【摘要】 目的探讨血清铁过载与老年女性骨质疏松性骨折的关系。方法选取2017年1月至2018年8月西安市红会医院骨显微修复外科收治的100例老年女性骨质疏松骨折患者为研究对象(研究组),检测所有患者的血清铁蛋白(FER)水平,依据检测结果将患者分为FER过载组(42例)、FER正常组(58例),并选择100例正常老年女性为对照组,分析各组受检者的FER、骨密度(BMD)、骨代谢指标[Ⅰ型原胶原氨基端延长肽(P1NP)、Ⅰ型胶原C端肽β降解产物(β-CTX)]水平的差异,并对各指标进行相关性分析。结果研究组患者的血清FER、PINP、β-CTX及BMD分别为(235.52±63.73) ng/mL、(67.25±31.02) ng/L、(651.23±67.25) ng/L和(-2.21±0.92),对照组分别为(128.85±20.95) ng/m L、(49.36±22.15) ng/L、(442.01±39.52) ng/L和(-1.62±1.15),组间比较差异均有统计学意义(P<0.05);FER过载组患者的PINP、β-CTX及BMD分别为(75.25±35.92) ng/L、(692.34±81.02) ng/L和(-2.51±1.02),FER正常组分别为(54.01±25.14) ng/L、(602.51±52.04) ng/L和(-1.43±0.68),组间比较差异均有统计学意义(P<0.05);Pearson直线相关性分析结果显示,FER与股骨颈BMD、腰椎BMD呈负相关(r=-0.667、-0.568,P<0.01);Logistic多元逐步回归分析结果显示,血清钙与股骨颈BMD、腰椎BMD呈正相关(β=1.356、0.125,P<0.05),FER、PINP、β-CTX与股骨颈BMD、腰椎BMD呈负相关(β=-0.325～-0.923,P<0.05)。偏相关分析显示FER与PINP、β-CTX呈正相关(r=0.438、0.507,P<0.05)。结论老年女性骨质疏松性骨折患者存在铁过载,血清铁过载与骨转换活跃可能是导致老年女性骨量丢失、骨代谢异常的相关因素。更多还原

【Abstract】 Objective To investigate the relationship between serum iron overload and osteoporotic fracture in elderly women. Methods A total of 100 elderly women with osteoporotic fracture, who admitted to Department of Bone Microsurgery of Xi’an Honghui Hospital from Jan. 2017 to Aug. 2018, were selected as the study group. According to the serum ferritin(FER) levels, the patients were divided into the FER overload group(42 cases) and the normal FER group(58 cases). At the same time, 100 normal elderly women were selected as the control group. The FER, bone mineral density(BMD) and bone metabolism indexes were analyzed. The differences of procollagen type Ⅰ N-terminal propeptide(PINP) and plasma cross-linking C-terminal telopeptide of type Ⅰ collagen( β-CTX) were analyzed.Results The serum FER, PINP, beta-CTX and BMD of the study group were(235.52 ± 63.73) ng/mL,(67.25 ±31.02) ng/L,(651.23±67.25) ng/L and(-2.21±0.92) respectively, versus(128.85±20.95) ng/mL,(49.36±22.15) ng/L,(442.01±39.52) ng/L and(-1.62±1.15) in the control group respectively(all P<0.05). PINP, beta-CTX and BMD of the FER overload group were(75.25±35.92) ng/L,(692.34±81.02) ng/L and(-2.51±1.02) respectively; PINP, beta-CTX and BMD in the normal FER group were(54.01 ± 25.14) ng/L,(602.51 ± 52.04) ng/L and(-1.43 ± 0.68) respectively; there were significant differences between the two groups(P<0.05). Pearson linear correlation analysis showed that FER was negatively correlated with BMD of femoral neck and lumbar spine(r=-0.667,-0.568, P<0.001). Logistic multiple stepwise regression analysis showed that serum calcium was positively correlated with BMD of femoral neck and lumbar vertebra(β=1.356, 0.125, P<0.05), PINP and beta-CTX were negatively correlated with BMD of femoral neck and lumbar vertebra(β=-0.325 to-0.923, P<0.05). Partial correlation analysis showed that FER was positively correlated with PINP and beta-CTX(r=0.438, 0.507, P<0.05). Conclusion Iron overload exists in elderly women with osteoporotic fracture. Serum iron overload and active bone turnover may be related factors leading to bone loss and abnormal bone metabolism in elderly women.更多还原