Association between serum ferritin level and bone mineral density in adult females of Dhaka city

Authors

  • Nishat Rahman Department of Physiology, Dhaka Medical College, Dhaka, Bangladesh
  • Qazi S. Akhter Department of Physiology, Dhaka Medical College, Dhaka, Bangladesh
  • Khadijatul Busra Department of Physiology, Jashore Medical College, Jashore, Bangladesh
  • Manasi Saha Department of Physiology, Shaheed Ziaur Rahman Medical College, Bogura, Bangladesh
  • Nawshin Islam Department of Physiology, Mugda Medical College, Dhaka, Bangladesh
  • Mahbuba Akter Department of Physiology, Shaheed Tajuddin Ahmad Medical College, Dhaka, Bangladesh
  • Keya Sarker Department of Physiology, Mugda Medical College, Dhaka, Bangladesh
  • Mostafizur Rahman Department of Physiology, Shaheed Syed Nazrul Islam Medical College, Kishorgonj, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20250660

Keywords:

BMD, Bone health, Reproductive age females, Serum Ferritin

Abstract

Background: Osteoporosis and osteopenia are among the alarming issues worldwide affecting people of all ages. Bone mass is influenced by several factors including iron. Iron deficiency is common in Bangladesh among the women of reproductive age group. So, iron depletion could have a detrimental impact on bone, resulting in episodes of fracture. The present study was carried out to assess the association of serum ferritin level and bone mineral density in adult females.

Methods: A cross sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka from July 2018 to June 2019.  A total of 122 adult females of age ranging from 18-44 years were enrolled. Eligible subjects were divided into three groups on the basis of hemoglobin concentration. The serum ferritin level and bone mineral density were measured. For statistical analysis, One-way ANOVA followed by Bonferroni test and Pearson’s correlation coefficient (r) were performed as applicable using SPSS for windows version 25.0.

Results: The mean (±SD) serum ferritin level and BMD T score of lumbar spine and femoral neck showed significant differences among the groups (p<0.001, p=0.002, p=0.001 respectively). We found positive correlation (r±0.378 and r±0.353 respectively) between serum ferritin level and BMD T score of both lumbar spine and femoral neck which was statistically significant (p<0.001).

Conclusions: Low serum ferritin level is positively associated with low bone mineral density among adult females of Dhaka city. Therefore, early detection and correction of iron deficiency could be an important preventive measure against the disruption of bone composition at various stages of life.

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References

Banu DA. Peak bone mineral density of Bangladeshi men and women. International Journal of Scientific & Technology Research 2015; 4(11):8-13.

National Institute of Health (NIH). Osteoporosis: peak bone mass in women. 2018. Available at: http:/www.bones.nih.gov/healthinfo/bones/osteoporosis/bone-mass. Accessed on 6 June 2019.

Modagan P, Silambanan S, Menon PG, Arunalatha P. Comparison of bone mineral density with biochemical parameters and prevalence of osteopenia and osteoporosis in South Indian population. Biomed & Pharmacol J. 2018;11(4):2209-14. DOI: https://doi.org/10.13005/bpj/1603

National Institute of Health (NIH) Consensus Development Panel. Osteoporosis prevention, diagnosis and therapy. The J American Med Assoc. 2001;285(6):785-95. DOI: https://doi.org/10.1001/jama.285.6.785

Peck WA, Burckhardt P, Christiansen C, Fleisch HA, Genant HK, Gennari C, et al. Consensus Development Conference: diagnosis, prophylaxis and treatment of osteoporosis. The American J Med. 1993;94(1):646-50. DOI: https://doi.org/10.1016/0002-9343(93)90218-E

Jabin Z, Hussain R, Begum SMF, Parveen R, Sultana N, Khatun N. Pattern of bone mineral density (BMD) among patients attending tertiary hospital: 9 years’ experience. Bangladesh J Nuclear Med. 2015;18(1):47-50. DOI: https://doi.org/10.3329/bjnm.v18i1.34934

Blake GM, Fogelman I. Dual energy X-ray absorptiometry and its clinical applications. Seminars in Musculoskeletal Radiol. 2002;6(3):207-17. DOI: https://doi.org/10.1055/s-2002-36718

Jung D-W, Park J-H, Kim D-H, Choi M, Kim S, Kim H, et al. Association between serum ferritin and hemoglobin levels and bone health in Korean adolescents. Med J. 2017;96(51):1-6. DOI: https://doi.org/10.1097/MD.0000000000009403

Mousa SM, Ibrahim AA, Adsani RAA. Serum ferritin: is it an independent predictor of reduced bone mineral density among elderly women?. Advances in Aging Res. 2016;5(1):142-50. DOI: https://doi.org/10.4236/aar.2016.56014

International Centre for Diarrhoeal Diseases Research, Bangladesh (ICDDR,B), Global Alliance for Improved Nutrition (GAIN), The United 60 Nations Children’s Fund (UNICEF), Institute of Public Health and Nutrition (IPHN). National micronutrients status survey 2011-12, Dhaka, 2013.

Bhattacharjee L, Saha SK, Nandi BK. Food-based nutrition strategies in Bangladesh. RAP Publication Bangkok; 2007. Available at: www.fao.org/3/a-ag126e.pdf. Accessed on 16 October 2019.

