DOI 10. 3969 /j. issn. 1674-2591. 2014. 01. 002 9 435 1 1 1 1 1 2 2 2 3 Huang Xi 4 2 2011 1 2012 12 435 22 ~ 80 X 5 1 5 Logistic - 2. 5 < T < - 1. 0 P < 0. 001 T - 2. 5 P < 0. 01 P < 0. 001 5 Logistic OR 95% CI 2. 82 1. 25 ~ 6. 38 2. 04 0. 92 ~ 4. 51 BMI BMI C CRP P < 0. 05 R681 A Relationship between serum ferritin and bone mineral density in 435 healthy women Zhang Lin-lin 1 ZHENG Min-qian 1 XU Xiao-zu 1 DIAO Yong-li 1 GE Nai-hang 1 ZHANG Peng 1 DONG Qi-rong 2 QIAN Zhi-yuan 2 LIN Hua 3 HUANG Xi 4 XU You-jia 2 1. Department of Orthopaedics Yancheng First Peoples' Hospital Yancheng 224000 2. Department of Orthopaedics Second Affiliated Hospital Soochow University Suzhou 215004 3. The Center of Research for Metabolic Bone Disease Affiliated Drum Tower Hospital of Medical School Nanjing University Nanjing 210009 China 4. New York University NYU Cancer Institute NYU School of Medcine New York Abstract Objective To study how iron content and BMD alter with age also the relationship between iron 81273090 BK2012608 SZS201208 LCZX201305 1. 224000 2. 215004 3. 210009 4. New York University NYU Cancer Institute NYU School of Medicine New York E-mail xuyoujia@ medmail. com. cn
10 content and BMD. Methods This study induded of 435 women from January 2011 to December 2012 whose serum levers of ferritin Fer were measured and remarked. Bone mineral density BMD in femur and lumbar spine were measured by dual-energy X-ray absorptiometry. We observed serum Fer and BMD was changed with age. Then we categorized subjects into 5 groups according to the level of ferritin and Non-conditional Logistic Regression Analysis was used to evaluate the risk of osteopenia. At last associations between Fer and BMD in all areas were measured by multiple regression analyses and partial correlation. Results The serum Fer level was low and stable in women before the age of 40 gradually increased in women aged 41-49 rapidly rose in women aged 50-65 and was remaining steady high after the age of 65. However the BMD was high before the age of 50 rapidly fall in women aged 50-65 and kept low after the age of 65. The concentration of Fer in the group of osteoporosis was higher than in the group of osteopenia P < 0. 01 and in the normal group P < 0. 001. Also the Fer was higher in the group of osteopenia than in the normal P < 0. 001. In analysis by quintiles after adjusting confounding factors compared with the individuals in the lowest quintile those in the highest quintile were more than twice as likely to suffer osteopenia in femur neck and L 1-4 OR 2. 