血清铁蛋白在绝经后女性2型糖尿病并发肌少症患者的变化  

Change of serum ferritin in postmenopausal women with type 2 diabetes and sarcopenia

作　　者：吴梦娇[1] 陈超[1] 施毕旻[1] WU Meng-jiao;CHEN Chao;SHI Bi-min(Department of Endocrinology,the First Affiliated Hospital of Soochow University,Suzhou 215000,Jiangsu,China)

机构地区：[1]苏州大学附属第一医院内分泌科,苏州215000

出　　处：《中华骨质疏松和骨矿盐疾病杂志》2020年第3期222-228,共7页Chinese Journal Of Osteoporosis And Bone Mineral Research

摘　　要：目的探讨血清铁蛋白(ferritin,Fer)在绝经后女性2型糖尿病(type 2 diabetes mellitus,T2DM)并发肌少症患者中的变化及意义。方法选取2018年4月至2019年4月于苏州大学附属第一医院内分泌科住院的绝经后女性T2DM患者126例,以体成分分析仪完成身体测量,用电化学发光法测定血清Fer。按亚洲肌少症共识,以身高校正的四肢骨骼肌质量指数(appendicular skeletal muscle mass index,ASMI)及握力定义肌少症。采用数字法随机分为T2DM并发肌少症患者63例(肌少症组),不并发肌少症患者63例(非肌少症组)。比较两组人群一般资料、身体成分、血液学指标的差异,Spearman相关分析血清Fer与其余临床指标的相关性,二元Logistic回归分析绝经后女性T2DM患者并发肌少症的影响因素。结果肌少症组血清Fer较非肌少症组明显升高214.79(106.09)μg/L vs.145.17(85.04)μg/L,P<0.05]。Spearman相关分析显示血清Fer与病程、全身骨骼肌质量、四肢骨骼肌质量、ASMI、尿酸呈负相关(r=-0.209、-0.337、-0.392、-0.448、-0.214,P<0.05),与年龄、腰臀比、体脂百分比、糖化血红蛋白、游离甲状腺素呈正相关(r=0.181、0.199、0.208、0.201、0.182,P<0.05)。二元Logistic回归分析显示,高体质量指数、高全身骨骼肌质量是绝经后女性T2DM患者并发肌少症的独立保护因素(OR=0.090、0.159,P<0.05),而高血清Fer、高内脏脂肪面积是其独立危险因素(OR=1.021、1.125,P<0.05)。结论绝经后女性T2DM患者的铁蓄积与肌少症指标密切相关,高血清Fer是T2DM并发肌少症的独立危险因素。Objective To investigate the change and significance of serum ferritin in postmenopausal women with type 2 diabetes(T2DM)and sarcopenia.Methods A total of 126 postmenopausal women with T2DM hospitalized from April 2018 to April 2019 participated in this study.Body measurement was accomplished with a body composition analyzer,and serum ferritin was measured by ECLIA.Height-adjusted appendicular skeletal muscle mass index(ASMI)and grip strength were used to define sarcopenia according to the consensus of Asian Working Group for Sarcopenia(AWGS).63 patients with sarcopenia and 63 patients without sarcopenia were enrolled in this study,and there were no differences in the course of diabetes between them.The differences of general data,body composition,and laboratory parameters were compared between the two groups.Spearman correlation analysis was used to find out the relationships between serum ferritin and other parameters.Binary Logistic analysis was used to determine the independent factors for postmenopausal female patients with type 2 diabetes and sarcopenia.Results Serum ferritin level was increased in postmenopausal wome with T2DM and sarcopenia than those without sarcopenia[214.79(106.09)μg/L vs.145.17(85.04)μg/L,P<0.05].Spearman correlation analysis showed that serum ferritin was negatively correlated with course of diabetes,total skeletal muscle mass,appendicular skeletal muscle mass,ASMI,and uric acid(r=-0.209,-0.337,-0.392,-0.448,-0.214;P<0.05),and positively correlated with age,waist-to-hip ratio,body fat percentage,glycated hemoglobin,and free thyroxine(r=0.181,0.199,0.208,0.201,0.182,P<0.05).Binary Logistic analysis showed that higher body mass index and total skeletal muscle mass were the independent protective factors for postmenopausal women with T2DM and sarcopenia(OR=0.090,0.159;P<0.05),while higher serum ferritin and visceral fat area were the independent risk factors(OR=1.021,1.125;P<0.05).Conclusion The phenomenon of iron overload is closely correlated to sarcopenia and higher serum ferritin

关 键 词：2型糖尿病 肌少症 铁蛋白 铁蓄积 

分 类 号：R587.1[医药卫生—内分泌]