临床铁代谢指标与骨密度的相关性分析

Correlation analysis of clinical iron metabolism indexes and bone mineral density

目的 研究临床40周岁及以上患者骨密度与铁代谢相关指标的关系。方法 纳入广州中医药大学第一附属医院二骨科40周岁及以上的住院患者208例,分为骨量正常组(64例)、骨量减少组(92例)和骨质疏松组(52例),测量患者的骨密度、血红蛋白、血清铁、转铁蛋白、γ-谷氨酰转肽酶等,进行各变量的组间比较及其与骨密度的相关性研究和回归分析。结果血红蛋白(P<0.001)、转铁蛋白(P=0.001)、γ-谷氨酰转肽酶(P<0.001)的组间差异具有统计学意义;血红蛋白、转铁蛋白与股骨大粗隆(r=0.493,P<0.001;r=0.243,P<0.001)及股骨干骨密度(r=0.319,P<0.001;r=0.331,P<0.001)明显相关,与L_(1)~L_(4)腰椎骨密度无明显相关;有序多元Logistic回归分析结果显示,年龄、性别、BMI、血红蛋白、转铁蛋白为骨质疏松的独立影响因素(分别为OR=1.06,P<0.001;OR=3.36,P<0.001;OR=0.82,P<0.001;OR=0.97,P=0.008;OR=0.27,P=0.021)。结论 人体内铁蓄积与骨密度水平负相关,血红蛋白、转铁蛋白及γ-谷氨酰转肽酶是骨质疏松发生的重要影响因素。

Objective To study the relationship between iron and osteoporosis.Methods A total of 208 inpatients were enrolled in the second Department of Orthopedics,The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine.They were divided into normal group(n=64),osteopenia group(n=92)and osteoporosis group(n=52).The BMD,hemoglobin content,serum iron,transferrin and gamma-glutamyltransferase were measured.All variables were compared between groups and their correlation with bone mineral density was studied and regression analysis was performed.Results The hemoglobin content(P<0.001),transferrin(P=0.001),γ-glutamyltranspeptidase(P<0.001)were statistically significant;Hemoglobin content,transferrin and greater trochanter of femur(r=0.493,P<0.001;r=0.243,P<0.001)and bone mineral density(r=0.319,P<0.001;r=0.331,P<0.001)significantly correlated with L_(1)-L_(4) lumbar bone mineral density;The result of ordered multiple logistic regression analysis showed that age,gender,BMI,hemoglobin content and transferrin were independent influencing factors of osteoporosis(OR=1.06,P<0.001;OR=3.36,P<0.001;OR=0.82,P<0.001;OR=0.97,P=0.008;OR=0.27,P=0.021).Conclusion Iron accumulation in human body is negatively correlated with bone mineral density.Hemoglobin,transferrin andγ-glutamyltranspeptidase are important factors affecting the occurrence of osteoporosis.