Abstract
BackgroundAs women go through menopause, serum estrogen decreases and ferritin increases. Decreased serum estrogen is well known to cause detrimental effects on bone health; however, data on the associations of serum ferritin with BMD before and after menopause are still lacking. Therefore, this study aimed to investigate the association between serum ferritin levels and BMD in premenopausal and postmenopausal Korean women.MethodsThis study was performed using data from the 2008–2010 Korean National Health and Nutrition Examination Survey, including 7300 women (4229 premenopausal and 3071 postmenopausal). BMD was measured using dual X-ray absorptiometry at the femur and the lumbar spine, and serum ferritin levels were measured by chemiluminescent immunoassay.ResultsMedian serum ferritin levels in postmenopausal women were higher than those in premenopausal women despite the same age ranges. Serum ferritin levels were only significantly correlated with BMD on the lumbar spine (β = −0.189, p-value = 0.005) in premenopausal women after adjusting confounding factors. Additionally, BMD on the lumbar spine had tended to decrease as serum ferritin quartiles increase (P for trend = 0.035) in premenopausal women after adjusting confounding factors. On the other hand, there were no significant associations between serum ferritin levels and BMD on the total femur and, femur neck in premenopausal women, and BMD on the total femur, femur neck, and lumbar spine in postmenopausal women.ConclusionIncreased serum ferritin levels were significantly associated with BMD in premenopausal women, particularly on the lumbar spine, but not in postmenopausal women.
Highlights
Ferritin is an essential component of the body, but many studies have stated that ferritin that exceeds the normal physiological range may potentially cause health problems in women
body mass index (BMI), serum ferritin, and vitamin D were statistically significantly higher in postmenopausal women than in premenopausal women, whereas calcium and phosphate supplementations and bone mineral density (BMD) on total femur, femur neck, and lumbar spine were lower in postmenopausal women than in premenopausal women
BMD on total femur and femur neck were not associated with differences in serum ferritin, whereas statistically significant decrease in BMD on lumbar spine was noted as serum ferritin increased (b520.189, p-value50.005)
Summary
Ferritin is an essential component of the body, but many studies have stated that ferritin that exceeds the normal physiological range may potentially cause health problems in women. Excessive iron is toxic, causing cellular dysfunction mainly as a powerful catalyst for the generation of highly toxic free radicals, which can damage all molecular classes found in vivo [1] Modifications in these molecules are considered to cause adverse effects on diverse aspects of health, most notably, decrease in bone mineral density (BMD), which must be carefully considered as mortality due to osteoporotic hip fractures alone is the same as that from breast cancer [2, 3]. Decreased serum estrogen is well known to cause detrimental effects on bone health; data on the associations of serum ferritin with BMD before and after menopause are still lacking. BMD on the lumbar spine had tended to decrease as serum ferritin quartiles increase (P for trend50.035) in premenopausal women after adjusting confounding factors. There were no significant associations between serum ferritin levels and BMD on the total femur and, femur neck in PLOS ONE | DOI:10.1371/journal.pone.0114972 December 18, 2014
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