铁代谢与糖尿病早期微血管病变的相关性研究

Correlation between iron metabolism and early diabetic microangiopathy

目的评估铁代谢相关指标在2型糖尿病早期微血管并发症中的作用。方法收集2019年1月至12月就诊于哈尔滨医科大学附属第一医院内分泌科的2型糖尿病患者作为研究对象,共计141例。单纯2型糖尿病(T2DM)患者60例为T2DM组,非增殖期糖尿病视网膜病变(NPDR)患者47例为NPDR组,早期糖尿病肾病(EDN)患者34例为EDN组。检测3组患者血清铁,铁蛋白以及空腹血糖等生化指标。Logistic回归分析法分析血清铁与NPDR和EDN发生的关系。结果NPDR组[(16.22±5.06)umol/L]和EDN组[(15.71±4.15)umol/L]血清铁水平显著低于T2DM组[(18.38±5.91)umol/L]。NPDR组和EDN组与T2DM组相比,病程、甘油三酯、血肌酐和肾小球滤过率等指标有显著的统计学意义,高血压与糖尿病肾病发生密切相关(P<0.05)。Logistic回归分析显示,血清铁是NPDR和EDN发生的保护性因素(OR=0.925,95%C1;0.857~0.998,P<0.05;OR=0.899,95%CI;0.818~0.988,P<0.05),血肌酐和病程是NPDR发生的危险因素(OR=1.093,95%CI:1.027~1.160,P<0.05;OR=1.044,95%CI;1.014~1.075,P<0.05)。结论血清铁是糖尿病早期微血管并发症发生的保护性因素。

Objective To evaluate the effects of iron metabolism-related indicators on mild micro-vascular complications in type 2 diabetes.Methods A total of 141 patients with type 2 diabetes who atten-ded in the Department of Endocrinology,the First Affiliated Hospital of Harbin Medical University from Jan-uary to December 2019 were collected.A total of 60 patients with simple type 2 diabetes mellitus(T2DM)were selected as the T2DM group,47 patients with nonproliferative diabetic retinopathy(NPDR)as theNPDR group,and 34 patients with early diabetic nephropathy(EDN)as the EDN group.The levels of ser-um iron,ferritin and fasting blood glucose were measured.Lagistic regression analysis was used to analyzethe relationship between serum iron and the occurrence of NPDR and EDN.Results The serum iron levelin the NPDR group[(16.22±5.06)umol/L]or the EDN group[(15.71±4.15)umol/L]was lowerthan that in the simple T2DM group[(18.38±5.91)umolL](P<0.05).Compared with simple T2DMgroup,NPDR group and EDN group had statistically significant differences in disease course,triacylglycer-ol,glomerular filtration rate and creatinine,and hypertension was associated with the occurrence of diabeticnephropathy(P<0.05).Logistic regression analysis showed that serum iron was a protective factor for theoccurrence of NPDR and EDN(OR=0.925,95%CI;0.857-0.998,P<0.05;OR=0.899,95%CI:0.818-0.988,P<0.05),whereas blood creatinine and course of disease were risk factors for the occurrenceof NPDR(OR=1.093,95%CI:1.027-1.160,P<0.05;OR=1.044,95%CI;1.014-1.075,P<0.05).Conclusion Serum iron is a protective factor for early microvascular complications in T2DM.