General Hospital Oberndorf, Oberndorf, Austria.
Eur J Clin Invest. 2010 Feb;40(2):155-63. doi: 10.1111/j.1365-2362.2009.02238.x. Epub 2009 Dec 27.
Iron overload may contribute to the pathogenesis of insulin resistance. We aimed to investigate the relationship among iron stores, liver transaminases and components of the metabolic syndrome in healthy teenagers in a cross-sectional study.
We determined body mass index (BMI), waist-to-hip-ratio (WHR), blood pressure, liver ultrasound, serum lipids, insulin, fasting glucose, liver transaminase levels, hsCRP, iron parameters in 325 of 341 (95.3%) students (234 men, 16.7 +/- 1.7 years; 91 women, 16.5 +/- 1.7 years) of one single high school. Male and female study participants were allocated to increasing quartiles of body iron stores as assessed by sTfr/ferritin and alanine aminotranspeptidase (ALT) levels, and the distribution of cardiometabolic risk factors along quartiles was analysed. Regression analysis was performed to confirm the independent relationship between parameters.
In male students, BMI, WHR, systolic and diastolic blood pressure, serum triglyceride levels and hsCRP were higher in the top sTfR/ferritin and ALT quartiles compared with the lowest quartiles (P < 0.01 for all parameters). In female students, sTfR/ferritin were not associated with antropomorphic cardiometabolic risk factors but with insulin resistance (HOMA-IR, P = 0.046). Moreover, ALT levels were independently related to BMI, waist and hip circumference, systolic blood pressure, serum triglyceride and insulin concentrations (P < 0.05 for all parameters) in female students.
These results provide evidence for linkage among body iron stores, transaminase activity and the prevalence of cardiometabolic risk factors in apparently healthy, non-obese adolescents even within the range of normal laboratory and anthropomorphic values and suggest that iron stores should be investigated as a potentially modifiable risk factor in healthy teenagers.
铁过载可能导致胰岛素抵抗的发病机制。我们旨在研究铁储存量、肝转氨酶和代谢综合征成分在健康青少年中的关系。
我们测定了 341 名学生中的 325 名(234 名男性,16.7 ± 1.7 岁;91 名女性,16.5 ± 1.7 岁)的体重指数(BMI)、腰臀比(WHR)、血压、肝脏超声、血脂、胰岛素、空腹血糖、肝转氨酶水平、hsCRP、铁参数。男性和女性研究参与者根据血清转铁蛋白受体/铁蛋白(sTfr/ferritin)和丙氨酸氨基转移酶(ALT)水平分为体铁储存量递增四分位数,并分析四分位数内心血管代谢危险因素的分布。进行回归分析以确认参数之间的独立关系。
在男性学生中,sTfR/ferritin 和 ALT 最高四分位数的 BMI、WHR、收缩压和舒张压、血清三酰甘油水平和 hsCRP 均高于最低四分位数(所有参数的 P < 0.01)。在女性学生中,sTfR/ferritin 与人体心血管代谢危险因素无关,但与胰岛素抵抗(HOMA-IR,P = 0.046)有关。此外,ALT 水平与女性学生的 BMI、腰围和臀围、收缩压、血清三酰甘油和胰岛素浓度独立相关(所有参数的 P < 0.05)。
这些结果为体铁储存量、转氨酶活性和心血管代谢危险因素在看似健康、非肥胖青少年中的相关性提供了证据,即使在正常实验室和人体测量值范围内,也表明铁储存量应作为健康青少年的一个潜在可改变的危险因素进行研究。