老年骨质疏松症患者血清铁调素、铁蛋白与骨代谢指标及骨折风险的关系研究  

Relationship between serum hepcidin,ferritin and bone metabolism indicators,and fracture risk in elderly patients with osteoporosis

作　　者：左双 邹函朔 马宇 佟思羽 吴曼 ZUO Shuang;ZOU Han-shuo;MA Yu(Health Management Center,Suqian First People's Hospital,Suqian Jiangsu 223300,China;Department of Medical Imaging,Suqian First People's Hospital,Suqian Jiangsu 223300,China)

机构地区：[1]宿迁市第一人民医院健康管理中心,江苏宿迁223300 [2]宿迁市第一人民医院医学影像科,江苏宿迁223300 [3]宿迁市第一人民医院老年医学科,江苏宿迁223300

出　　处：《临床和实验医学杂志》2025年第5期498-502,共5页Journal of Clinical and Experimental Medicine

基　　金：江苏省自然科学基金资助项目(编号:BK20221246)。

摘　　要：目的分析老年骨质疏松症患者血清铁调素、铁蛋白与骨代谢指标及骨折风险的关系。方法回顾性分析2020年1月至2023年12月宿迁市第一人民医院收治的200例老年骨质疏松症患者的临床资料。所有患者均接受骨折风险评估工具(FRAX)评估10年内骨折发生风险,依据评估结果将患者分为高风险组(n=96)和低风险组(n=104)。收集患者一般资料(性别、年龄、体重指数、饮酒史、吸烟史、脆性骨折史、家族脆性骨折史等)、骨代谢指标[Ⅰ型前胶原氨基端延长肽(PⅠNP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、25-羟基维生素D3(25-OH-D3)]以及血清铁调素、铁蛋白水平,比较两组患者临床资料;采用Pearson相关性分析对血清铁调素、铁蛋白与骨代谢指标以及骨折风险的关系进行分析;采用多因素Logistic回归分析对影响骨折风险的因素进行分析;并以受试者操作特征(ROC)曲线分析血清铁调素、铁蛋白对老年骨质疏松患者骨折风险的预测价值。结果高风险组与低风险组在性别构成比、年龄、体重指数、吸烟史、饮酒史、脆性骨折史、家族脆性骨折史、髋部骨密度、腰椎骨密度等方面比较,差异均无统计学意义(P>0.05);高风险组患者PⅠNP、β-CTX、铁蛋白水平分别为(12.73±3.44)、(0.69±0.17)、(228.88±67.53)ng/mL,均高于低风险组[(11.07±2.53)、(0.59±0.14)、(184.59±54.73)ng/mL],25-OH-D3、铁调素水平分别为(22.33±6.28)nmol/L、(85.77±21.54)ng/mL,均低于低风险组[(26.21±7.21)nmol/L、(101.94±22.81)ng/mL],差异均有统计学意义(P<0.05)。Pearson相关性分析结果显示,铁调素与PⅠNP、β-CTX及骨折风险均呈负相关(P<0.05),与25-OH-D3呈正相关(P<0.05);铁蛋白与PⅠNP和骨折风险均呈正相关(P<0.05),与25-OH-D3呈负相关(P<0.05)。多因素Logistic回归分析结果显示,PⅠNP、β-CTX、25-OH-D3、铁调素和铁蛋白均为老年骨质疏松性骨折风险的影响因素(P<0.05)。ROC�Objective To analyze the relationship between serum hepcidin,ferritin and bone metabolism indicators,and fracture risk in elderly patients with osteoporosis.Methods A retrospective analysis was conducted on the clinical data of 200 elderly patients with osteoporosis admitted to the Suqian First People's Hospital from January 2020 to December 2023.The fracture risk assessment tool(FRAX)was used to assess fracture risk within 10 years.Based on assessment results,the patients were divided into high-risk group(n=96)and low-risk group(n=104).The general information(gender,age,body mass index,drinking history,smoking history,history of fragility fracture,family history of fragility fracture,etc.),bone metabolism indicators[typeⅠprocollagen amino terminal prolongation peptide(PⅠNP),c-terminal cross-linking telopeptide of typeⅠcollagen(β-CTX),and 25-hydroxy vitamin D3(25-OH-D3)],serum hepcidin and ferritin were collected.The clinical data of the two groups were compared.Pearson correlation analysis was conducted to analyze the relationship between serum hepcidin,ferritin and bone metabolism indicators,and fracture risk.Multivariate logistic regression analysis was conducted to identify the factors influencing fracture risk.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum hepcidin and ferritin for fracture risk in elderly patients with osteoporosis.Results There were no statistically significant differences in gender composition ratio,age,body mass index,smoking history,drinking history,brittle fracture history,family brittle fracture history,hip bone mineral density and lumbar bone mineral density between the high-risk group and the low-risk group(P>0.05).The levels of PⅠNP,β-CTX and ferritin in the high-risk group were(12.73±3.44),(0.69±0.17)and(228.88±67.53)ng/mL,respectively,which were higher than those in the low-risk group[(11.07±2.53),(0.59±0.14)and(184.59±54.73)ng/mL],the levels of 25-OH-D3 and hepcidin were(22.33±6.28)nmol/L and(85.77±21.54)ng/mL,res

关 键 词：老年人 骨质疏松 骨折 铁调素 铁蛋白 骨代谢指标 相关性 

分 类 号：R681[医药卫生—骨科学]