血清铁蛋白与2型糖尿病及其危险因素相关关系的研究

Relationship of serum ferritin with type 2 diabetes and other risk factors

目的探讨血清铁蛋白(SF)与2型糖尿病及其各主要危险因素[体质指数(BMI)、腹内脂肪面积(VA)、血脂及血压水平]的关系。方法测定并比较60例2型糖尿病患者及60例健康对照的身高、体质量、腰围、臀围、SF、腹部脂肪扫描、总胆固醇(TC)、三酯甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBG)、口服75 g葡萄糖粉测量2 h血糖、空腹血清胰岛素(FINS)、收缩压(SBP)、舒张压(DBP)、血尿酸(UA)及C反应蛋白(CRP),计算BMI、腰臀围比(WHR)、胰岛素抵抗指数(HOMR-IR)及VA。结果2型糖尿病组SF水平较对照组升高,差异具显著性(P<0.01),SF与BMI、FBG、DBP、TG、LDL-C、UA、VA、CRP呈正相关,与HDL-C负相关,与SBP无相关性。与对照组相比,初诊的2型糖尿病患者具有较高的BMI、WHR、FINS、TG、UA、CRP、VA以及SBP水平(P<0.05);HOMA-IR明显升高(P<0.05);较低的HDL-C水平(P<0.05);而TC、LDL-C水平及DBP无明显差异(P>0.05);糖尿病组不论男性与女性SF浓度明显高于对照组(P<0.05)。通过直线相关分析可知,经对数转换后的2型糖尿病患者SF与TC、TG、LDL-C、UA、CRP呈正相关(P<0.05);与FBG、PBG、VA、HOMR-IR及DBP显著正相关(P<0.01);与HDL-C呈负相关(P<0.05);与SBP、BMI、WHR、FINS非线性关系。经多因素逐步回归分析发现SF是参与HOMR-IR的独立变量。结论SF水平升高即体内储存铁过多是2型糖尿病形成和进展的危险因素之一,并且SF可以预测2型糖尿病代谢控制程度,可能为2型糖尿病的诊治提供新途径。

Objective To study the relationship of serum ferrintin with type 2 diabetes and other risk factors. Methods Serum ferritin （ SF）, abdominal visceral fat area （ VA）, total cholesterol （ TC ）, triglyeride （ TG ）, low - density lipoprotein cholesterol （ LDL - C ）, high density lipoprotein cholesterol （HDL- C）, body mass index （BMI）, waist hip ratio （WHR）, fasting blood glucose （FBG）, postprandial glucose （2 - h PPG）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, fasting serum insulin （FINS）, insulin resistance index （HOMA - IR）, serum uric acid （UA） and C - reactive protein （CRP） were measured in 60 patients with type 2 diabetes and 60 healthy control, Results Individuals with diabetes had higher SBP, TG, BMI, WHR, VA, UA, CRP and FINS and lower HDL- C than individuals with normal glucose concentrations. Newly diagnosed diabetes patients had statistically higher ferritin concentrations than control subjects. Log - transformed serum ferritin correlated positively with TC, TG, LDL- C, VA, UA, CRP, FBG, PBG and HOMA -IR, negatively with HDL -C, but not with BMI, WHR, SBP and FINS. Using multiple regression analysis, we found that SF is an independent variable of HOMA - IR. Conclusion Elevated iron plays an important role in the development of type 2 diabetes. Serum ferritin may be a marker of poor metabolic control in the diabetic patients and may indicate a new way in the diagnosis and treatment of type 2 diabetes.