Ferritin plays an important role in maintaining intracellular iron balance and, in the stable state, serum levels are related to total-body iron stores.
How iron store affects bone health in the general population has been reported, but the same had not been investigated among Korean adolescents.
Based on this, researchers at Korea University and Seoul's Catholic University College of Medicine conducted a population-based study to explore the link between haemoglobin and serum ferritin levels and BMC in South Korean adolescents.
They referred to data from the 2009 — 2010 Korea National Health and Nutrition Examination Survey (KNHANES), including 1,321 participants between the ages of 10 and 18 years.
Boys and bones
Using dual-energy X-ray absorptiometry, they then measured the participants' BMC at the femur and lumbar spine; they also examined their haemoglobin and serum ferritin levels.
The researchers subsequently observed that in the male participants, levels of haemoglobin and serum ferritin had a direct relationship with BMC of the total femur and lumbar spine even after adjustment for possible confounders.
In addition, their haemoglobin levels rose significantly alongside an increase in BMC at all sites (femur, femur neck and lumbar spine).
They wrote: "Likewise, serum ferritin levels showed increasing trends according to increasing BMC of the total femur and lumbar spine in boys. However, these associations were not observed in girls."
More needed on mechanisms
The study's limitations included its cross-sectional design, which made it difficult to determine any causal link between BMC and haemoglobin and serum ferritin levels.
At the same time, the study did not include any new biochemical markers related to bone metabolism, and did not take into account all conditions linked with reduced bone mass in children and adolescents.
Still, the researchers stated that after adjusting for covariates, the study showed a positive relationship between levels of haemoglobin and serum ferritin and BMC in South Korean adolescent boys but not in adolescent girls.
Furthermore, the existing hypothesis is that iron deficiency is a risk factor in osteoporosis, making anaemia prevention and treatment necessary for the improvement of bone health.
In conclusion, the researchers wrote: "Further studies are needed to determine the principles governing bone formation and resorption according to iron store status without underlying disorders."
"Association between serum ferritin and hemoglobin levels and bone health in Korean adolescents: A nationwide population-based study"
Authors: Dong-Wook Jung, et al.