Association between levels of serum ferritin and bone mineral density in Korean premenopausal and postmenopausal women: KNHANES 2008-2010

Seung Joo Chon, Yun Rak Choi, Yun Ho Roh, Bo Hyon Yun, SiHyun Cho, Young Sik Choi, Byung Seok Lee, Seok Kyo Seo, Seung Joo Chon, Yun Rak Choi, Yun Ho Roh, Bo Hyon Yun, SiHyun Cho, Young Sik Choi, Byung Seok Lee, Seok Kyo Seo

Abstract

Background: As 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.

Methods: This 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.

Results: Median 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.

Conclusion: Increased serum ferritin levels were significantly associated with BMD in premenopausal women, particularly on the lumbar spine, but not in postmenopausal women.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Median serum ferritin concentrations according…
Figure 1. Median serum ferritin concentrations according to age group.
As women become older, the median serum ferritin levels showed tendency to increase. After dividing women into two groups depending on menopausal status, the median serum ferritin in premenopausal women was found to be much lower than that in postmenopausal women, in between 40–59 years old.
Figure 2. BMD according to serum ferritin…
Figure 2. BMD according to serum ferritin quartiles after adjusting with confounders in premenopausal and postmenopausal women.
Only lumbar spine in premenopausal women showed significantly decreased tendency in BMD as serum ferritin increased in quartiles (P for trend = 0.035). On the other hand, BMD on total femur and femur neck (P for trend = 0.903, 0.890, respectively) in premenopausal women. BMD on total femur, femur neck, and lumbar spine in postmenopausal women were not found to be statistically significantly associated (P for trend = 0.396, 0.160, 0.793, respectively).

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