体检女性血清铁蛋白与骨密度的关系

摘要
图/表
参考文献(22)
相关文章 (14)

全文: PDF (613 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨体检女性血清铁蛋白（Fer）与骨密度（BMD）和骨代谢的关系。方法选择2017年2～10月于广东省中医院体检中心体检的女性志愿者104名，按照年龄分为高龄组（年龄≥50岁，n = 67）和低龄组（年龄＜50岁，n = 37）；按照绝经情况分为绝经组（n = 58）和未绝经组（n = 46）；按照骨量分为骨量正常组（股骨颈和腰椎T值≥ -1 SD，n = 40）和骨量减低组（股骨颈和腰椎T值＜-1 SD，n = 64）。比较不同年龄和不同骨量受试者血清Fer、BMD及骨代谢指标水平[碱性磷酸酶（ALP）、Ⅰ型原胶原氨基端延长肽（P1NP）和β-降解产物（β-CTX）]的变化，同时分析月经对于血清Fer、BMD及骨代谢指标水平的影响，另外分析体检女性血清Fer水平与BMD及骨代谢指标水平的相关性。结果高龄组女性血清中Fer、ALP、P1NP及β-CTX水平明显高于低龄组，而髋部、腰椎第1~4节（L1~4）和总股骨的BMD水平显著低于低龄组，且差异均有统计学意义（P ＜ 0.05）；与骨量减低组相比，骨量正常组血清Fer、ALP、P1NP及β-CTX水平明显降低，而髋部、L1~4和总股骨的BMD水平显著升高，且差异均有统计学意义（P ＜ 0.05）；绝经组血清中Fer、ALP、P1NP及β-CTX水平明显高于未绝经组，而髋部、L1~4和总股骨的BMD水平显著低于未绝经组；体检女性血清Fer与髋部、L1~4和总股骨的BMD水平呈负相关（r = -0.698、-0.714、-0.682，P ＜ 0.05），而与血清中ALP、P1NP及β-CTX水平呈正相关（r = 0.732、0.725、0.619，P ＜ 0.05）。结论女性血清Fer水平受到年龄、月经的影响，同时与BMD及骨代谢指标联系密切，可以作为预测骨量下降的重要指标。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	张迪晖黄泽鑫罗斌

关键词 ：女性, 铁蛋白, 骨密度, 骨代谢

Abstract：Objective To explore the relationship between serum ferritin (Fer) and bone density (BMD), bone metabolism in physical examination. Methods A total of 104 cases of female volunteers from February 2017 to October 2017 in Physical Examination Center of Guangdong Province Traditional Chinese Medical Hospital were selected. According to the age, they were divided into elder group (age≥50, n = 67) and young group (age＜50, n = 37). According to the menopausal status, they were divided into the postmenopausal group (n = 58) and the non-menopausal group (n = 46). According to the bone mass, they were divided into the normal bone mass group (femoral neck and lumbar T value≥-1 SD, n = 40) and the bone mass reduction group (femoral neck and lumbar T value＜-1 SD, n = 64). The levels of serum Fer, BMD and bone metabolism index [alkaline phosphatase (ALP), type Ⅰ collagen amino terminal extension of the peptide (P1NP) and β-degradation products (β-CTX)] of the volunteers with different age and different bone mass were compared, meanwhile the effect of menstruation on serum Fer, BMD and bone metabolism indices was analyzed. In addition, the correlation between serum Fer and the levels of BMD and bone metabolism index was analyzed. Results The levels of Fer, ALP, P1NP and β-CTX of the elder group were obviously higher than the young group, while the BMD of hip and L1-4 and total femoral were significantly lower than the young group, and the differences were statistically significant (P ＜ 0.05). Compared with bone mass reduction group, the levels of Fer, ALP, P1NP and β-CTX of normal bone mass group significantly decreased, but the BMD of hip and L1-4 and total femoral significantly increased, and the differences were statistically significant (P ＜ 0.05). The levels of Fer, ALP, P1NP and β-CTX of menopausal group were significantly higher than those of the non-menopausal group, while the BMD levels of the hip, L1-4 and the total femur were significantly lower than those in the non-menopausal group. There was a negative correlation between serum Fer and BMD levels of hip, L1-4 and the total femur (r = -0.698, -0.714, -0.682, P ＜ 0.05), but a positive correlation with ALP, P1NP and β-CTX in serum (r = 0.732, 0.725, 0.619, P ＜ 0.05). Conclusion The female serum Fer level is affected by age and menstruation, which is closely related to BMD and bone metabolism index, and it can act as an important indicator for predicting the decline of bone mass.

