铁与2型糖尿病发病的最新进展

Advances in the study of iron metabolism and pathogenesis of type 2 diabetes

糖尿病对人类健康的威胁日益加重,近年来大量的实验、临床及流行病学资料显示体内铁过载与糖尿病发生存在密切关联。作为机体必需的营养元素,铁在机体组织中的稳态平衡对维持正常的生理功能至关重要。同时铁还是一种极强的促氧化剂,机体铁含量升高往往导致氧化压力增强,进而加大罹患2型糖尿病的风险;膳食中血红素铁摄入量增加以及机体铁代谢紊乱都可能导致2型糖尿病及其并发症发生。此外,其他胰岛素抵抗疾病如代谢综合征、妊娠糖尿病以及多囊卵巢综合征都与铁过载呈显著关联,过量铁是诱发这些疾病的主要原因,并直接导致胰岛素抵抗。治疗中可通过铁螯合剂的使用来有效降低机体铁水平,并改善胰岛素抵抗。这些研究成果为2型糖尿病的干预治疗提供了新思路。对铁代谢与2型糖尿病及其并发症的最新研究做简要综述。

Diabetes mellitus is one of the most serious diseases threatening human health. The role of trace elements in the etiology of Type 2 Diabetes （T2D） is not well established but several studies have shown iron may play a key i role. Iron is a strong oxidant and high levels of body iron may produce oxidative stress that increases the risk ofT2D. Several epidemiological studies have reported a positive association between high levels of circulating ferritin and the prevalence of T2D as well as other insulin resistant conditions such as obesity, metabolic syndrome, and gestational diabetes. Dietary iron, especially heine iron, is positively associated with high risk of T2D. Catalytic iron that is available to participate in free radical reactions may play a role in the pathogenesis of iron metabolic disorder-mediated diabetes and its complications. Reducing body iron level by iron chelate can ameliorate insulin resistance, suggesting a novel approach for the treatment of T2D. This review summarizes recent studies of iron metabolism and T2D.