Sun Liang, Franco Oscar H, Hu Frank B, Cai Lu, Yu Zhijie, Li Huaixing, Ye Xingwang, Qi Qibin, Wang Jing, Pan An, Liu Yong, Lin Xu
Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, 294 Tai-Yuan Rd., Shanghai 200031, China.
J Clin Endocrinol Metab. 2008 Dec;93(12):4690-6. doi: 10.1210/jc.2008-1159. Epub 2008 Sep 16.
Elevated ferritin concentrations frequently cluster with well-established risk factors of diabetes including obesity, metabolic syndrome, chronic inflammation, and altered circulating adipokines. Few studies, however, have systematically evaluated the effect of these risk factors on ferritin-diabetes association, particularly in Chinese populations.
We aimed to investigate, in a middle-aged and elderly Chinese population, whether elevated ferritin concentrations are associated with higher risk of metabolic syndrome and type 2 diabetes and to what extent the associations were influenced by obesity, inflammation, and adipokines.
We conducted a population-based, cross-sectional survey of 3,289 participants aged 50-70 yr in Beijing and Shanghai in 2005. Fasting plasma ferritin, glucose, insulin, lipid profile, glycohemoglobin, inflammatory markers, adipokines, and dietary profile were measured.
Median ferritin concentrations were 155.7 ng/ml for men and 111.9 ng/ml for women. After multiple adjustment, the odds ratios (ORs) were substantially higher for type 2 diabetes (OR 3.26, 95% confidence interval 2.36-4.51) and metabolic syndrome [OR 2.80 (95% confidence interval 2.24-3.49)] in the highest ferritin quartile compared with those in the lowest quartile. These associations remained significant after further adjustment for dietary factors, body mass index, inflammatory markers, and adipokines.
Elevated circulating ferritin concentrations were associated with higher risk of type 2 diabetes and metabolic syndrome in middle-aged and elderly Chinese independent of obesity, inflammation, adipokines, and other risk factors. Our data support the crucial role of iron overload for metabolic diseases, even in a country with relatively high prevalence of iron deficiency.
铁蛋白浓度升高常常与已明确的糖尿病风险因素聚集在一起，包括肥胖、代谢综合征、慢性炎症以及循环中脂肪因子的改变。然而，很少有研究系统地评估这些风险因素对铁蛋白与糖尿病关联的影响，尤其是在中国人群中。
我们旨在调查中国中老年人群中铁蛋白浓度升高是否与代谢综合征和2型糖尿病的较高风险相关，以及肥胖、炎症和脂肪因子在多大程度上影响这种关联。
2005年，我们在北京和上海对3289名年龄在50 - 70岁的参与者进行了基于人群的横断面调查。测量了空腹血浆铁蛋白、血糖、胰岛素、血脂谱、糖化血红蛋白、炎症标志物、脂肪因子和饮食情况。
男性铁蛋白浓度中位数为155.7 ng/ml，女性为111.9 ng/ml。经过多重调整后，与铁蛋白最低四分位数组相比，最高四分位数组患2型糖尿病（比值比3.26, 95%置信区间2.36 - 4.51）和代谢综合征[比值比2.80（95%置信区间2.24 - 3.49）]的比值比显著更高。在进一步调整饮食因素、体重指数、炎症标志物和脂肪因子后，这些关联仍然显著。
在中国中老年人群中，循环铁蛋白浓度升高与2型糖尿病和代谢综合征的较高风险相关，且独立于肥胖、炎症、脂肪因子和其他风险因素。我们的数据支持铁过载在代谢疾病中的关键作用，即使在一个缺铁患病率相对较高的国家。
