年龄对老年股骨粗隆间骨折患者骨组织钙、磷及金属微量元素相对含量的影响
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摘要
目的研究年龄对骨组织不同区域的骨钙、磷及金属微量元素相对含量的影响。方法收集2015年9月至2016年9月在复旦大学附属华东医院骨科接受手术治疗的62例股骨粗隆间骨折老年患者临床资料,并在术中用改进的空心钻头对骨组织的皮质骨与松质骨整体取材,根据年龄将患者分成高龄组(<85岁)和超高龄组(≥85岁)。运用X线聚焦荧光能谱仪检测骨组织皮质骨区域、松质骨区域及交界区域的钙、磷、锰、铁、铜、锌元素含量比重,结合相应患者的血骨代谢指标及髋部骨密度值,比较2组患者骨代谢、骨密度值及骨组织无机元素含量之间的差异性,并分析研究年龄、BMI等与骨组织不同区域无机元素含量的相关性。结果在皮质骨与松质骨交界区域,超高龄组的骨铁含量明显高于高龄组(P=0.018),而骨锰和铜含量较高龄组有所下降。Pearson相关分析结果提示年龄与交界区域的骨铁含量呈显著正相关性(r=0.30,P=0.047),血钙水平与松质骨区域的骨锰和铁元素含量均存在显著负相关性(r=-0.35、-0.39,P=0.020、0.009)。结论骨组织中铁元素可能会随着年龄增长而不断在体内蓄积,而骨铜和锰元素可能会不断丢失。
Objective To investigate the effect of age on the relative contents of bone calcium,phosphorus and metal trace elements in geriatric patients with intertrochanteric fractures. Methods From62 geriatric patients with intertrochanteric fractures accepted surgical treatment in Department of Orthopaedics,Huadong Hospital,a barrel shape bone tissue were harvested during the operation.These patients were to be collected the clinical data and divided into advanced age group(<85 years)and super age group(≥85 years)from Sep.,2015 to Sep.,2016.Energy dispersive X-ray fluorescence was used to examine the bone inorganic element contents of calcium,phosphorus,manganese,iron,copper and zinc in cortical bone zone,cancellous bone zone and interfacing zone between cortical bone and cancellous bone.Combination of bone metabolism markers and bone mineral density(BMD)from relevant patients,we compared the differences of bone metabolism,BMD and bone inorganic element contents between super age group and advanced age group,and analyzed the relationship between age,body mass index(BMI)and bone inorganic element contents. Results Bone iron contents were significantly higher in super age group than those in advanced age group(P=0.018)at the interfacing zone between cortical bone and cancellous bone,while bone manganese and copper contents were lower in super age group.The results of Pearson correlation analysis indicated that age had a significantly positive correlation with bone iron contents in interfacing zone(r=0.30,P=0.047).In addition,the level of serum calcium was negatively correlated with bone manganese and iron contents in the cancellous bone zone(r=-0.35、-0.39,P=0.020、0.009). Conclusions The bone iron element may accumulate with age in the body,while copper and manganese element maydecrease in bone tissue.
Objective To investigate the effect of age on the relative contents of bone calcium,phosphorus and metal trace elements in geriatric patients with intertrochanteric fractures. Methods From62 geriatric patients with intertrochanteric fractures accepted surgical treatment in Department of Orthopaedics,Huadong Hospital,a barrel shape bone tissue were harvested during the operation.These patients were to be collected the clinical data and divided into advanced age group(<85 years)and super age group(≥85 years)from Sep.,2015 to Sep.,2016.Energy dispersive X-ray fluorescence was used to examine the bone inorganic element contents of calcium,phosphorus,manganese,iron,copper and zinc in cortical bone zone,cancellous bone zone and interfacing zone between cortical bone and cancellous bone.Combination of bone metabolism markers and bone mineral density(BMD)from relevant patients,we compared the differences of bone metabolism,BMD and bone inorganic element contents between super age group and advanced age group,and analyzed the relationship between age,body mass index(BMI)and bone inorganic element contents. Results Bone iron contents were significantly higher in super age group than those in advanced age group(P=0.018)at the interfacing zone between cortical bone and cancellous bone,while bone manganese and copper contents were lower in super age group.The results of Pearson correlation analysis indicated that age had a significantly positive correlation with bone iron contents in interfacing zone(r=0.30,P=0.047).In addition,the level of serum calcium was negatively correlated with bone manganese and iron contents in the cancellous bone zone(r=-0.35、-0.39,P=0.020、0.009). Conclusions The bone iron element may accumulate with age in the body,while copper and manganese element maydecrease in bone tissue.
引文
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[2]WILLSON T,NELSON SD,NEWBOLD J,et al.The clinical epidemiology of male osteoporosis:a review of the recent literature[J].Clin Epidemiol,2015,7:65-76.
[3]ZAICHICK S,ZAICHICK V,KARANDASHEV VK,et al.The effect of age and gender on 59 trace-element contents in human rib bone investigated by inductively coupled plasma mass spectrometry[J].Biol Trace Elem Res,2011,143(1):41-57.
[4]KANIS JA,MCCLOSKEY EV,JOHANSSON H,et al.European guidance for the diagnosis and management of osteoporosis in postmenopausal women[J].Osteoporosis Int,2013,24(1):23-57.
[5]HAVEZOV I.Atomic absorption spectrometry(AAS)-a versatile and selective detector for trace element speciation[J].Anal Bioanal Chem,1996,355(5-6):452-456.
[6]HAN P,LU S,ZHOU Y,et al.Multi-elemental profiling of tibial and maxillary trabecular bone in ovariectomised rats[J].Int J Mol Sci,2016,17(6):977.
[7]张伟,王兵,张林林,等.绝经后股骨颈骨折股骨头骨铁含量、血清铁蛋白与骨密度相关性研究[J].中华骨科杂志,2014,34(1):39-47.
[8]王兵,赵环,姜习凤,等.绝经后女性股骨头铁含量与骨密度的相关性[J].中华骨质疏松和骨矿盐疾病杂志,2013,6(1):9-14.
[9]ZAICHICK V,ZAICHICK S,KARANDASHEV V,et al.The effect of age and gender on Al,B,Ba,Ca,Cu,Fe,K,Li,Mg,Mn,Na,P,S,Sr,V,and Zn contents in rib bone of healthy humans[J].Biol Trace Elem Res,2009,129(1-3):107-115.
[10]DERMIENCE M,LOGNAY G,MATHIEU F,et al.Effects of thirty elements on bone metabolism[J].J Trace Elem Med Biol,2015,32:86-106.
[11]BLANCO-ROJO R,PREZ-GRANADOS AM,TOXQUI L,et al.Relationship between vitamin D deficiency,bone remodelling and iron status in iron-deficient young men consuming an iron-fortified food[J].Eur J Nutr,2013,52(2):695-703.