血清铁蛋白与糖尿病高滤过之间的关系研究

Association between serum ferritin and hyperfiltron in type 2 diabetes mellitus

目的探讨血清铁蛋白水平与2型糖尿病(T2DM)高滤过状态之间关系。方法选取T2DM病人116例。完善问卷调查基线资料,并行血清铁蛋白浓度、尿白蛋白/肌酐,核素肾动态显像肾小球滤过率(GFR)测定。根据多元线性回归方程,以GFR为因变量,矫正年龄、性别和体质量指数后将研究对象分为2组:正常滤过率组(90 m L·min^(-1)·1.73 m^(-2)≤GFR≤130m L·min^(-1)·1.73 m^(-2))和高滤过率组(GFR>130 m L·min^(-1)·1.73 m^(-2))。结果 (1)入组的T2DM病人116例,年龄(57.52±12.81)岁,其中男52例、女64例。根据人群特点,矫正性别、年龄、体质量指数后,有67例57.8%(男性32例)被定义为高滤过组,平均GFR130.0(125.7~356.8)m L·min^(-1)·1.73 m^(-2)。高滤过组铁蛋白显著高于正常滤过率组。(2)血清铁蛋白水平与核素GFR呈正相关(r=0.543,P<0.001),多因素Logistic回归分析显示,校正性别、体质量指数后,血清铁蛋白浓度、空腹血糖和糖化血红蛋白的OR值分别是1.07(1.03~1.12)、1.77(1.14~2.78)和1.98(1.09~3.62)(均P<0.05)。结论血清铁蛋白是T2DM病人高滤过状态的独立危险因素;检测血清铁蛋白有助于预测早期肾脏损害。

Objective This study aimed to investigate the correlation between serum ferritin and glomerular filtration rate （ GFR） in type 2 diabetes mellitus （T2DM） patients and to investigate the role of serum ferritin in the diagnosis of early diabetic nephropathy（ DN） in T2DM patients. Methods One hundred and sixteen T2DM inpatients were recruited and divided into two groups according to GFR calcu-lated with 99mTc-DTPA renal dynamic imaging method adjusted by age, gender and body mass index （ BMI ）： Normal GFR group （90 mL· min-1 · 1.73 m-2≤GFR≤130 mL · min-1 · 1.73 m-2） and hypeifiltration group （GFR〉130 mL ·min-1 · 1.73 m-2）. Results Among all subjects,67 subjects （ 32 men） were defined as being with hyperfiltration,for a mean GFR of 130. 0 （ range 125. 7 · 356. 8 ） mL · min-1 · 1.73 m -2. However, serum ferritin level in hyperfiltration group was higher than others. Serum ferritin was positive-ly related to GFR （r =0.543,P 〈0.001）. Multivariate logistic regression analysis showed that after adjustment for gender and BMI,the OR of ferritin,fast plasma glucose and glycosylated hemoglobin HAjC were 1.07（1.03 -1.12 ）, 1 .7 7 （1.14 -2.78 ） and 1 .9 8 （ 1.09- 3.62 ） （ P 〈 0.05 ） . Conclusion Serum ferritin is an independent risk factor of hyperfiltron of T2DM patients. The analysis of serum fer-ritin is helpful for the early forecast of DN. The relationship between serum ferritin and GFR is required further discussion.