血清铁蛋白与2型糖尿病及其相关危险因素的关系

Relation of Serum Ferritin with Type 2 Diabetes Mellitus and Its Relative Risk Factors

目的探讨血清铁蛋白(SF)水平对2型糖尿病(T2DM)的发病基础——胰岛素抵抗和胰岛β细胞功能的影响,及与T2DM相关危险因素的相关性。方法测定65例T2DM患者(病例组)和20例健康对照者(对照组)血清SF、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白A1(ApoA1)、载脂蛋白B(ApoB)、脂蛋白(a)〔Lp(a)〕、空腹血浆葡萄糖(FPG)、空腹胰岛素(FINS)、餐后胰岛素(PINS)、C肽〔空腹C肽(FC-P)及餐后C肽(PC-P)〕水平及糖化血红蛋白(HbA1c),计算并比较胰岛素抵抗指数(Homa-IR)和胰岛素分泌指数(Homa-IS)。结果病例组患者血清SF水平显著高于对照组〔(252±257)μg/L和(112±41)μg/L〕,血清FPG、TG、LDL、Lp(a)水平及HbA1c、Homa-IR亦显著高于对照组,PINS、C肽水平及Homa-IS显著低于对照组,差异有统计学意义(P<0.05)。相关分析显示,血清SF水平与FPG、LDL水平及Homa-IR呈正相关,与PINS、C肽水平及Homa-IS呈负相关(P<0.05)。多元逐步回归分析显示,血清SF水平与Homa-IS呈负相关。结论血清SF水平升高可能影响糖尿病患者的糖脂代谢;高血清SF与胰岛β细胞分泌功能损害具有一定的相关性,而对胰岛素抵抗无明显影响;高血清SF可能是2型糖尿病发生、发展中的一个重要的危险因子。

Objective To investigate the effect of serum ferritin to the Insulin Resistance and the pancreatic B - cell function in type 2 diabetic patients, and the relationship between serum ferritin and the relative risk factors. Methods For 65 T2DM patients and 20 normal control subjects, the levels of SF, total cholesterol （ TC）, triglyceride （ TG）, high density lipo- protein - cholesterol （ HDL - C）, lower density lipoprotein - cholesterol （ LDL - C）, apolipoprotein A1 （ ApoA1 ）, apolipoprotein B （ApoB）, hpoprotein （a） [ Lp （a） 1, fasting blood glucose （ FBG）, fasting insulin （FINS）, postprandial insulin （PINS）, fasting C peptide （FC- P）, postprandial C peptide （PC -P）, and glycosylated hemoglobin （HbA1c） were measured. Then Homa insulin resistance index （ Homa - IR） and Homa - insulin secretion （ Homa - IS） were calculated and compared. Resets The SF [ （252 ±257） μg/L] in the T2DM group was significant higher than the normal control group [ （112 ± 41 ） μg/L]. The levels of FPG, HbA1c, TG, LDL, Lp （a）, HOMA -IR in the T2DM group were significantly higher, the levels of PINS, C - peptide level, Homa- IS in the T2DM group were significantly lower as compared with those in the normal control group （ P 〈 0. 05 ）. The correlation analysis revealed that serum ferritin level was positively associated with the levels of FPG and LDL, and Homa - IR; but negatively associated with the levels of PINS and C - peptide, and Homa - IS （P 〈 0. 05）. The multiple stepwise regression analysis showed that serum ferritin level was negatively associated with Homa - IS. Conclusion The increased serum ferritin may affect glucose and lipid metabolism. It may be correlated with the functional damage of pancreatic β cell, but it has no evident influence on insulin resistance. So it may be an important risk factor in the process of T2DM.