Department of Gastroenterology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, RO China.
Ann Nutr Metab. 2012;61(1):32-40. doi: 10.1159/000339265. Epub 2012 Jul 11.
Iron overload identified by elevated ferritin concentrations has been implicated in risks of altered glucose metabolism and diabetic complications. The relationship between ferritin and insulin resistance in different gender and ethnicities remains uncertain; this study aimed to investigate it using homeostasis model assessment (HOMA-IR), and to explore whether it is gender-specific.
A total of 524 type 2 diabetic patients were selected cross-sectionally from a cohort participating in a diabetic control study in Taiwan.
Overall, tertiles of ferritin were significantly and dose-dependently associated with elevated fasting plasma glucose, hemoglobin A1c, high-sensitivity C-reactive protein, HOMA-IR levels as well as Western dietary pattern scores generated by factor analysis (all p trend <0.05). Stratified by gender, a 1-tertile ferritin increase significantly correlated with a 0.241-unit increase in HOMA-IR (beta = 0.241, p = 0.001) in female diabetes, but not in male diabetes (beta = 0.072, p = 0.232), after adjusting for demographic, dietary, clinical and inflammatory factors.
Iron overload, which produces elevated levels of ferritin, may augment insulin resistance in female but not in male type 2 diabetes. Longitudinal studies are warranted to establish relationships between iron stores and diabetes development in men and women of different ethnicities.
铁过载通过升高的铁蛋白浓度与葡萄糖代谢改变和糖尿病并发症风险相关。铁蛋白与不同性别和种族人群胰岛素抵抗之间的关系尚不确定；本研究旨在通过稳态模型评估（HOMA-IR）来对此进行研究，并探讨其是否存在性别特异性。
本研究共纳入了来自台湾糖尿病控制研究队列的 524 例 2 型糖尿病患者。
总体而言，铁蛋白三分位与空腹血糖、糖化血红蛋白、高敏 C 反应蛋白、HOMA-IR 水平以及通过因子分析生成的西方饮食模式评分升高呈显著的、剂量依赖性相关（所有 p 趋势<0.05）。按性别分层后，铁蛋白增加 1 个三分位与女性糖尿病患者的 HOMA-IR 增加 0.241 单位显著相关（β=0.241，p=0.001），但与男性糖尿病患者无相关性（β=0.072，p=0.232），调整了人口统计学、饮食、临床和炎症因素后依然如此。
铁过载导致铁蛋白水平升高，可能会增加女性而非男性 2 型糖尿病患者的胰岛素抵抗。需要进行纵向研究以确定不同种族的男性和女性的铁储存与糖尿病发展之间的关系。
