铁过载对绝经后骨质疏松患者骨密度和骨代谢的影响

目的 观察铁过载对绝经后骨质疏松患者骨密度和骨代谢的影响。方法 将234名绝经后妇女按照骨密度（bone mineral density, BMD）分为正常组、骨量减少组和骨质疏松组。分析铁过载对年龄、绝经年数、血钙(Ca)、磷(P)、体质量指数（bone mass index,BMI）、肝肾功能、葡萄糖代谢、脂质代谢、炎症反应、BMD、抗酒石酸酸性磷酸酶5b(TRACP-5b)、ALP、Ⅰ型胶原交联C端肽(β-CTX)和Ⅰ型胶原交联N端肽(PINP)的影响。结果 与正常组相比，骨量减少组和骨质疏松组血清铁蛋白(Fer)显著升高(P<0.05)。Fer水平与BMD呈负相关(P<0.05)。TRACP-5b水平在骨质疏松组明显高于正常组(P<0.05)。与正常组相比，骨质疏松症组的ALP水平显著升高(P<0.05)。与骨量减少组相比，骨质疏松组血清β-CTX水平明显升高(P<0.05)；且骨质疏松组的PINP水平显著高于正常组(P<0.05)。更重要的是，血清Fer和PINP之间存在正相关(P<0.05)；血清Fer和β-CTX之间呈正相关(P<0.05)。结论 铁过载对绝经后骨质疏松患者骨密度和骨代谢均有显著影响。

Effects of iron overload on bone mineral density and bone metabolism in postmenopausal patients with osteoporosis

Objective To observe the effects of iron overload on bone mineral density and bone metabolism in postmenopausal osteoporosis patients. Methods According to bone mineral density results, 234 postmenopausal women were divided into Normal group, Osteopenia group, and Osteoporosis group. We evaluated the effects of iron overload on age, years of menopause, Ca, P, BMI, liver and kidney function, glucose metabolism, lipid metabolism, inflammatory response, BMD, Tartrate resistant acid phosphatase type 5b (TRACP-5B), ALP, N-terminal propeptides of type I procollagen (PINP) and carboxyterminally cross-linked telopeptides (??-CTX). Results Compared with Normal group, the serum ferritin (Fer) levels in Osteopenia group and Osteoporosis group were significantly increased (P<0.05). Fer level was negatively correlated with BMD (P<0.05). TRACP-5B levels in Osteoporosis group were significantly higher than that in Normal group (P<0.05). ALP levels in Osteoporosis group were significantly up regulated compared with Normal group (P<0.05). ??-CTX levels in Osteoporosis group were significantly increased compared with Osteopenia group (P<0.05). PINP levels in Osteoporosis group were significantly higher than that in Normal group (P<0.05). More importantly, there was a positive correlation between serum Fer and PINP (P<0.05). Serum Fer showed a positive correlation with serum ??-CTX (P<0.05). Conclusion Iron overload has significant effects on bone mineral density and bone metabolism in postmenopausal osteoporosis patients.