老年脆性骨折患者铁代谢对骨转换指标影响的性别差异探讨  

Exploration of gender differences in correlation between iron metabolism and bone turnover markers in elderly patients with fragility fractures

作　　者：张伟[1] 吴春帅 范建波[1] 保国锋[1] 朱新辉[1] 刘巍[1] 崔志明[1] Zhang Wei , Wu Chunshuai , Fan Jianbo , Bao Guofeng , Zhu Xinhui ,Liu Wei ,Cui Zhiming(Department of Orthopaedic, the Second Affiliated Hospital of Nantong University, Nantong Jiangsu 226001 ,China)

机构地区：[1]南通大学第二附属医院骨科,226001

出　　处：《中华老年医学杂志》2018年第10期1118-1121,共4页Chinese Journal of Geriatrics

基　　金：国家自然科学基金项目（81501866,81771319）,江苏省临床医学科技专项（BL2014061）

摘　　要：目的分析老年脆性骨折患者铁代谢与骨转换指标的变化趋势，探索铁代谢对骨代谢影响的性别差异。方法收集南通大学第二附属医院骨科2014年8月至2017年10月271例老年骨质疏松性骨折患者271例，按年龄分为60～70岁，71～80岁和≥81岁三组。留取人院后8h静脉血标本进行血清一般生化、铁代谢和骨转换指标的检测。结果男性组血清铁蛋白和血清Ⅰ型原胶原氨基端延长肽（PINP）组间没有统计学差异（均P〉0．05），血清Ⅰ型胶原C端肽p降解产物（pCTX）随年龄增加而增加。女性组血清铁蛋白、血清PINP和β—CTX均随年龄增加而增加。两组患者血清铁蛋白与β-CTX呈正相关（均P〈0．05），不存在性别差异。两组患者血清铁蛋白与PINP的关系存在性别差异，女性血清铁蛋白与PINP呈正相关（r=0．255，P=0．001），男性血清铁蛋白与PINP呈负相关（r=-0．207，P=0．031）。结论血清铁蛋白与骨转换指标的关系存在性别差异，绝经后女性体内存在铁蓄积，铁蓄积与高骨转换密切相关。Objective To explore the gender differences in the association between iron metabolism and bone turnover markers in elderly patients with fragility fracture. Methods A total of 271 patients admitted in our hospital from Aug 2014 to Oct 2017 with osteoporotic fractures were divided into two groups.. 109 males and 162 females, aged from 60 to 92 years. Both groups were further divided into 3 age groups（60 to 70,71 to 80,and ≥81 year group）. Biochemical indicators, serum ferritin and bone turnover markers were detected eight hours after admission. Results In the male group, there were no statistical differences in serum ferritin and serum procollagen type I Nterminal propeptide（PINP）among age groups（all P 〈0.05）. Serum β-carboxy terminal telopeptide of collagen type Ⅰβ -CTX（β-CTX）was elevated with ageing. In the female group, serum ferritin, PINP, and β-CTX were elevated with ageing. There was a significant positive correlation between serum ferritin and β-CTX in two gender groups （all P 〈 0. 05 ） without gender difference. Gender difference was observed in the correlation between serum ferritin and PINP between two gender groups.-a significant positive correlation in the female group （r = 0. 255, P = 0. 001）whereas a significant negative correlation in the male group（r = -0. 207, P= 0.031）. Conclusions There are gender differences in correlations of serum ferritin with bone turnover markers. Increased iron accumulation in postmenopausal women is closely correlated with high bone turnover rate.

关 键 词：骨折 骨转换指标 铁代谢障碍 

分 类 号：R683[医药卫生—骨科学]