. Methods A total of 167 postmenopausal women aged 55-84 years old were selected from January to September in 2015, （68.06±2. 21 ） years old on average. All the women were divided into four groups： ≤60-year-old group （57 women）, 61-70- year-old group （48 women）, 71-80-year-old group （37 women）, and 〉80-year-old group （25 women） . Physical examination was conducted, fasting venous blood specimens were abstracted, chemiluminescence was used to detect serum estrogen, ferritin, procollagen type Ⅰ N-terminal propeptide, β-carboxy terminal telopeptide of collagen type Ⅰ （β-CTX）, and osteocalcin contents; scattering immunoturbidimetric assay was used to detect serum total iron binding capacity and transferrin content; dual energy X-ray absorptiometry was used to detect BMD of femoral neck and lumbar vertebra （L1-L4）, statistical analysis was performed. Results There were statistically significant differences in serum estrogen, ferritin, transferrin, total iron binding capacity, procollagen type Ⅰ N-terminal propeptide, β-carboxy terminal telopeptide of collagen type Ⅰ, osteocalcin, and BMD of femoral neck and lumbar vertebra （ L1 -L4） among the four groups （P〈0. 05 or P〈 0. 01 ） . Serum estrogen levels decreased significantly with age, serum ferritin levels increased significantly with age, BMD of femoral neck and lumbar vertebra （L1-L4） decreased significantly with age. Multivariate logistic regression analysis showed that serum estrogen was posi- tively correlated with BMD of femoral neck and lumbar vertebra, serum ferritin was negatively correlated with BMD of femoral neck, there was no significant correlation between serum ferritin and BMD of lumbar vertebra. Conclusion Serum estrogen and ferritin levels are closely related to bone metabolism in postmenopausal women, the level of serum estrogen decreases gradually with age, while serum ferritin increases gradually with age, BMD decreases gradually with age. The decrease of serum estrogen level and gradual increase of serum ferritin level may be the independent risk factors of postmenopausal osteoporosis.