有2型糖尿病家族史的一级亲属不同糖代谢状态时血清铁蛋白水平变化及意义

Change of Serum Ferritin in First-degree Relatives with Family History of Type 2 Diabetes in Different Status of Glucose Metabolism and Its Significance

【目的】探讨有2型糖尿病家族史的一级亲属不同糖代谢状态时血清铁蛋白（SF）水平变化及意义。【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126例，据有无糖尿病家族史（FHD）及75克葡萄糖耐量试验（OG—TT）的结果分为四组。1组：FHD’的正常糖耐量（NGT）24人；2组：FHD’的糖调节受损（IGR）46人；3组：FHD＋的糖尿病（DM）34人；4组：FHD一的NGT22人。测量身高、体质量，计算体质量指数（BMI），取空腹静脉血栓测血清铁蛋白（SF）、空腹血糖（FPG）、真胰岛素（FINS）水平。【方法】①3组FPG、FINS、HOMA—IR明显高于1、2、4组，2组FPG、FINS、HOMA-IR明显高于1和4组（P〈0．01），1组FPG、FINS、HOMA—IR与4组比较差异无统计学意义（P〉0．05）。四组间年龄、BMI、H0一MA—G比较差异无统计学意义（P〉O．05）。②血清sF3组升高最明显，2、3组的血清sF值明显高于1和4组（P〈0．01），1组和4组比较、2组和3组比较差异无统计学意义（P〉0．05），③Pearson相关分析显示：lgSF与FPG、FINs、HOMA—IR、FHD成正相关（P值均〈0．001），r分别为0．468、0．497、0．528、0．298；lgSF与年龄、性别、BMI、HOMA-8无相关性（P〉0．05）。④多元线性回归分析显示：以lgSF为因变量，HOMA_IR和FPG的偏回归系数0分别为0．053和0．08，t值分别为：4．269和2．742（P〈O．001）。【结论】血清SF在有2型糖尿病家族史糖代谢异常患者中明显升高，胰岛素抵抗和FPG的升高是其升高的主危险因素。

[Objective] To explore the change of serum ferritin（SF） in first-degree relatives with family history of type 2 diabetes （FHD） in different status of glucose metabolism and its significance. [Methods]A total of 126 patients admitted to endocrinology de- partment of our hospital from Jan. 2009 to June 2011 were enrolled in the study. According to FHD and results of oral 75g glucose tol- erance test, all patients were divided into group 1[normal glucose tolerance（NGT） with FHD＋ , n = 24], group 2[impaired glucose regulation（IGR） with FHD＋ , n =46], group 3[diabetes mellitus（DM） with FHD＋ , n = 34] and group 4（NGT with FHD＋ , n = 22）. Height and weight were measured, and body mass index（BMI） was calculated. Fasting venous blood samples were collected to detect SF, fasting plasma glucose（FPG） and fasting insulin（FINS） levels. [Results]The FPG, FINS and HOMA-IR value in group 3 was obviously higher than that in group 1, group 2 and group 4. The FPG, FINS and HOMA-IR value in group 2 was obviously high- er than that in group 1 and group 4（ P 〈0.01）. There was .no significant difference in age, BMI and HOMA-13 among the four groups （ P 〈0.05）. The SF value increased most obviously in group 3, while the SF in group 2 and group 3 was much higher than that in group 1 and group 4（ P 〈0. 01）. There was no significant difference between group 1 and group 4 or group 2 and group 3 （ P 〈0.05）. Pearson analysis showed that lgSF was positively correlated with FPG, FINS, HOMA-IR and FHD（all P〈0. 001）. The rate was 0. 468, 0. 497, 0.528 and 0. 298, respectively. The lgSF had no correlation with age, gender, BMI and HOMA-β（ P 〉0.05）. Multiple linear analysis showed that the regression coefficient β of HOMA-IR and FPG were 0. 053 and 0.08 when taking lgSF as de- pendent variable and T value was 4. 269 and 2. 742, respectively（ P 〈0. 001）. [Conclusion] There is obvious increasing of SF value in patients of abnormal glucose metabolism with FHD. The main risk factors causing the rise of SF value are insulin resistance and the in- creasing of FPG.