Soheilykhah Sedigheh, Mojibian Mahdieh, Jannati Moghadam Maryam
Endocrine Department, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Department of Obstetrics and Gynecology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Int J Reprod Biomed. 2017 Mar;15(3):155-160.
Elevated serum ferritin concentration is associated with insulin resistance and diabetes. Recently it has also been described in gestational diabetes mellitus (GDM).
A prospective study was done to determine whether there was a relationship between serum ferritin concentration in early pregnancy and the risk of GDM.
A study was performed on 1,384 pregnant women with gestational age of 12-16 weeks. A blood sample was obtained for measurement of ferritin in the first trimester. Diagnosis of GDM was done by 75 gr oral glucose tolerance test between 24-28 wk.
Women who developed GDM had a higher concentration of serum ferritin than women who did not develop GDM (p=0.01). A ferritin concentration of 45 ng/ml was calculated to be the 75 percentile for healthy pregnant women. Considering this level 32% in the GDM group and 25.2%of normal subjects exhibited high ferritin levels (p=0.01). The risk of GDM with these high levels of ferritin was 1.4-fold higher than that for subjects with lower concentrations. The Odds Ratio was 1.4 (95% CI= 1-1.87) (p=0.01). After adjusted for age Odds Ratio was 1.38 (95% CI=1.02-1.86) (p=0.03) and after adjustment for pre-pregnancy Body Mass index, the adjusted odds ratio was 1.31 (CI= 0.96-1.79) (p=0.08). After multivariable adjustment (age and body mass index), the adjusted odds ratio was 1.3 (0.95-1.8) (p=0.09).
High serum ferritin can be regarded as a significant risk factor for the development of gestational diabetes.
血清铁蛋白浓度升高与胰岛素抵抗及糖尿病相关。最近在妊娠期糖尿病（GDM）中也有相关描述。
进行一项前瞻性研究以确定孕早期血清铁蛋白浓度与GDM风险之间是否存在关联。
对1384例孕龄为12 - 16周的孕妇进行研究。在孕早期采集血样检测铁蛋白。通过24 - 28周时的75克口服葡萄糖耐量试验诊断GDM。
发生GDM的女性血清铁蛋白浓度高于未发生GDM的女性（p = 0.01）。计算得出健康孕妇铁蛋白浓度的第75百分位数为45 ng/ml。以此水平为参照，GDM组中32%以及正常组中25.2%的受试者铁蛋白水平较高（p = 0.01）。铁蛋白水平高的孕妇发生GDM的风险比铁蛋白浓度低的孕妇高1.4倍。优势比为1.4（95%可信区间 = 1 - 1.87）（p = 0.01）。校正年龄后优势比为1.38（95%可信区间 = 1.02 - 1.86）（p = 0.03），校正孕前体重指数后，校正优势比为1.31（可信区间 = 0.96 - 1.79）（p = 0.08）。经过多变量校正（年龄和体重指数）后，校正优势比为1.3（0.95 - 1.8）（p = 0.09）。
高血清铁蛋白可被视为妊娠期糖尿病发生的一个重要风险因素。
