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血清铁蛋白水平与新发 2 型糖尿病风险的关系:中国多省份队列研究的 10 年随访。

The association between serum ferritin levels and the risk of new-onset type 2 diabetes mellitus: A 10-year follow-up of the Chinese Multi-Provincial Cohort Study.

机构信息

Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Institute of Heart, Lung and Blood Vessel Diseases, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China.

Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Institute of Heart, Lung and Blood Vessel Diseases, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China.

出版信息

Diabetes Res Clin Pract. 2017 Aug;130:154-162. doi: 10.1016/j.diabres.2017.05.013. Epub 2017 Jun 20.

Abstract

AIMS

To investigate the association of serum ferritin levels and ferritin level changes with the 10-year risk of new-onset type 2 diabetes mellitus (T2DM).

METHODS

Among 2359 subjects without T2DM at baseline in 2002, 1956 subjects were re-examined in 2007, and 1660 subjects were invited to be re-examined in 2012. Serum ferritin (ng/ml) levels were measured by latex-enhanced turbidimetric immunoassay. Five-year serum ferritin changes were categorized into four groups using the median as the cut-off point. Multivariate logistic regression was performed to examine the independent association of serum ferritin levels and 5-year ferritin level changes with 10-year new-onset T2DM.

RESULTS

At the 10-year follow-up, 205 (12.3%) subjects had developed new-onset T2DM. After adjusting for traditional risk factors and high-sensitivity C-reactive protein, 10-year new-onset T2DM risk was significantly increased in subjects in the highest tertile of baseline serum ferritin levels [odds ratio (OR)=1.80, 95% confidence interval (CI): 1.17-2.79] and in subjects with high serum ferritin levels in both 2002 and 2007 (OR=1.54, 95% CI: 1.01-2.34). After adjusting for baseline fasting blood glucose, the effect was attenuated and became borderline or non-significant.

CONCLUSIONS

Serum ferritin levels and ferritin level changes were associated with 10-year new-onset T2DM risk in the Chinese population, whereas the independent effect awaits validation from studies with larger sample sizes.

摘要

目的

探讨血清铁蛋白水平及其变化与新发 2 型糖尿病(T2DM)10 年发病风险的关系。

方法

在 2002 年无 T2DM 的 2359 例受试者中,1956 例于 2007 年再次接受检查,1660 例受邀于 2012 年再次接受检查。采用乳胶增强比浊免疫法检测血清铁蛋白(ng/ml)水平。以中位数为界点,将 5 年血清铁蛋白变化分为四组。采用多因素 logistic 回归分析血清铁蛋白水平及 5 年铁蛋白水平变化与 10 年新发 T2DM 的独立相关性。

结果

在 10 年随访中,205 例(12.3%)受试者发生新发 T2DM。在调整传统危险因素和高敏 C 反应蛋白后,基线血清铁蛋白水平最高三分位的受试者发生新发 T2DM 的风险显著增加[比值比(OR)=1.80,95%置信区间(CI):1.17-2.79],2002 年和 2007 年血清铁蛋白水平均较高的受试者发生新发 T2DM 的风险也显著增加[OR=1.54,95%CI:1.01-2.34]。调整基线空腹血糖后,其作用减弱且呈边缘或无统计学意义。

结论

血清铁蛋白水平及其变化与中国人群新发 T2DM 风险相关,但其独立作用尚待大样本量研究验证。

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