Osteoporotic fracture risk is associated with higher plasma ferritin and serum iron level in females

Knowing that iron overload has been associated to osteoporosis, we investigated whether plasma metals concentrations, including iron parameters, were associated to the occurrence of fractures in osteoporotic patients.

Two patients’ groups were included in a prospective monocentric study: Patients with severe osteoporotic fracture (n=125; OF) and a control group with abnormally low bone mineral density (BMD) without fracture (n= 100; OD). Routine blood tests were performed to explore bone diseases. ICP-MS was used to measure plasma concentrations of metals of interest (iron, copper, zinc, selenium, strontium, molybdenum, manganese, cobalt, cadmium, lead and aluminum). BMD was determined using the same machine.

Fractured patients were older (77±11 vs 66±13 years, p<0.001). There was no significant difference between the two groups for gender (80% female vs. 72% for OF and OD respectively), blood calcium, phosphorus, 25OH-vitamin D, CRP and parathyroid hormone. In overall population, ferritin was significantly higher in the OF group than in the OD group (273±276 vs 199±227 ng/ml (p<0.05)). The difference was related to the female population (239±232 vs 164±181ng/ml (p<0.05). In OF women, serum iron and selenium levels were lower (p<0.05). In OF men, selenium level was decreased (p<0.05) and aluminum concentration was increased (p<0.05).

Our results show in women an association between higher ferritin and serum iron and the fracture risk. Increased aluminum appears to be associated with an increased risk of fracture in men. Decreased serum selenium appears to be associated of fracture risk in both sexes.