绝经后骨质疏松症患者血清铁调素水平变化及临床意义

Changes of serum hepcidin levels in postmenopausal women with osteoporosis

目的探讨绝经后女性骨质疏松症患者血清铁调素水平与骨代谢指标及骨矿物质密度(BMD)的相关性。方法选取绝经后女性骨质疏松症患者106例及非骨质疏松症患者92例,根据BMD检查结果分为骨质疏松症组(106例)、骨量减少组(57例)和骨量正常组(35例)。收集所有对象的临床资料,检测BMD及血清铁调素、骨代谢指标[Ⅰ型前胶原氨基端前肽(PⅠNP)、骨桥蛋白(OPN)、Ⅰ型原胶原C端肽β降解产物(β-CTX)、N-端骨钙素(OC)]水平。采用受试者工作特征(ROC)曲线评价血清铁调素诊断骨质疏松症的价值,采用Pearson相关分析及偏相关分析评估各项指标之间的相关性。结果骨质疏松症组血清铁调素水平及腰椎BMD、股骨颈BMD均低于骨量减少组和骨量正常组(P<0.05),且骨量减少组均低于骨量正常组(P<0.05)。骨质疏松症组血清PⅠNP、OPN、β-CTX、OC水平均高于骨量减少组和骨量正常组(P<0.05)。骨量减少组血清PⅠNP、OPN、β-CTX水平均高于骨量正常组(P<0.05)。ROC曲线分析显示,血清铁调素诊断绝经后女性骨质疏松症的曲线下面积(AUC)为0.780,最佳临界值为35.0μg/L,敏感性为91.5%,特异性为57.6%。Pearson相关分析显示,铁调素与年龄、PⅠNP、OPN、β-CTX、OC均呈负相关(P<0.05),与体重、腰椎BMD、股骨颈BMD均呈正相关(P<0.05);偏相关分析显示,无论是校正年龄,还是校正年龄和体重,铁调素与PⅠNP、OPN均呈负相关(P<0.05),与腰椎BMD、股骨颈BMD均呈正相关(P<0.05)。结论绝经后女性骨质疏松症患者血清铁调素水平降低,且与年龄、骨代谢指标和BMD相关。

Objective To investigate the correlations of serum hepcidin levels with bone metabolism indices and bone mineral density(BMD)in postmenopausal women with osteoporosis.Methods A total of 106 postmenopausal women with osteoporosis and 92 postmenopausal women without osteoporosis were enrolled.According to BMD,they were classified into osteoporosis group(106 cases),bone mass reduction group(57 cases)and bone mass normal group(35 cases).Their clinical data were collected.BMD was determined.Serum levels of hepcidin and bone metabolism indices[procollagenⅠN-terminal peptide(PⅠNP),osteopontin(OPN),beta degradation product of carboxylterminal telopeptide of typeⅠcollagen(β-CTX)and N-terminal osteocalcin(OC)]were determined.Receiver operating characteristic(ROC)curve was used to analyze the role of serum hepcidin in the diagnosis of osteoporosis.Pearson correlation analysis and partial correlation analysis were used to evaluate the correlations.Results Serum levels of hepcidin,lumbar BMD and femoral neck BMD in osteoporosis group were lower than those in bone mass reduction group and bone mass normal group(P<0.05),and those in bone mass reduction group were lower than those in bone mass normal group(P<0.05).Serum levels of PⅠNP,OPN,β-CTX and OC in osteoporosis group were higher than those in bone mass reduction group and bone mass normal group(P<0.05),and serum levels of PⅠNP,OPN andβ-CTX in bone mass reduction group were higher than those in bone mass normal group(P<0.05).ROC curve analysis showed that the area under curve(AUC)of serum hepcidin in the diagnosis of osteoporosis for postmenopausal women was 0.780,the optimal cut-off value was 35.0μg/L,the sensitivity was 91.5%,and the specificity was 57.6%.Pearson correlation analysis showed that serum level of hepcidin was negatively correlated with age,PⅠNP,OPN,β-CTX and OC(P<0.05),while it was positively correlated with weight,lumbar BMD and femoral neck BMD(P<0.05).Partial correlation analysis showed that whether age was corrected,or age and weight were corrected,serum level of hepcidin was negatively correlated with PⅠNP and OPN(P<0.05),while it was positively correlated with lumbar BMD and femoral neck BMD(P<0.05).Conclusions Serum level of hepcidin in postmenopausal women with osteoporosis is decreased,and it is related with age,bone metabolism indices and BMD.