Serum ferritin levels are positively associated with bone mineral density in elderly Korean men: the 2008–2010 Korea National Health and Nutrition Examination Surveys

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Abstract
A possible negative effect of iron overload on bone metabolism has been suggested by the fact that patients with hemochromatosis, thalassemia, and sickle cell anemia have lower bone mineral density than the general population. However, the influence of iron overload on bone health in the general population is uncertain. The aim of this study was to investigate the relationship between serum ferritin levels and bone mineral density (BMD) in elderly Koreans. A total of 2,943 subjects aged 65 years and over who participated in the 2008–2010 Korea National Health and Nutrition Examination Surveys were included in this study. Age, physical activity, current smoking status, alcohol consumption, education level, household income, and dietary assessment were surveyed by a face-to-face interview. BMD was measured at the lumbar spine and femur by dual-energy X-ray absorptiometry, and other biochemical markers, including serum ferritin, 25-hydroxyvitamin D3, serum alkaline phosphatase, and parathyroid hormone, were assayed. After adjusting for age and body mass index, we found an association between BMD of the total lumbar spine, total femur, and femur neck and levels of alkaline phosphatase, parathyroid hormone, vitamin D3, and daily intake of calcium and protein. Serum ferritin levels were positively associated with BMD of the total lumbar spine, total femur, and femur neck after adjusting for all covariates in men, but not in women. This study suggests a positive association between serum ferritin levels and BMD in elderly South Korean men without hematologic disorders. Further study is warranted to verify the effects of iron on bone metabolism.

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