肥胖2型糖尿病患者血清铁蛋白 同型半胱氨酸水平变化及其影响因素分析  

Analysis of the changes of serum ferritin and homocysteine levels and their influencing factors in obese patients with type 2 diabetes

作　　者：陈佳慧 李占平 梁永丽 Chen Jiahui;Li Zhanping;Liang Yongli(Department of Laboratory,Xinzheng Huaxin People's Hospital,Zhengzhou 451100,China)

机构地区：[1]新郑华信民生医院检验科,451100

出　　处：《实用医技杂志》2025年第2期138-141,共4页Journal of Practical Medical Techniques

摘　　要：目的探讨肥胖2型糖尿病(T2DM)患者血清铁蛋白(SF)、同型半胱氨酸(Hcy)水平变化及其影响因素分析。方法研究组为新郑华信民生医院2022年5月至2024年5月收治的肥胖T2DM住院患者140例,对照组为同期年龄、性别匹配的非肥胖/超重的T2DM患者140例。采用t检验,比较2组肥胖类型不同患者血清SF、Hcy、游离脂肪酸(FFA)、甘油三酯(TG)、总胆固醇(TC)以及胰岛素抵抗指数(HOMA-IR)水平等;采用Pearson法分析血清SF、Hcy、TG、TC及HOMA-IR水平相关性;多因素logistic回归分析影响肥胖T2DM患者血清SF、Hcy水平变化的独立危险因素。结果研究组Hcy水平高于对照组[(13.4±1.8)μmol/L比(9.8±1.3)μmol/L,P<0.05];研究组血清SF水平高于对照组[(285±35)ng/ml比(237±32)ng/ml,P<0.05]。Hcy与HOMA-IR(r=0.202,P=0.001)、BMI(r=0.155,P=0.011)、FPG(r=0.256,P<0.001)、TG(r=0.171,P=0.007)、TC(r=0.151,P=0.013)、空腹胰岛素(FINS)(r=0.246,P<0.001)呈正相关;SF与收缩压(SBP)(r=0.225,P<0.001)、TG(r=0.169,P=0.005)、Hcy(r=0.175,P=0.004)、FFA(r=0.228,P<0.001)、体质指数(BMI)(r=0.233,P<0.001)、舒张压(DBP)(r=0.154,P=0.012)、HOMA-IR(r=0.168,P=0.008)呈正相关。多因素logistic分析结果显示,SF与BMI[OR值(95%CI)=1.324(1.194,1.469),P<0.001]、FFA[OR值(95%CI)=1.429(1.231,1.659),P<0.001]具有相关性。结论肥胖T2DM患者血清SF、Hcy、FFA、TG、HOMA-IR及血压都高于单纯T2DM患者,其中BMI、FFA水平过高影响SF水平。Objective To investigate the changes of serum ferritin(SF)and homocysteine(Hcy)levels and their influencing factors in obese type 2 diabetes mellitus(T2DM)patients.Methods The study group consisted of 140 obese T2DM inpatients admitted to Xinzheng Huaxin People′s Livelihood Hospital from May 2022 to May 2024,and the control group consisted of 140 non-obese/overweight T2DM patients matched by age and sex during the same period.t test was used to compare serum SF,Hcy,FFA,TG,TC and insulin resistance index(HOMA-IR)levels of patients with different types of obesity in the two groups.The correlation of serum SF,Hcy,TG,TC and HOMA-IR levels was analyzed by Pearson method.Multivariate Logistic regression analysis of independent risk factors affecting serum SF and Hcy levels in obese T2DM patients.Results The Hcy level in the study group was higher than that in the control group[(13.4±1.8)μmol/L vs.(9.8±1.3)μmol/L,P<0.05].The serum SF level of the study group was higher than that of the control group[(286±35)ng/ml vs.(237±32)ng/ml,P<0.05].Hcy and HOMA-IR(r=0.202,P=0.001),BMI(r=0.155,P=0.011),FPG(r=0.256,P<0.001),TG(r=0.171,P=0.007),TC(r=0.151,P=0.013),FINS(r=0.246,P<0.001)were positively correlated;SF and SBP(r=0.225,P<0.001),TG(r=0.169,P=0.005),Hcy(r=0.175,P=0.004),FFA(r=0.228,P<0.001),BMI(r=0.233,P<0.001),DBP(r=0.154,P=0.012)and HOMA-IR(r=0.168,P=0.008)were positively correlated.Multivariate Logistic analysis showed that SF was correlated with BMI[OR(95%CI)=1.324(1.194,1.469),P<0.001]and FFA[OR(95%CI)=1.429(1.231,1.659),P<0.001].Conclusion Serum SF,Hcy,FFA,TG,HOMA-IR and blood pressure in obese T2DM patients are higher than those in simple T2DM patients,and high levels of BMI and FFA can affect SF level.

关 键 词：糖尿病 2型 铁蛋白质类 高半胱氨酸 胰岛素抵抗 

分 类 号：R58[医药卫生—内分泌]