新诊断2型糖尿病患者血清铁蛋白与糖、脂代谢及胰岛功能的关系

Relationship between serum ferritin levels and glycolipid metabolism, islet function in newly diagnosed type 2 diabetic patients

目的 比较不同血清铁蛋白（SF）水平的新诊断2型糖尿病（T2DM）患者糖、脂代谢及胰岛功能,分析其与SF的关系.方法 以新诊断T2DM患者115例为观察对象,按SF浓度分为高SF组40例（SF≥274.66 μg/L）与正常SF组75例（21.80 μg/L≤SF＆lt; 274.66 μg/L）.测量两组患者的身高、体重、腰围、臀围,检测空腹血糖、餐后2h血糖（2 hPG）、HbA1c、空腹胰岛素（FINS）、总胆固醇、甘油三酯、高密度脂蛋白-胆固醇（HDL-C）、低密度脂蛋白-胆固醇（LDL-C）,计算体重指数、腰臀比、稳态模型评估-胰岛素抵抗指数（HOMA-IR）、稳态模型评估-胰岛β细胞功能指数（HOMA-β）、定量胰岛素敏感性指数（QUICKI）和处置指数,并进行Spearman相关性及多元线性回归分析.结果 高SF组体重指数、FINS、甘油三酯、HOMA-IR高于正常SF组（t=2.470、2.631、2.316、2.879,P均＆lt;0.05）,HDL-C、QUICKI低于正常SF组（t=-2.030、-2.623,P均＆lt;0.05）;SF水平与体重指数、腰臀比、空腹血糖、2 hPG、HOMA-IR、甘油三酯均呈正相关（r=0.191 -0.303,P均＆lt;0.05）,与HDL-C、QUICKI、处置指数呈负相关（r=-0.221、-0.261、-0.293,P均＆lt;0.05）;多元线性回归分析显示体重指数、处置指数和甘油三酯是SF的独立相关因素（β=0.041、-0.443、0.270,P均＆lt;0.05）.结论 高SF水平的新诊断T2DM患者其糖、脂代谢紊乱及胰岛素抵抗程度较正常SF的T2DM患者更严重,SF可能通过增加胰岛素抵抗,促进T2DM的发生和发展.

Objective To compare glycolipid metabolism and islet function in patients with newly diagnosed type 2 diabetes mellitus （T2DM） with different levels of serum ferritin （SF） and explore the relationship between glycolipid metabolism, islet function and SF.Methods According to SF concentration,115 patients with newly diagnosed T2DM were divided into high SF group （SF ≥ 274.66 μg/L, 40 cases）and normal SF group （21.80 μg/L≤SF 〈274.66 μg/L, 75 cases）.Height, weight, waist circumference,hip circumference were measured and fasting plasma glucose （FPG）, 2 hours postprandial blood glucose（2 hPG）, HbA1c, fasting insulin （FINS）, total cholesterol, triglyceride, high density lipoprotein-cholesterol （HDL-C） and low density lipoprotein-cholesterol （LDL-C） were tested, and body mass index, waist-tohip ratio, homeostasis model assessment insulin resistance index （HOMA-IR）, homeostasis model assessment β-cell function index （HOMA-β）, quantitative insulin sensitivity index （QUICKI） and disposition index （DI） were calculated.The data were analyzed by Spearman correlation and multivariable linear regression analysis.Results The levels of body mass index, FINS, triglyceride and HOMA-IR in high SF group were significantly higher （t =2.470, 2.631,2.316, 2.879, all P 〈 0.05）, while the levels of HDL-C and QUICK were significantly lower （t =-2.030,-2.623, all P 〈 0.05） compared with those in normal SF group.The level of SF was positively correlated with body mass index, waist-to-hip ratio, FPG, 2 hPG,HOMA-IR and triglyceride （r =0.191-0.303, all P 〈0.05）, but negatively correlated with HDL-C, QUIC-KI and DI （r =-0.221,-0.261,-0.293, all P 〈 0.05）.Multivariate linear regression analysis showed that body mass index, DI and triglyceride were independent related factors of SF （β =0.041,-0.443,0.270, all P 〈 0.05）.Conclusions The newly diagnosed T2DM patients with high level of SF are more severe in glycolipid metabolism and insulin resistance than those with normal SF.SF may promote the occurrence and development of T2DM by increasing insulin resistance.