绝经后髋关节炎与骨质疏松症患者骨及铁代谢指标比较

Comparison of the bone and iron metabolism indexes between postmenopausal patients with hip arthritis and osteoporosis

目的 了解绝经后髋关节炎(osteoarthritis,OA)、绝经后骨质疏松症(osteoporosis,OP)患者血清铁蛋白、骨密度、骨转换指标及身高、体质量、BMI等指标间的联系,探讨两种疾病的临床相关性。方法 收集2012年6月至2014年12月于苏州大学附属第二医院就诊的绝经后女性分为OA组60例、OP组109例、非OP组(对照)161例,利用方差分析、二元 Logistics 回归分析等统计学方法回顾性比较分析OA和OP临床指标的相关性。结果 骨转换指标3组组间比较,差异有统计学意义( P <0.05)。70~79岁年龄段OA组Ⅰ型前胶原氨基末端肽(procollagen type 1 N-terminal propeptide,P1NP)高于OP组( P = 0.019),两组其余年龄段骨转换指标比较,差异无统计学意义( P >0.05);OP组各年龄段及OA组70~79岁、80~89岁两年龄段较对照组血清铁蛋白升高( P <0.05)。 Logistic 回归分析结果显示,年龄、体质量指数(body mass index,BMI)、铁蛋白为OA危险因素,年龄、铁蛋白为OP危险因素,BMI为OP保护因素。结论 绝经后女性OA和OP患者都存在“铁蓄积”,两者骨转换无差异,且致病因素一致,OP采用的部分防治方法可能对骨关节炎具有潜在的治疗价值。

Objective To explore the connection between the serum ferritin, BMD, bone turnover marker, height, weight, body mass index(BMI) and other clinical indexes of the patients with hip arthritis and osteoporosis. Methods Sixty cases with hip arthritis (OA),109 cases with osteoporosis (OP) and 161 cases without osteoporosis (control group) were collected from the same hospital. The clinical indicators and the correlation between osteoarthritis and osteoporosis were analyzed using dual analysis of variance,regression analysis and other statistical methods. Results Significant differences of bone turnover markers indexes could be observed among three groups. Procollagen type 1 N-terminal propeptide(P1NP) level of OA group was higher than that of OP group in ages from 70 to 79 ( P =0.019). Serum ferritin of OA group was increased in ages from 70 to 79 and 80 to 89,compared to control group ( P =0.026,0.000). Results of binary Logistic regression: age,ferritin and BMI were the risk factors of OA. Age and ferritin were the risk factors of OP,while BMI was the protective factor. Conclusions Both postmenopausal women with hip arthritis and osteoporosis suffered from iron accumulation and shared the same pathogenic factors. No difference of bone turnover was found between OA and OP. The prevention for osteoporosis maybe has potential clinical value for the treatment of osteoarthritis.