Objective To explore the correlation between femoral head bone iron content,serum ferritin (SF) and bone mineral density of postmenopausal women with femoral neck fragility fracture.Methods From June 2010 to March 2013,156 postmenopausal women with femoral neck fragility fractures aged from 56 to 92 years old,with an average age of 72.40±8.97 years,were divided into 5 groups based upon the stratification of 10-year age intervals (≤60,61-70,71-80,81-90 and ≥91).Blood samples were collected to determine iron metabolism and bone metabolic markers after overnight fasting.Bone specimens were obtained for detecting bone iron contents and performing iron stain respectively after hip arthroplasty surgery.BMD was measured by dual energy X-ray absorptiometry(DXA)at hip and lumbar spine from L1 to L4 ten days after surgery.Results There were significant differences in the values of bone iron content,SF,transferrin,total iron binding capacity,serum procollagen type Ⅰ N-terminal propeptide,β-carboxy terminal telopeptide of collagen type Ⅰ and BMD at hip and L1 to L4 in all groups.BMD at hip and L1 to L4 decreased while bone iron content and SF increased with age; the peaks of bone iron content and SF were both in 81-90 years group; the average of bone iron content and SF was 96.81 μg/g and 235.66 μg/L respectively.There were 100 patients (100/156,64.1％) whose SF was over 200 μg/L.Bone iron content combined with SF,age and BMI could be put into the regression models of BMD at various proximal femur sites (femoral neck R2=0.443,Wards triangle R2=0.397,greater trochanter R2=0.322 and total femur R2=0.379).After adjustment of age,weight,BMI and other factors,we found that bone iron content and SF were negatively correlated with BMD at proximal femur,but had no significant correlation with BMD at lumbar spine.Conclusion Iron accumulation is prevalent in postmenopausal women with hip fragility fractures.High bone iron content and SF are independent risk factors for low BMD at proximal femur.These results provide clinical evidences that iron accumulation is associated with postmenopausal osteoporosis.

Objective Detecting the femoral head bone iron contents of femoral neck fracture patients (postmenopausal women), and further contacting of bone mineral density(BMD),serum ferritin(FER)and serum bone metabolic markers to explore the potential values of the iron contents of bone tissue in osteoporosis patients. Methods 10 elderly women aged 56～87 years old(an average of 72.6 years old)as the older age group with the brittle femoral neck fracture (6 cases with walking falls, while 4 cases with sprains fell); Meanwhile 6 cases of young female violence femoral neck fracture(traffic accidents in 4 cases, rider fell 1 cases, falls 1 case)as the control group aged 19～43 years with mean 31 years; Both cases were hospitalized, single, non-open fracture with no inflammation abnormal indicators and no previous pathological history of iron overload. The serum specimens were measured for iron metabolism and bone metabolic markers were detected, the biopsy specimens were performed in both groups by a special require to detect the bone iron contents and bone iron were stained after operation and BMD considered of lumbar vertebras and hips were undertook after surgeries. Results Hip and L1-L4 BMD values, FER and 25-OH-VD,of elderly women were outside the reference range; while the control group were within it. The bone iron contents, FER, β-CTX and TRAP5b of postmenopausal group were significantly higher than those of the control group (88.9±47.2 μg/g vs 32.5±12.7 μg/g,234.3±91.70 ng/mL vs 69.6±42.5 ng/mL, 643.4±284.3 pg/mL vs 254.3±129.9 pg/mL,3.4±0.73 U/L vs 2.3±0.45 U/L; P<0.05), while hip and L1-4 BMD values were less than the control group(0.63±0.11 g/cm2vs 0.88±0.67 g/cm2, 0.87±0.10 g/cm2 vs 1.06±0.18 g/cm2; P<0.05). HE staining covered by Prussian showed iron was seen as blue-staining lines at the bone trabecular structures in old age group, and no obvious blue staining structures of control group were appeared; Specific iron deposition (blue staining areas) also could be showed outside of the trabecular bone structures in both groups. A significant phenomenon was found that bone iron contents and FER showed a positive correlation (r =0.966), and were negatively correlated with hip BMD values (r=-0.820)among postmenopausal women.Conclusion Postmenopausal women often had abnormal iron and bone metabolism. When bone iron contents increased, bone mass reduced. Iron contents of bone tissue may be a potential risk factor for osteoporosis in postmenopausal women.