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目的探讨绝经女性血清雌激素及铁蛋白含量与骨密度的相关性。方法 2015年1-9月收集绝经女性167例作为研究对象,年龄55~84岁,平均年龄(68.06±2.21)岁。按10岁为1个年龄段组,共分为4组,分别为≤60岁组57例、61~70岁组48例、71~80岁组37例和>80岁组25例。所有研究对象均进行体格检查并抽取空腹静脉血,采用化学发光法检测血清雌激素、铁蛋白、Ⅰ型原胶原氨基段延长肽、Ⅰ型原胶原C段肽β降解产物及氨基酸中段骨钙素含量;采用免疫散射比浊法检测血清总铁结合力及转铁蛋白含量;采用双能X线骨密度测量仪检测股骨颈和腰椎正位(L1~L4)骨密度,并进行统计学分析。结果 4组绝经女性血清雌激素、铁蛋白、转铁蛋白、总铁结合力、Ⅰ型原胶原氨基段延长肽、Ⅰ型原胶原C段肽β降解产物、氨基酸中段骨钙素、股骨颈骨密度及腰椎L1~L4骨密度组间比较,差异有统计学意义(P<0.05或P<0.01)。血清雌激素随着年龄增长而降低,血清铁蛋白随着年龄增长而增加,股骨颈和腰椎L1~L4骨密度随着年龄的增长而降低。多因素Logistic回归分析结果显示,血清雌激素与股骨颈及腰椎骨密度呈正相关,血清铁蛋白与股骨颈骨密度呈负相关,与腰椎骨密度无明显相关性。结论绝经女性血清雌激素及铁蛋白含量水平与骨代谢密切相关。随着年龄增长雌激素水平逐渐下降,而血清铁蛋白逐渐升高,骨密度则逐渐下降。血清雌激素降低和铁蛋白逐渐升高可能是绝经后骨质疏松症发生的独立危险因素。
Objective To investigate the relationship between serum estrogen, ferritin and bone mineral density in postmenopausal women. Methods 167 cases of postmenopausal women were collected from January to September in 2015. The age ranged from 55 to 84 years with a mean age of 68.06 ± 2.21 years. According to 10-year-old age group, they were divided into 4 groups, 57 cases were ≤60 years old, 48 cases were from 61 to 70 years old, 37 cases were from 71 to 80 years old and 25 cases were from> 80 years old. All the subjects underwent physical examination and fasting venous blood was collected. Chemiluminescence was used to detect serum estrogen, ferritin, type Ⅰ procollagen aminopeptidase, type Ⅰ procollagen C peptide beta degradation product and amino acid middle osteocalcin . The total iron binding capacity and transferrin content in serum were detected by immune nephelometry. Bone mineral density (BMD) of femoral neck and lumbar vertebrae (L1 ~ L4) were detected by dual energy X-ray absorptiometry and analyzed statistically. Results Serum estrogen, ferritin, transferrin, total iron binding capacity, type Ⅰ procollagen aminopeptidase, type Ⅰ procollagen C peptide β degradation products, amino acid middle osteocalcin, femoral neck bone Density and lumbar L1 ~ L4 bone mineral density between the two groups, the difference was statistically significant (P <0.05 or P <0.01). Serum estrogen decreased with age, serum ferritin increased with age, femoral neck and lumbar spine L1 ~ L4 bone mineral density decreased with age. Multivariate Logistic regression analysis showed that serum estrogen was positively correlated with femoral neck and lumbar spine BMD, serum ferritin was negatively correlated with femoral neck BMD, and had no significant correlation with lumbar BMD. Conclusion Serum estrogen and ferritin levels in postmenopausal women are closely related to bone metabolism. As age estrogen levels gradually decreased, while serum ferritin gradually increased, bone mineral density decreased gradually. Reduced serum estrogen and increased ferritin may be independent risk factors for postmenopausal osteoporosis.