铁储备与2型糖尿病关系的探讨

Relationship between iron reserve and type 2 diabetic mellitus

目的探讨2型糖尿病铁储备的临床相关性，为合理防治2型糖尿病提供又一新的途径。方法（1）随机选取80例新发的男性2型糖尿病患者和无糖尿病家族史的正常糖耐量者40例为研究对象。（2）检测体重、血压、血脂、空腹血糖（FPG）、血浆胰岛素（FINS）、血清铁蛋白（SF）和血清转铁蛋白受体（sTFR）。（3）结合口服葡萄糖耐量试验，用胰岛素抵抗指数（HOMA—IR）评估胰岛素抵抗；用血清铁蛋白（sF）水平和血清转铁蛋白受体／血清铁蛋白的比值（sTFR／SF）评估体内铁储备。（4）分析sF水平和sTFR／SF的比值与胰岛素抵抗的关系。结果（1）病例组的TG、TC、空腹INS、HOMA—IR、SF均高于对照组，且有统计学意义（P〈0．05），sTFR／SF低于对照组，亦有统计学意义（P〈0．05）。（2）以对数HOMA—IR为因变量，年龄、BMI、TG、TC、HDL—C、SF、sTFR／SF为自变量，进行多元线性逐步回归分析，sF和sTFR／SF进入回归方程，显示对数HOMA—IR与sF显著正相关．而与sTFR／SF呈负相关。结论体内铁储备过多与HOMA—IR呈正相关，提示体内铁储备量过多可能是2型糖尿病的预测因子，铁储备可作为2型糖尿病防治新的着眼点之一。

Objective To study the relationship between iron reserve and type 2 diabetic meUitus （T2DM） .Methods Eighty parents with T2DM and 40 control subjects with normal glucose tolerance were enrolled. The levels of body weight, blood pressure, lipid, fasting blood glucose,blood plasma insulin,Serum ferrition （SF）and serum ferrition receptor （sTFR） were measured in two groups.All subjects underwent a oral 75 g glucose tolerance test （OGTT） for determinations of 0,30,60,120, and 180 minutes glucose and insulin. Insulin resistance was estimated using the homeostasis assessment （ HOM A - IR）, SF and the ratio of sTFR/SF were estimated to evaluate iron reserve. The relationship between HOM A- IR and the level of SF and the ratio of sTFR/SF was assessed. Results The group of type 2 diabetes had higher levels of iron reserve, TG, TC, FINS and HOMA-IR than control group（ P 〈 0.05 ）. HOMA- IRSF, and sTFR/SF underwent multivariate stepwise regression analysis. SF level was signifiantly positively correlated with LnHOMA - IR. sTFR/SF level was significantly negatively correlated with LnHOMA - IR. Conclusions Excessive iron reserve is obviously positively correlated with HOMA - IR. Iron reserve level is closely correlated with insulin resistance. Therefore, iron reserve can predict type 2 diabetes mellitus and its complications, and be used as an important target of prevention and treatment of type 2 diabetes mellitus.