血清铁蛋白对有T2DM家族史一级亲属代谢综合征的影响

Effect of Serum Ferritin on Metabolic Syndrome of First Degree Relatives with Family History of Type 2 Diabetes Mellitus

【目的】探讨血清铁蛋白对有2型糖尿病（T2DM）家族史一级亲属代谢综合征（MS）的影响。【方法】纳入2009年1月至2011年6月在本院内分泌门诊就诊的患者203例，测量身高、体重、腰围（WC）、血压，测定空腹血糖（FPG）、血甘油三脂（TG）、高密度脂蛋白胆固醇（HDL-C）水平、血清真胰岛素（FTI）及血清铁蛋白（SF），据样本中SF中位数（98．7ng／mL）及有无糖尿病（DM）家族史（FHD）分为四组：1组（FHD低SF组），2组（FHD-高SF组），3组（FHD＋低SF组），4组（FHD＋高SF组），分析SF水平对MS的影响。【结果】①与1组相比，2、3、4组FPG、HOMA—IR明显升高，以4组升高最明显，2、4组WC、DBP、FINS水平明显升高，而LDL-C明显降低；与3组相比，4组wC、DBP、FPG、FINS、HOMA-IR水平明显升高，而LDL—C明显降低（P〈0．05）。②四组间≤1项Ms组分情况的检出率1组高于2、3、4组，≥3项MS组分情况的检出率1组低于2、3、4组，差异均有统计学意义（P〈0．05），四组间2项MS组分情况的检出率差异无统计学意义（P〉O．05）。③logistic回归分析显示：调整年龄、性别和BMI后，相对于发生≤1项MS组分情况，4组发生2项和≥3项MS组分情况的风险分别是1组的4．079倍和10．566倍，2组发生≥3项MS组分情况的风险是1组的6．103倍。【结论】血清铁蛋白水平增高时，胰岛素抵抗明显，使MS的风险增加，特别在有DM家族史人群中更为明显。

[Objectivel To explore the influence of serum ferritin（SF） on metabolic syndrome（MS） of first degree relatives with family history of type 2 diabetes mellitus. [Methodsl Totally 203 patients admitted to clinic service of our hospital from Jan. 2009 to June 2011 were enrolled in the study. Body height, weight, waist circumference （WC） and blood pressure（BP） were measured. Fasting blood glucose（FPG）, triglyceride（TG）, high density lipoprotein cholesterol（ HDL-C）, fasting insulin index（FTI） and SF were examined. According to SF median（98.7ng/mL）of samples and family history of diabetes mellitus（FHD）, all patients were divided into group I（FHD low SF group）, groupII（FHD-high SF. group）, group III （FHD＋ low SF group） and group IV （FHD＋ high SF group）. [Results] Compared with group I, FPG and HOMA-IR in group II, III and IV obviously increased, and those in group IV increased more obviously. Compared with group I, WC, DBP and FINS of group II and IV increased obviously, but LDL-C decreased obviously. Compared with group IH, WC, DBP, FPG, FINS and HOMA-IR in group IV obviously increased, but LDL-C decreased obviously（ P〈0.05）. The detection rate of MS component 41 item in group I was higher than that in group II, III and IV. The detection rate of MS component ≥3 items in group I was higher than that in group II, III and IV, and there was significant difference（ P d0.05）. Logistic regression analysis showed that the risk of MS components =2 or ≥3 items in group IV was 4. 079 and 10. 566 times of that in group I respectively after the adjustment of age, gender and BMI in comparison with the risk of MS component ≤1 item. The risk of MS component 93 items in group II was 6. 103 times of that in group I.. [Conclusion] When the level of SF increases, there is significant insulin resistance, and the risk of MS increases especially for people with family history of T2DM.