Fu Shimin, Li Feifei, Zhou Jianguo, Liu Zhiping
From the Department of Endocrinology (SF, FL, ZL), The First Affiliated Hospital of Chongqing Medical University, Chongqing; and Department of Oncology (JZ), Affiliated Hospital of Zunyi Medical University, Guizhou, China.
Medicine (Baltimore). 2016 Jan;95(2):e2383. doi: 10.1097/MD.0000000000002383.
Biological and epidemiological evidence have found that gestational diabetes mellitus (GDM) may be correlated with body iron status and dietary iron intake. Therefore, we investigated the relationship between dietary iron intake and body iron status and GDM risk.We conducted a systematic search in Embase, PubMed, Web of Science, and Cochrane Library up to April 2015. Prospective cohort studies or case-control studies which appraised the relationship between body iron status, dietary iron intake, and GDM risk were included. Relative risks (RRs), standard mean difference (SMD), and 95% confidence intervals [CIs] were used to measure the pooled data.A total of 8 prospective cohort studies and 7 case-control studies were in accordance with inclusive criteria, and 14 studies were included in meta-analysis. The overall RR comparing the highest and lowest levels of serum ferritin was 3.22 (95% CI: 1.73-6.00) for prospective cohort studies. Serum ferritin of GDM group is markedly higher than that of control (0.88 ng/mL; 95% CI: 0.40-1.35 ng/mL) for case-control studies. The comparison between the highest and the lowest serum ferritin levels and dietary total iron levels revealed pooled RRs of 1.53 (95% CI: 1.17-2.00) and 1.01 (95% CI: 1.00-1.01) for prospective cohort studies, respectively. The combined SMD comparing serum transferrin levels of cases and controls was -0.02 μmol/L (95% CI: -0.22 to 0.19 μmol/L) for case-control studies.Increased higher ferritin levels were significantly correlated with higher risk of GDM, and higher heme iron levels may be correlated with higher risk of GDM; however, the present conclusion did not constitute definitive proof that dietary total iron or serum transferrin have relation to GDM.
生物学和流行病学证据表明，妊娠期糖尿病（GDM）可能与机体铁状态及膳食铁摄入量相关。因此，我们研究了膳食铁摄入量与机体铁状态及GDM风险之间的关系。我们在截至2015年4月的Embase、PubMed、科学网和考克兰图书馆进行了系统检索。纳入评估机体铁状态、膳食铁摄入量与GDM风险之间关系的前瞻性队列研究或病例对照研究。采用相对风险（RRs）、标准均数差（SMD）和95%置信区间[CIs]来汇总数据。共有8项前瞻性队列研究和7项病例对照研究符合纳入标准，14项研究纳入荟萃分析。前瞻性队列研究中，血清铁蛋白最高水平与最低水平比较的总体RR为3.22（95%CI：1.73 - 6.00）。病例对照研究中，GDM组血清铁蛋白显著高于对照组（0.88 ng/mL；95%CI：0.40 - 1.35 ng/mL）。前瞻性队列研究中，血清铁蛋白最高水平与最低水平以及膳食总铁水平比较的汇总RR分别为1.53（95%CI：1.17 - 2.00）和1.01（95%CI：1.00 - 1.01）。病例对照研究中，病例组与对照组血清转铁蛋白水平比较的合并SMD为 -0.02 μmol/L（95%CI： -0.22至0.19 μmol/L）。较高的铁蛋白水平升高与较高的GDM风险显著相关，较高的血红素铁水平可能与较高的GDM风险相关；然而，目前的结论并不构成膳食总铁或血清转铁蛋白与GDM有关的确凿证据。