82 95% CI 1. 25-6. 38 and OR 2. 04 95% CI 0. 92-4. 51. Age weight serum Fer and BMI were associated with BMD using multiple regression analyses. Then adjusting age weight and BMI serum Fer also showed negative correlation with BMD at all regions P < 0. 05. Conclusion The concentration of serum Fer increased and BMD decreased with age. With increasing with the concentrations of Fer the BMD decreased and the risk of osteopenia in creased. Key words ferritin iron overload bone mineral density osteoporosis 1 2-5 435 2011 1 2012 6 12 Li 7 8-9 10 11-12 Fer > 500 ng /ml 13-14 ferritin Fer Fer Fer 15 Fer 13. 00 ~ 150. 00 ng /ml Kim 16 3 C- CRP Fer g /cm 2 Lunar DPX-NP X Fer bone mineral density BMD Ward 435 Fer L 1-4 Fer T - 1. 0 T - 1. 0 ~ - 2. 5 Fer T - 2. 5 Fer
11 435 35 n = 52 Fer 36 ~ 40 n = 72 41 ~ 45 n = 64 46 ~ 50 n = 76 51 ~ 55 n = 54 56 ~ 60 1 n = 58 61 ~ 65 n = 22 66 ~ 70 n = T Fer 19 71 n = 18 36. 4 ± 38. 5 ng /ml Fer 62. 1 ± 57. 2 ng /ml Fer 150 ng /ml 86. 5 ± 57. 5 ng /ml 2 ANOVA Fer % 2 Fer T P < 0. 001-2. 5 0. 625 g /cm 2 Fer P = 0. 004 0. 815g /cm 2 BMD L 1-4 BMD % Logistic T OR L 1-4 T > - 1 95% CI 6. 70 3. 19 ~ 14. 04 L 1-4 L 1-4 T - 2. 5 SPSS18. 0 x ± s P < 0. 05 1 Fer 40 41 ~ 50 51 ~ 60 61 ~ 65 Fig 1 65 50 50 ~ 65 1 Table 1 Fer ng /ml 65 1 Fer Fer Serum ferritin and BMD at femoral neck and lumbar with age Fer BMD L 1-4 1-4 Fer ng /ml BMD x ± s Vaule of serum ferritin and BMD in each age group x ± s BMD g /cm 2 Ward L 1-4 35 52 26. 50 ± 22. 0 0. 912 ± 0. 102 0. 814 ± 0. 139 0. 729 ± 0. 102 0. 941 ± 0. 109 1. 144 ± 0. 111 36 ~ 40 72 26. 49 ± 23. 0 0. 915 ± 0. 122 0. 797 ± 0. 138 0. 725 ± 0. 092 0. 940 ± 0. 119 1. 145 ± 0. 127 41 ~ 45 64 35. 74 ± 37. 6 0. 943 ± 0. 107 0. 828 ± 0. 128 0. 785 ± 0. 094 0. 991 ± 0. 112 1. 158 ± 0. 117 46 ~ 50 76 38. 46 ± 38. 8 0. 961 ± 0. 141 0. 835 ± 0. 162 0. 792 ± 0. 126 1. 002 ± 0. 141 1. 133 ± 0. 158 51 ~ 55 54 56. 6 ± 54. 6 0. 888 ± 0. 123 0. 727 ± 0. 150 0. 740 ± 0. 117 0. 940 ± 0. 132 0. 997 ± 0. 152 56 ~ 60 58 79. 13 ± 56. 3 0. 849 ± 0. 094 0. 674 ± 0. 108 0. 710 ± 0. 099 0. 894 ± 0. 110 0. 955 ± 0. 114 61 ~ 65 22 90. 33 ± 56. 4 0. 766 ± 0. 0. 93 0. 584 ± 0. 130 0. 665 ± 0. 112 0. 827 ± 0. 120 0. 887 ± 0. 138 66 ~ 70 19 91. 27 ± 78. 0 0. 778 ± 0. 121 0. 602 ± 0. 121 0. 674 ± 0. 081 0. 843 ± 0. 108 0. 946 ± 0. 161 71 18 92. 52 ± 61. 6 0. 761 ± 0. 102 0. 557 ± 0. 119 0. 661 ± 0. 073 0. 824 ± 0. 090 0. 888 ± 0. 108 Fer BMD L 1-4 1-4
