Aregbesola Alex, Voutilainen Sari, Virtanen Jyrki K, Mursu Jaakko, Tuomainen Tomi-Pekka
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Finland.
Ann Clin Biochem. 2017 Jan;54(1):113-120. doi: 10.1177/0004563216646397. Epub 2016 Sep 28.
Background Studies of gender difference in type 2 diabetes have been inconclusive. We investigated gender difference in type 2 diabetes and the contribution of body iron, as assessed by serum ferritin to this difference. Methods We performed cross-sectional ( n = 1707) and prospective ( n = 1506) analyses in males and females aged 53-73 years in 1998-2001. Type 2 diabetes diagnosis was determined by questionnaire, blood glucose measurements and record linkage to type 2 diabetes registers. Gender difference in type 2 diabetes and serum ferritin contribution to the difference was examined in multivariable logistic and Cox regression models. Gender difference in fasting plasma glucose and insulin and homeostasis model assessment of insulin resistance was examined in linear regression analysis. Results In the cross-sectional analysis, a total of 201 type 2 diabetes cases were observed (males = 111 [55.2%] vs. female = 90 [44.8%], P = 0.032), and in adjusted models, males had higher odds of type 2 diabetes (OR = 1.61, 95% CI 1.10 to 2.34); higher fasting plasma glucose (β = 0.28, 95% CI 0.15 to 0.41), fasting plasma insulin (β = 0.73, 95% CI 0.26 to 1.19) and homeostasis model assessment of insulin resistance (β = 0.11, 95% CI 0.04 to 0.17). In the prospective analysis, males had increased risk of type 2 diabetes (HR = 1.46, 95% CI 1.03 to 2.07). With serum ferritin introduction (100 µg/L, log-transformed) into the models, the type 2 diabetes prevalence (OR = 1.35, 95% CI 0.91 to 1.99) and incidence (HR = 1.38, 95% CI 0.96 to 1.97) were appreciably attenuated. Conclusions These data suggest a gender difference in type 2 diabetes, with a higher prevalence and increased type 2 diabetes risk in males. Body iron explains about two-fifths and one-fifth of the gender difference in type 2 diabetes prevalence and incidence, respectively.
关于2型糖尿病性别差异的研究尚无定论。我们调查了2型糖尿病的性别差异以及血清铁蛋白评估的体内铁对这种差异的影响。方法：我们在1998 - 2001年对年龄在53 - 73岁的男性和女性进行了横断面分析（n = 1707）和前瞻性分析（n = 1506）。通过问卷调查、血糖测量以及与2型糖尿病登记册的记录关联来确定2型糖尿病诊断。在多变量逻辑回归和Cox回归模型中检验2型糖尿病的性别差异以及血清铁蛋白对该差异的影响。在线性回归分析中检验空腹血糖、胰岛素的性别差异以及胰岛素抵抗的稳态模型评估。结果：在横断面分析中，共观察到201例2型糖尿病病例（男性 = 111例[55.2%]，女性 = 90例[44.8%]，P = 0.032），在调整模型中，男性患2型糖尿病的几率更高（OR = 1.61，95% CI 1.10至2.34）；空腹血糖更高（β = 0.28，95% CI 0.15至0.41），空腹血浆胰岛素更高（β = 0.73，95% CI 0.26至1.19）以及胰岛素抵抗的稳态模型评估更高（β = 0.11，95% CI 0.04至0.17）。在前瞻性分析中，男性患2型糖尿病的风险增加（HR = 1.46，95% CI 1.03至2.07）。将血清铁蛋白（100 µg/L，对数转换）纳入模型后，2型糖尿病患病率（OR = 1.35，95% CI 0.91至1.99）和发病率（HR = 1.38，95% CI 0.96至1.97）明显降低。结论：这些数据表明2型糖尿病存在性别差异，男性患病率更高且2型糖尿病风险增加。体内铁分别解释了2型糖尿病患病率和发病率性别差异的约五分之二和五分之一。