Faraj JM. Iron status, inflammation and anemia in Bangladeshi women exposed to arsenic. Master Theses, University of Massachusetts Amherst. 2011. Available at: https://scholarworks.umass.edu. Accessed on 16 October, 2019.

Flora MS, Islam MS. Anemia in Bangladesh: a longstanding, preventable public health problem. Bangladesh Med J. 2010;39(3):78. DOI: https://doi.org/10.3329/bmj.v39i3.8471

Chon SJ, Choi YR, Roh YH, Yun BH, Cho S, Choi YS, et al. Association between levels of serum ferritin and bone mineral density in Korean premenopausal and postmenopausal women: 67 KNHANES 2008-2010. Public library of Science ONE. 2014;9(12):1- 13. DOI: https://doi.org/10.1371/journal.pone.0114972

Wang W, Knovich MA, Coffman LG, Torti FM, Torti SV. Serum ferritin: past, present and future. Biochemica et Biophysica Acta. 2010;1800(8):760-9. DOI: https://doi.org/10.1016/j.bbagen.2010.03.011

Toxqui L and Vaquero MP. Chronic iron deficiency as an emerging risk factor for Osteoporosis: a hypothesis. Nutr. 2015;7(1):2324- 44. DOI: https://doi.org/10.3390/nu7042324

Balogh E, Paragh G, Jeney V. Influence of iron on bone homeostasis. Pharmaceuticals. 2018;11(107):1-18. DOI: https://doi.org/10.3390/ph11040107

Pikuleva IA, Waterman MR. Cytochromes P450: roles in diseases. J Biolog Chem. 2013;288(24):17091-98. DOI: https://doi.org/10.1074/jbc.R112.431916

World Health Organization (WHO). Obesity: preventing and managing the global epidemic. 2020. Available at http://www.who.int/nutrition. Accessed on 14 July 2019.

World Health Organization (WHO). Hemoglobin concentrations for the diagnosis of anaemia and assessment of severity, 2011: 3. Available at http://www.who.int/iris/handle. Accessed on 12 May 2019.

Laudisio A, Marzetti E, Pagano F, Bernabei R, Zuccala G. Haemoglobin levels are associated with bone mineral density in the elderly: a population-based study. Clinical Rheumatol. 2009;28(1):145-51. DOI: https://doi.org/10.1007/s10067-008-0998-6

Oraibi FA, Khan JA, Ardawi MS. Changes in hematological markers associated with bone turnover in male subjects. International J of Life Sciences Res. 2015;3(4):47-54.

Gorres KL, Raines RT. Prolyl 4-hydroxylase. Critical Reviews in Biochemistry and Molec Biol. 2010;45(2):106-24. DOI: https://doi.org/10.3109/10409231003627991

Knott L, Bailey AJ. Collagen cross-links in mineralizing tissues: a review of their chemistry, function and clinical relevance. Bone. 1998;22(3):181-7. DOI: https://doi.org/10.1016/S8756-3282(97)00279-2

Eisman JA, Bouillon R. Vitamin D: direct effects of vitamin D metabolites on bone: lessons from genetically modified mice. BoneKEy Reports. 2014;3(499):1-6. DOI: https://doi.org/10.1038/bonekey.2013.233

Blanco-Rojo R, Perez-Granados AM, Toxqui L, Zazo P, Piedra C, Vaquero MP. Relationship between vitamin D deficiency, bone remodeling and iron status in iron-deficient young women consuming an iron fortified food. Europ J Nutr. 2013;52(2):695-703. DOI: https://doi.org/10.1007/s00394-012-0375-8

DeLuca HF. Metabolism of vitamin D: current status. American J of Clin Nutr. 1976;29(1):1258-70. DOI: https://doi.org/10.1093/ajcn/29.11.1258

Dhur A, Galan P, Hercberg S. Effects of different degrees of iron deficiency on cytochrome P450 complex and pentose phosphate pathway dehydrogenases in the rat. The J Nutri. 1989;119(1):40-7. DOI: https://doi.org/10.1093/jn/119.1.40

Pan ML, Chen LR, Tsao HM, Chen KH. Iron deficiency anemia as a risk factor for osteoporosis in Taiwan: a nationwide population based study. Journal of Nutrients. 2017;9(616):1-10. DOI: https://doi.org/10.3390/nu9060616

Wright I, Blanco-Rojo R, Fernandez MC, Toxqui L, Moreno G, Perez Granados AM, et al. Bone remodeling is reduced by recovery from iron-deficiency anaemia in 66 premenopausal women. J Physiol and Biochem. 2013;69(4):889-96. DOI: https://doi.org/10.1007/s13105-013-0266-3

Bahtiri E, Islami H, Hoxha R, Qorraj-Bytyqi H. Serum calcium, magnesium and iron levels and their relation to bone mineral density in postmenopausal women from Kosovo. J Soc for Develo Envir. 2015;9(3):100-5.

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Published

2025-02-28

How to Cite

Rahman, N., Akhter, Q. S., Busra, K., Saha, M., Islam, N., Akter, M., Sarker, K., & Rahman, M. (2025). Association between serum ferritin level and bone mineral density in adult females of Dhaka city. International Journal of Research in Medical Sciences, 13(3), 1012–1018. https://doi.org/10.18203/2320-6012.ijrms20250660

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Original Research Articles