12 Fig 2 2 Fer Levels of serum ferritin among different bone mass group Fer 2. 09 0. 95 ~ 4. 61 CRP OR 95% CI 2 BMI Fer CRP Fer Fer BMI BMD 3 BMI CRP Fer BMD Fer Wards L 1 -L 4 BMD P 0. 011 0. 014 0. 034 7. 63 3. 80 ~ 15. 29 OR 0. 019 0. 000 < 0. 05 Fer 95% CI 2. 83 1. 25 ~ 6. 39 L 1-4 BMD 2 Fer Table 2 With increasing serum ferritin the risk of bone loss of the femoral neck and lumbar OR 95% CI Q1 Q2 Q3 Q4 Q5 Fer ng /ml 1. 5 ~ 12. 7 12. 8 ~ 25. 1 25. 2 ~ 42. 3 42. 4 ~ 78. 6 78. 7 ~ 313. 7-87 87 87 87 87 - OR 95% CI 1. 00 1. 52 0. 68 ~ 3. 40 1. 99 0. 91 ~ 4. 35 4. 01 1. 90 ~ 8. 46 6. 70 3. 19 ~ 14. 04 < 0. 001 OR 1. 00 1. 23 0. 54 ~ 2. 82 1. 37 0. 61 ~ 3. 10 2. 36 1. 07 ~ 5. 20 2. 83 1. 25 ~ 6. 39 0. 037 CRP OR 1. 00 1. 57 0. 70 ~ 3. 53 2. 00 0. 91 ~ 4. 37 4. 07 1. 93 ~ 8. 60 6. 68 3. 18 ~ 14. 01 < 0. 001 + CRP OR 1. 00 1. 23 0. 53 ~ 2. 82 1. 37 0. 61 ~ 3. 09 2. 36 1. 07 ~ 5. 20 2. 82 1. 25 ~ 6. 38 0. 037 L 1-4 OR 95% CI P Q1 Q2 Q3 Q4 Q5 OR 95% CI 1. 00 0. 92 0. 43 ~ 2. 01 1. 89 0. 93 ~ 3. 85 3. 13 1. 57 ~ 6. 25 7. 63 3. 80 ~ 15. 29 < 0. 001 OR 1. 00 0. 60 0. 26 ~ 1. 39 1. 05 0. 48 ~ 2. 27 1. 34 0. 62 ~ 2. 89 2. 09 0. 95 ~ 4. 61 0. 033 CRP OR 1. 00 0. 93 0. 43 ~ 2. 04 1. 89 0. 93 ~ 3. 85 3. 15 1. 58 ~ 6. 28 7. 61 3. 80 ~ 15. 27 < 0. 001 + CRP OR 1. 00 0. 58 0. 25 ~ 1. 33 1. 04 0. 48 ~ 2. 26 1. 23 0. 59 ~ 2. 79 2. 04 0. 92 ~ 4. 51 0. 033 Fer CRP C- P BMD Table 3 3 BMD Multiple regression analysis to identify determinants of bone mineral density of every part Fer β P β P β P β P - 0. 368 < 0. 001-0. 393 < 0. 001 0. 116 0. 012 0. 266 Wards - 0. 466 < 0. 001 0. 294 < 0. 001-0. 111 0. 014 0. 293-0. 220 < 0. 001 0. 442 < 0. 001-0. 096 0. 044 0. 216-0. 325 < 0. 001 0. 242 0. 007-0. 111 0. 018 0. 209 0. 026 0. 242 L 1-4 BMD - 0. 487 < 0. 001 0. 222 < 0. 001-0. 184 < 0. 001 0. 345 BMD L 1-4 1-4 Fer BMI BMI R 2
13 L 1-4 50 50 ~ 65 65 6-14 16 Fer Fer Fer 17 Fer Fer Fer apoferritin Fe 3 + Fe 3 + Fer Schnitzler 20 Sadat-Ali 21 Ⅱ Fer Valenti 22 87 Fer CRP CRP 1 3 Fer Fer 3 Fer Fer 16 Fer 435 iron response element IRE VA Fer Fer 2 Fer Fer Fer ANO- 250 mg ANOVA Fer 18 Kato 18 Fer Fer 43 ng /ml 106 ng /ml Zacharski 19 50 Fer Fer 50 ~ 70 BMI 50 ~ 70 BMI CRP Fer 50 ~ 60 60 ~ 69 Fer Fer 40 BMI Fer 41 ~ 50 51 ~ 60 61 ~ 65 Fer 65 Fer 50 ~ 65 Ⅰ 65 1 McCord JM. Iron free radicals and oxidative injury J.
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