联合检测血清铁蛋白和胱抑素C对绝经后骨质疏松症的意义

Clinical significance of combined detection of serum ferritin and Cys-C for postmenopausal osteoporosis

目的分析探讨绝经后体检女性血清铁蛋白、胱抑素C与骨密度相关性。方法收集2015年10月至2019年4月南通市第一人民医院体检中心有完整临床资料的492例绝经后体检女性,年龄55~80岁。留取空腹静脉血检测血清铁蛋白(SF)、血清胱抑素(Cys-C)、血肌酐(Scr)、甲状旁腺素(PTH)、25-羟基维生素D(25OHD)、骨钙素(OC)、Ⅰ型原胶原氨基端延长肽(PⅠNP)和Ⅰ型胶原C端肽β降解产物(β-CTX)等指标,双能X线骨密度仪检测左髋股骨颈、总股骨和腰椎1-4骨密度,分析血清铁蛋白和胱抑素C与骨密度相关性及骨质疏松症发生相对风险。结果本组人群骨质疏松发生率46.5%,不同骨密度组年龄、体重、BMI、SF、Cys-C、25OHD、PⅠNP和β-CTX组间差异有统计学意义;血清铁蛋白和胱抑素的四分位数分组中,年龄、体重、BMI、Scr及各部位骨密度T值组间差异有统计学意义;控制年龄、体重、BMI、Scr、25OHD和PⅠNP等指标后,高血清铁蛋白和胱抑素C组骨质疏松相对风险分别为2.272(95%CI:1.090~4.727)和2.224(95%CI:1.047-4.723)。结论血清铁蛋白和胱抑素C升高是绝经后骨质疏松症发生的独立危险因素,需要重视绝经后女性血清铁蛋白和胱抑素C的变化。

Objective To investigate the association between serum ferritin(SF),cystatin C(Cys-C)and bone mineral density(BMD)in postmenopausal women.Methods Four hundred and Ninety-two postmenopausal women aged from 55 to 80 with complete clinical data were collected from the physical examination center of Nantong first people's Hospital from October 2015 to April 2019.Serum samples were collected to detect SF,Cys-C,Scr,PTH,25OHD,OC,PⅠNP,and β-CTX.BMD of the femoral neck,total femur,and 1-4 lumber vertebrae were measured with dual energy X-ray absorptiometry.Results The incidence of osteoporosis was 46.5% in our study.There were significant differences in age,weight,BMI,SF,Cys-C,25OHD,PⅠNP,and β-CTX among different BMD groups.In the quartile groups of SF and Cys-C,there were statistically significant differences in age,weight,BMI,Scr,and T value of BMD.Higher SF and Cys-C levels were associated with a higher prevalence of osteoporosis in postmenopausal women(OR=2.272,95%CI,1.090-4.727 and OR=2.224,95%CI,1.047-4.723,respectively)after adjusted for age,weight,BMI,Scr,25OHD,and PⅠNP.Conclusion The increase of SF and Cys-C are independent risk factors for postmenopausal osteoporosis.It is necessary to pay attention to the changes of SF and Cys-C in postmenopausal women.