雌激素与绝经后女性铁蓄积相关骨丢失的相关性分析

The Correlation Between Estrogen and Iron Accumulation Related Bone Loss in Postmenopausal Women

目的分析绝经前后女性雌激素对血清铁蛋白与骨密度(BMD)相互关系的影响,明确铁蓄积对绝经后骨质疏松是否存在独立影响。方法回顾性分析2016年8月—2018年8月在昆山市第一人民医院参加健康体检485名女性,收集铁蛋白和雌激素水平以及腰椎和股骨BMD数据。通过相关性分析比较雌激素对BMD与铁蛋白的相关性的影响。运用Logistics回归分析评估影响BMD的独立危险因素。结果绝经前后女性受试者血清铁蛋白和雌激素水平差异均具有统计学意义,绝经后女性的腰椎及股骨颈BMD较绝经前女性也显著降低。相关性分析结果显示,在绝经前女性中,仅BMI与腰椎、股骨颈BMD呈显著正相关;在绝经后女性中,年龄、血清铁蛋白与腰椎、股骨颈BMD呈负相关,BMI、雌激素与BMD呈正相关。同时,绝经后女性血清铁蛋白与雌激素呈负相关,而在绝经前女性中两者不存在相关性。多元Logistics回归分析,血清铁蛋白是绝经后女性骨丢失的独立危险因素,雌激素对防止绝经后女性骨丢失具有保护作用。结论该研究证实了雌激素与体内铁储量会共同对绝经后女性的BMD产生影响,进一步证实了铁蓄积是绝经后女性骨量下降的独立危险因素。

Objective To analyze the effect of estrogen on the correlation between ferritin and bone mineral density(BMD)in premenopausal and postmenopausal women to determine whether iron accumulation has an independent effect on postmenopausal osteoporosis.Methods A total of 485 women who participated in physical examination in Kunshan First People's Hospital from August 2016 to August 2018 were retrospectively analyzed.The data of ferritin and estrogen levels and BMD of lumbar spine and femur were collected.Correlation analysis was used to compare the effect of estrogen on the correlation between BMD and ferritin.Logistic regression analysis was used to evaluate the independent risk factors of BMD.Results There were significant differences in serum ferritin and estrogen levels between premenopausal and postmenopausal women.The BMD of lumbar spine and femoral neck in postmenopausal women was significantly lower than that in premenopausal women.Correlation analysis showed that only BMI was positively correlated with BMD of lumbar spine and femoral neck for premenopausal women;For postmenopausal women,age and serum ferritin were negatively correlated with BMD of lumbar spine and femoral neck,while BMI and estrogen were positively correlated with BMD.At the same time,there was a negative correlation between serum ferritin and estrogen for postmenopausal women,but there was no correlation between serum ferritin and estrogen for premenopausal women.Multiple Logistic regression analysis showed that serum ferritin was an independent risk factor of bone loss for postmenopausal women,and estrogen had a protective effect on preventing bone loss in postmenopausal women.Conclusion The study confirmed that estrogen and iron storage in the body will jointly affect the BMD of postmenopausal women,and further confirmed that iron accumulation is an independent risk factor of bone loss for postmenopausal women.