60岁及以上非糖尿病人群代谢紊乱集簇与血清铁蛋白水平的关系  

Relationship between serum ferritin level and clustering of metabolic disorders in adults aged 60 years or above

作　　者：盛励[1] 刘军[1] 徐炯[1] 王芳[1] 丁和远[1] 查英[1] 陈灶萍[1] 赵燕萍 

机构地区：[1]复旦大学附属上海市第五人民医院内分泌科,上海200240 [2]闵行区江川卫生服务中心

出　　处：《中华糖尿病杂志》2011年第5期367-370,共4页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：上海市科学技术委员会科研计划项目（08411962500）

摘　　要：目的探讨60岁及以上人群代谢紊乱集簇与血清铁蛋白水平的关系。方法2008年6至7月人选上海市闵行区汀川社区60岁以上非糖尿病老年人3416名，测定血压、血脂、血糖、空腹胰岛素、尿白蛋白／肌酐比值、血清铁蛋白，采用稳态模型评价胰岛素抵抗指数和胰岛β细胞功能，计算胰岛素敏感指数及处置指数。根据上述结果将糖耐量正常者分为4组：胰岛素敏感＋胰岛素分泌减退组（SF2组，n=514）；胰岛素敏感＋胰岛素分泌正常组（SF，组，n=1049）；胰岛素抵抗＋胰岛素分泌减退组（SF，组，n=17）；胰岛素抵抗＋胰岛素分泌正常组（SF4组，n=516）。另根据代谢综合征诊断标准将全部研究对象分为代谢紊乱0组分组（MS0组，n=1564）、代谢紊乱1组分组（MS1组，n=1603）、代谢紊乱2组分组（MS2组，n=170）、代谢紊乱93组分组（MS3组，n=79）。各胰岛功能组及代谢紊乱组分别进行血清铁蛋白水平相关性分析。计数资料比较采用X^2检验，组间比较采用方差分析（Bonferroni法）。血清铁蛋白与各指标的相关性研究采用Spearman相关分析和多元逐步回归分析。结果随着代谢紊乱组分数目增加，血清铁蛋白、体质指数、体脂含量、收缩斥、舒张压、空腹血糖、总胆固醇、甘油三酯、尿白蛋白／肌酐比值、空腹胰岛素、胰岛素抵抗指数逐渐升高，胰岛素敏感指数及处置指数逐渐下降。高甘油三酯组、肥胖组患者血清铁蛋白水平分别高于正常甘油三酯组、正常体质量组。各代谢紊乱组（高甘油三酯、高胆同醇、高血压和肥胖组）中男性铁蛋白水平均高于女性。Spearman相关分析显示，空腹血糖、2h血糖、空腹胰岛素、体质指数、甘油三酯、总胆㈨醇、胰岛素抵抗指数、胰岛β细胞功能与血清铁蛋白呈显著正相关（P〈0．01），胰岛素处置指数、胰岛素敏感指数与血清铁蛋白Objective To analyze the relationship between serum ferritin level and clustering of metabolic disorders excluded diabetes in individuals aged 60 years or above. Methods A total of 3416 subjects from Jiangchuan Community of Shanghai were enrolled in this study. Blood pressure （BP）, serum lipid profiles, blood glucose （BG）, body mass index （BMI）, fasting insulin （FINS）, urinary album/creatinine ratio （UACR） and serum ferritin （SF） were tested. Homeostasis model was used to evaluate insulin resistance （HOMA-IR） and beta cell function （HOMAq3）. Insulin sensitive check index （QUICK） and deposition index （DI） were calculated. Those with normal glucose tolerance were assigned to 4 groups （ SFI , SF2 , SFz and SF4 ） according to the results of HOMA-IR and HOMA-[3. X2 test and Spearman analysis were used for data comparison. Results The levels of LnSF, BMI, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, total cholesterol （TC）, Ln triglyceride （TG）, LnFINS, body fat content （BFC）, LnHOMA-IR, and UACR were significantly increased while LnQUICK and LnDI were decreased when the number of metabolic disorders were increased. The patients in the high triglyceride gronp and obesity group showed higher SF level than in normal TG group and normal weight group （ P 〈 0.05 ）. The male patients in the metabolic disorder group （high TG, high cholesterol, high BP and obesity） were found to have higher SF level than female patients （P 〈 0. 05 ）. Spearman correlation showed that fasting blood ghleose （FBG） , 2-h BG, LnFINS, BMI, TG, TC, LnHOMA-IR, and LnHOMA-β were positively related to ImSF, while LnDI and LnQUICK were negatively related to SF （P 〈0.01 ）. Stepwise regression analysis showed that LnHOMA-IR, TC, BMI, and TG were dependent risk factors of LnSF. Conclusions Elevated serum level of ferritin in adults aged 60 years or above may be significantly related to the clustering of metabolic disorders. Dyslipidemia, obesity and in

关 键 词：代谢 胰岛素 铁蛋白质类 

分 类 号：R587.1[医药卫生—内分泌]