刘秀娟

【摘要】 目的：探讨血清铁调素、铁代谢水平与老年骨质疏松女性骨密度及发生骨折的相关性。方法：选取2018年11月-2020年11月于本院体检的老年女性129例作为研究对象，测定所有研究对象的骨密度并根据骨质疏松发生情况分为骨质疏松组与非骨质疏松组。比较两组骨密度、血清铁调素、铁代谢水平，分析血清铁调素、铁代谢水平与老年骨质疏松女性骨密度的相关性。随访至2020年12月15日，统计老年骨质疏松女性骨折发生情况，比较有无骨折发生者铁调素、铁代謝水平，分析铁调素、铁代谢水平与老年骨质疏松女性发生骨折的相关性。结果：129例老年女性中，发生骨质疏松

45例，发生率为34.88%。骨质疏松组的股骨颈、腰椎骨密度均低于非骨质疏松组（P<0.05）。骨质疏松组的血清铁调素水平低于非骨质疏松组（P<0.05），Ⅰ型前胶原氨基末端肽（procollagen type Ⅰ N-terminal propeptide，PⅠNP）、Ⅰ型胶原交联羧基端肽β降解产物（β-cross-linked carboxy-terminal telopeptide of typeⅠcollagen，β-CTX）、N-端骨钙素（osteocalcin，OC）水平均高于非骨质疏松组（P<0.05）。骨质疏松组患者随访至2020年12月15日，平均随访时间（11.48±2.57）个月，发生骨折8例，发生率为17.78%，且发生骨折组的血清铁调素水平低于未发生骨折组，PⅠNP、β-CTX与OC水平均高于未发生骨折组（P<0.05）。Pearson相关分析显示，骨质疏松组中铁调素、PⅠNP、β-CTX、OC与骨折发生、股骨颈和腰椎骨密度均具有相关性（P<0.05）。结论：老年女性骨质疏松患者多伴有血清铁调素水平降低与铁代谢水平升高，血清铁调素、铁代谢水平与老年骨质疏松女性骨密度及发生骨折存在相关性。

【关键词】 老年女性 骨质疏松 铁调素 铁代谢 骨折

Correlation Analysis of Serum Hepcidin， Iron Metabolism Levels and Bone Mineral Density and Fracture in Senile Women with Osteoporosis/LIU Xiujuan. //Medical Innovation of China， 2021， 18（32）： -126

[Abstract] Objective： To explore the correlation between serum hepcidin， iron metabolism and bone mineral density and fracture in senile women with osteoporosis. Method： A total of 129 senile women who underwent physical examination in our hospital from November 2018 to November 2020 were selected as research subjects. Bone mineral density of all subjects was measured and they were divided into osteoporosis group and non-osteoporosis group according to the occurrence of osteoporosis. Bone mineral density， serum hepcidin and iron metabolism levels were compared between the two groups， and the correlation between serum hepcidin， iron metabolism levels and bone mineral density of senile women with osteoporosis was analyzed. Follow-up to December 15， 2020， the incidence of fractures in elderly women with osteoporosis was analyzed， and the levels of hepcidin and iron metabolism were compared with those with or without fractures， and the correlation between hepcidin， iron metabolism and the occurrence of fractures in senile women with osteoporosis was analyzed. Result： Among 129 senile women， 45 cases （34.88%） had osteoporosis. The bone mineral density of femoral neck and lumbar vertebra in osteoporosis group were lower than those in non-osteoporosis group （P<0.05）. Serum hepcidin level in osteoporosis group was lower than that in non-osteoporosis group （P<0.05）， procollagen type Ⅰ N-terminal propeptide （PⅠNP）， β-cross-linked carboxy-terminal telopeptide of typeⅠcollagen （β-CTX）， osteocalcin （OC） were significantly higher than those in non-osteoporosis group （P<0.05）. The mean follow-up time of osteoporosis group was （11.48±2.57） months until December 15， 2020， and there were 8 cases （17.78%） of fracture. The serum hepcidin level of fracture group was lower than that of non-fracture group， and the levels of PⅠNP， β-CTX and OC were higher than those of non-fracture group （P<0.05）. Pearson correlation analysis showed that hepcidin， PⅠNP， β-CTX， OC were correlated with fracture occurrence， bone mineral density of femoral neck and lumbar vertebra （P<0.05）. Conclusion： Senile women with osteoporosis are mostly accompanied by decreased serum hepcidin levels and increased iron metabolism levels， serum hepcidin level and iron metabolism level are correlated with bone mineral density and fracture in elderly women with osteoporosis.

[Key words] Senile women Osteoporosis Hepcidin Iron metabolism Fractures

First-author’s address： The Central Hospital of Jiamusi City， Jiamusi 154002， China

doi：10.3969/j.issn.1674-4985.2021.32.031

骨质疏松（osteoporosis，OP）患者机体内的骨内矿物质及骨有机质明显减少，皮质骨变薄、骨小梁强度下降，容易导致患者出现骨折代谢障碍性骨骼疾病[1]。……