Key words： Women Ferritin Bone mineral density Bone metabolism

基金资助:广东省中医药管理局课题（20151228）。

作者简介: 张迪晖（1982.6-），男，硕士；研究方向：创伤骨科。

引用本文:

张迪晖黄泽鑫罗斌. 体检女性血清铁蛋白与骨密度的关系[J]. 中国医药导报, 2018, 15(25): 75-78.
ZHANG Dihui HUANG Zexin LUO Bin. The relationship between serum ferritin and bone density of female check-ups. 中国医药导报, 2018, 15(25): 75-78.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I25/75

[1] 刘晨.405例体检健康女性铁蛋白对骨量下降的预测性能评估及绝经后女性骨量下降影响因素研究[D].苏州：苏州大学，2015.
[2] 王广伟，黄宏兴，霍力为，等.绝经后骨质疏松症患者脂肪含量与骨密度的相关性研究[J].国际中医中药杂志，2012，34（9）：782-784.
[3] 赵心，白小涓，汉雯，等.绝经后女性雌激素水平与骨质疏松症和动脉粥样硬化风险相关性研究[J].中华老年心脑血管病杂志，2017，19（10）：1033-1038.
[4] 胡若梅，吴洁，孙寿丹，等.健康管理对社区绝经后妇女骨密度的影响[C].//第十二届全国营养科学大会论文汇编，2015：2.
[5] Elalfy MS，Esmat G，Matter RM，et al. Liver fibrosis in young Egyptian beta-thalassemia major patients：relation to hepatitis C virus and compliance with chelation [J]. Ann Hepatol，2013，12（1）：54-61.
[6] 贾鹏，何银峰，高超，等.铁离子对破骨细胞分化及骨吸收的影响[J].中华医学杂志，2012，92（31）：2214-2218.
[7] 张林林，郑闽前，徐小卒，等.435名女性体检者血清铁蛋白与骨密度的相关性[J].中华骨质疏松和骨矿盐疾病杂志，2014，7（1）：9-14.
[8] Kim BJ，Ahn SH，Bae SJ，et al. Iron overload accelerates bone loss in healthy postmenopausal women and middle-aged men：a 3-year retrospective longitudinal study [J]. J Bone Miner Res，2012，27（11）：2279-2290.
[9] Montonen J，Boeing H，Steffen A，et al. Body iron stores and risk of type 2 diabetes：results from the European Prospective Investigation into Cancer and Nutrition（EPIC）-Potsdam study [J]. Diabetologia，2012，55（10）：2613-2621.
[10] 王兵，赵环，姜习凤，等.绝经后女性股骨头铁含量与骨密度的相关性[J].中华骨质疏松和骨矿盐疾病杂志，2013， 6（1）：9-14.
[11] 冯玉爽，徐又佳，马勇，等.高龄女性骨质疏松性骨折与血清铁过载的关系[J].江苏医药，2011，37（8）：896-898.
[12] 王兵，徐又佳.铁过载检测在骨质疏松症诊断中的作用[J].中华骨质疏松和骨矿盐疾病杂志，2012，5（1）：69-72.
[13] 张林林，姜习凤，艾红珍，等.绝经后髋部脆性骨折中铁过载指标与骨密度骨转换指标关系的研究[J].中华外科杂志，2013，51（6）：518-521.
[14] 王宇强，苏学涛，赵永军，等.血清铁过载与老年女性骨质疏松性骨折的关系研究[J].陕西医学杂志，2016，45（12）：1596-1597.
[15] 姚喆.376例绝经后髋部脆性骨折患者铁蓄积、骨转换、骨密度指标相关性分析[D].苏州：苏州大学，2016.
[16] Kanis JA，McCloskey EV，Johansson H，et al. European guidance for the diagnosis and management of osteoporosis in postmenopausal women [J]. Osteoporos Int，2008， 19：399-428.
[17] 陆耀宇，李溥，李瑛，等.绝经女性血清雌激素及铁蛋白含量与骨密度的相关性研究[J].中国妇幼保健，2016， 31（11）：2295-2298.
[18] 王冀苏，陈治卿.血清铁蛋白与绝经早期骨质疏松症的相关性研究[J].中外医疗，2014（32）：46-48.
[19] 赵宇.绝经后髋关节炎、骨质疏松症临床血清指标回顾性比较[D].苏州：苏州大学，2015.
[20] 陈伟，张红梅，张静，等.骨质疏松症骨生化指标检测分析[J].医学综述，2016，22（14）：2846-2848，2852.
[21] 李声东.绝经后女性类风湿关节炎患者骨密度的影响因素[J].中国现代医生，2018，56（15）：9-13.
[22] 吴红丽，孙健，孙冀兵，等.绝经前和绝经后患者血红蛋白及血清铁蛋白含量的检测及其意义分析[J].中国实验诊断学，2017，21（4）：613-616.