2型糖尿病患者血清铁蛋白水平与外周血管粥样硬化关系

Correlation between serum ferritin and peripheral vascular atherosclerosis in patients with type 2 diabetes mellitus

目的探讨2型糖尿病患者血清铁蛋白(serum ferritin,SF)水平与糖化血红蛋白、高敏C反应蛋白、颈动脉内-中层厚度等的相关性。方法 160例2型糖尿病患者(糖尿病组),根据血清SF水平分为高SF组(SF≥300μg/L)92例和正常SF组(SF<300μg/L)68例;选择50例体检健康者为对照组。检测并比较各组血清SF等指标,分析糖尿病患者血清SF水平与高敏C反应蛋白、糖化血红蛋白、颈动脉内-中层厚度等的相关性。结果糖尿病组血清SF水平[(315.00±68.30)μg/L]高于对照组[(153.70±63.40)μg/L](P<0.05);高SF组糖化血红蛋白[(8.45±2.54)%]、空腹胰岛素[(2.12±0.71)mu/L]、高敏C反应蛋白[(6.20±1.32)mg/L]、颈动脉内-中层厚度[(13.85±3.48)mm]、体质量指数[(23.40±5.60)kg/m^2]、空腹血糖[(7.20±1.40)mmol/L]、胰岛素抵抗指数(0.54±0.37)均高于正常SF组[(8.37±2.33)%、(1.54±0.65)mu/L、(5.00±0.45)mg/L、(8.34±3.73)mm、(20.70±2.48)kg/m^2、(6.83±2.26)mmol/L、0.32±0.52],差异有统计学意义(P<0.05);SF与颈动脉内-中层厚度(r=0.15,P=0.037)、体质量指数(r=0.21,P=0.024)、糖化血红蛋白(r=0.31,P=0.021)、空腹血糖(r=0.19,P=0.022)、空腹胰岛素水平(r=0.27,P=0.019)、胰岛素抵抗指数(r=0.33,P=0.009)均呈正相关。结论血清SF参与了2型糖尿病的发生、发展;检测SF水平对评估糖尿病外周血管粥样硬化有一定临床意义。

Abstract： Objective To explore the correlation of serum ferritin with glycosylated hemoglobin A1 c （HbA^c）, high sensitivity C-reactive protein （hs-CRP） and carotid intima-media thickness （IMT） in patients with type 2 diabetes mellitus （T2DM）. Methods A total of 160 patients with T2DM were divided into high serum ferritin group （SF300μg/L, n= 92） and normal serum ferritin group （SF=300 μg/L, n= 68）, and another 50 healthy volunteers were as controls （control group）. The serum ferritin levels were detected and compared among groups to analyze the correlation of serum ferritin with hs-CRP, HbAlc and IMT. Results The serum ferritin in T2DM patients （（315. 0 ± 68. 3） 〉g/L） was significantly higher than that in control group （（153. 70 ± 63.40） μg/L） （P%0.05）. The levels of HbAje （（8.45 4- 2.54）%）, fasting insulin （（2.12±0.71） mu/L）, hs-CRP （（6. 20±1.32） mg/L）, carotid IMT （（13.85±3.48） mm）, body mass index （（23.40 ± 5. 60） kg/m2 ）, fasting plasma glucose （（ 7. 20 ± 1.40） mmol/L）, and homeostasis model assessment-insulin resistance （HOMA-IR） （0.54 ± 0.37） in high serum ferritin group were significantly higher than those in normal serum ferritin group （（8. 37±2.33）%, （1. 54±0. 65） mu/L, （5. 0±0. 45） mg/L, （8. 34±3. 73） ram, （20.70±2.48） kg/m2） , （6.83±2.26） mmol/L, 0.32±0.52） （P〈0.05）. Serum ferritin was positively correlated with carotid MIT （r=0.15, P=0.037）, body mass index （r=0.21, P=0.024）, HbAlc （r=0.31, P=0.021）, fasting plasma glucose （r=0.19, P=0.022）, fasting insulin （r=0. 27, P=0.019） and HOMA-IR （r=0. 33, P=0.009）. Conclusion Serum ferritin involves in the occurrence and development of T2DM. To detect serum ferritin levels has a certain clinical significance in the assessment of diabetic peripheral vascular atherosclerosis.