血清铁蛋白与绝经后骨质疏松症的相关性分析

Correlation between serum ferritin and postmenopausal osteoporosis

目的探讨血清铁蛋白与绝经后骨质疏松症之间的关系。方法以2018年5月至2019年12月期间就诊于河北医科大学第三医院的绝经后女性作为研究对象,其中骨质疏松(OP)组183例,是经双能X线骨密度检查诊断为骨质疏松症的患者。对照组98例,为同期双能X线骨密度检查骨量正常者。比较两组间年龄、绝经年龄、绝经时间、身体质量指数(BMI)、生化指标、血清铁蛋白水平等的差异,并分析血清铁蛋白水平与各临床指标及骨密度的相关性。结果OP组平均年龄(67.67±8.78)岁,较对照组[(58.86±7.90)岁]大;绝经年龄(48.83±3.61)岁,较对照组[(49.99±2.30)岁]早;绝经时间(18.73±9.75)年,较对照组[(8.29±3.04)年]长(P均<0.05);OP组腰椎骨密度和股骨颈骨密度[(0.76±0.12)g/cm^(2)和(0.71±0.12)g/cm^(2)]较对照组[(1.06±0.09)g/cm^(2)和(0.99±0.67)g/cm^(2)]显著降低(P均<0.05);OP组总胆固醇和血清铁蛋白水平[(4.92±1.10)mmol/L和(177.50±85.11)ug/L]较对照组[(4.48±1.17)mmol/L和(104.29±43.64)ug/L]明显升高(P<0.05);Pearson相关性分析显示,血清铁蛋白水平与BMI(r=0.188,P<0.05)、空腹血糖(r=0.153,P<0.05)呈正相关,与腰椎骨密度(r=-0.231,P<0.05)、股骨颈骨密度(r=-0.257,P<0.05)呈负相关;绝经后骨质疏松症组患者的血清铁蛋白水平在70岁之前上升较为缓慢,70岁及以后上升较快,在75~79岁达到峰值,80岁及以后呈下降趋势。二元Logistic回归分析显示,血清铁蛋白(OR=0.981,P<0.05)是绝经后骨质疏松症的危险因素,腰椎骨密度(OR=3.505,P<0.05)、股骨颈骨密度(OR=3.881,P<0.05)是绝经后骨质疏松症的保护因素。结论绝经后骨质疏松症患者的血清铁蛋白水平升高,血清铁蛋白可能参与绝经后骨质疏松症的发生发展;血清铁蛋白、腰椎骨密度、股骨颈骨密度与绝经后骨质疏松症的发生发展有关。

Objective To explored the relationship between serum ferritin and postmenopausal osteoporosis.Methods This study collected 281 postmenopausal female patients in the Third Hospital of Hebei Medical University from May 2018 to December 2019,183 were osteoporosis diagnosed by dual-energy X-ray bone mineral density(BMD),as osteoporosis(OP)group,98 subjects with normal bone mass,as control group.Clinical and biochemical characteristics were collected.Compare the difference between the two groups.Correlation between serum ferritin with clinical parameters and bone mineral density was performed.Results The average age of the OP group[(67.67±8.78)years]was older than that of the control group[(58.86±7.90)years],the age of menopause[(48.83±3.61)years]was earlier than that of the control group[(49.99±2.30)years],and the time of menopause[(18.73±9.75)years]was longer than that of the control group[(8.29±3.04)years](P<0.05).The lumbar spine bone mineral density and femoral neck bone mineral density in OP group[(0.76±0.12)g/cm^(2) and(0.71±0.12)g/cm^(2)]were significantly lower than those in the control group[(1.06±0.09)g/cm^(2) and(0.99±0.67)g/cm^(2)](P<0.05).The levels of total cholesterol and serum ferritin in OP group[(4.92±1.10)mmol/L and(177.50±85.11)ug/L]were significantly higher than those in con-trol group[(4.48±1.17)mmol/L and(104.29±43.64)ug/L](P<0.05).Pearson correlation analysis showed that serum ferritin level was positively correlated with BMI(r=0.188,P<0.05)and fasting blood glucose(r=0.153,P<0.05),and negatively correlated with lumbar bone mineral density(r=-0.231,P<0.05)and femoral neck bone mineral density(r=-0.257,P<0.05).The level of serum ferritin in postmenopausal osteoporosis group increased slowly before 70 years old,increased rapidly after 70 years old,peaked at 75-79 years old,and decreased after 80 years old.Binary Logistic regression analysis showed that serum ferritin(OR=0.981,P<0.05)was a risk factor for postmenopausal osteoporosis,while lumbar bone mineral density(OR=3.505,P<0.05)and femoral neck bone mineral density(OR=3.881,P<0.05)were protective factors for postmenopausal osteoporosis.Conclusion The level of serum ferritin in patients with postmenopausal osteoporosis is increased,and serum ferritin may be involved in the occurrence and development of postmenopausal osteoporosis.Serum ferritin,lumbar bone mineral density and femoral neck bone mineral density are related to the occurrence and development of postmenopausal osteoporosis.