2型糖尿病患者稳态模型评估与血清铁、铁蛋白水平分析

Analysis on homeostasis model assessment of serum iron and ferritin levels in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)与稳态模型评估法(HOMA)、血清铁(Fe)、铁蛋白(Ferr)水平的相关性。方法检测79例T2DM患者和50名表面健康者(正常对照组)的Fe、空腹胰岛素(FINS)、C-肽(C-p)、糖化白蛋白(GA)、Ferr、空腹葡萄糖(FPG)、糖化血红蛋白(HbA1C)、胰岛素抵抗指数(HOMA-IR)和胰岛β细胞功能指数(HOMA-β)并作统计分析。相关性分析采用Spearman相关。结果正常对照组男性Fe、Ferr水平明显高于女性(P均<0.05)。T2DM组FINS、GA、Ferr、FPG、HbA1C、HOMA-IR水平明显高于正常对照组;HOMA-β水平明显低于正常对照组(P<0.05)。Ferr与GA、FPG、HbA1C、HOMA-IR呈明显正相关[相关系数(r)分别为0.328、0.333、0.315(P均<0.01)、0.196(P<0.05)];与HOMA-β呈明显负相关(r=-0.246,P<0.01)。Fe与HOMA-IR、HOMA-β均无明显相关性(r分别为-0.049、0.039,P均>0.05)。结论 T2DM患者随着Ferr水平增加,其体内胰岛素抵抗程度也相应增加,而胰岛β细胞分泌胰岛素的敏感度下降。

Objective To investigate the correlation of type 2 diabetes mellitus（T2DM）with homeostasis model assessment（HOMA）,serum iron（Fe） and ferritin（Ferr）levels.Methods A total of 79 patients with T2DM and 50 healthy subjects（control group）were enrolled,and the levels of Fe and fasting insulin（FINS）,C-peptide（C-p）,glycated albumin（GA）,Ferr,fasting plasma glucose（FPG）,glycosylated hemoglobin（HbA1C）,homeostasis model assessment-insulin resistance（HOMA-IR） index and homeostasis model assessment-pancreatic islet beta cell function（HOMA-β） index were determined and analyzed statistically.The Spearman correlation analysis was performed.Results Fe and Ferr levels in males were significantly higher than those in females in the control group（P0.05）.The FINS,GA,Ferr,FPG,HbA1C and HOMA-IR levels in the T2DM group were significantly higher than those in the control group,and HOMA-β indices were significantly lower than those in the control group（P0.05）.The level of Ferr was positively correlated to GA,FPG,HbA1C and HOMA-IR[correlation coefficients（r）were 0.328,0.333,0.315（P0.01）and 0.196（P0.05）].The level of Ferr was negatively correlated with HOMA-β indices（r=-0.246,P0.01）.The level of Fe had no significant correlation with HOMA-IR and HOMA-β indices（r=-0.049 and 0.039,P0.05）.Conclusions When the Ferr level increases,the insulin resistance degree increases,and the sensitivity of beta cell insulin secretion decreases in the patients with T2DM.