Li Jiang, Bao Weimin, Zhang Tie, Zhou Yun, Yang Hui, Jia Hongbing, Wang Rui, Cao Yongtong, Xiao Cheng
Department of Laboratory Medicine, China-Japan Friendship Hospital, Beijing, China.
Community Health Service Center of Hepingli of Dongcheng District, Beijing, China.
PLoS One. 2017 Dec 22;12(12):e0190310. doi: 10.1371/journal.pone.0190310. eCollection 2017.
Several studies have indicated that elevated levels of circulating ferritin are associated with disturbances in energy metabolism. But none of this gave a clearly pathologic mechanism. We aimed to explore the independent relationship between serum ferritin levels and dyslipidemia.
We performed multivariable logistic regression analyses to estimate the odds ratios (ORs) for dyslipidemia, lipid parameters, the homeostasis model assessment of insulin resistance (HOMA-IR) and the risk of diabetes, according to sex-specific quartiles of serum ferritin by using the data of China Health and Nutrition Survey (2009 CHNS). We used three models to estimate the strength of the correlation. The basic model (Model 1) is without adjustment and the Model 2 and Model 3 are adjusted for demographic, anthropometric, and lifestyle confounding factors.
In both genders, the ORs for high TG level, TC level and LDL-C level increased progressively and for HDL-C decreased across the ferritin quartiles (P<0.001 for trend). After adjustment for confounding factors in different logistic regression models, the results remained unchanged. The ORs for the risk of diabetes and high HOMA-IR level in the highest quartile group of serum ferritin levels were significantly increased in Model 1, but after adjustment for lipid parameters, the ORs for the risk of diabetes was decreased from 1.91 (95% CI: 1.37-2.67; P<0.001 for trend) to 1.48 (95% CI: 1.03-2.12; P = 0.036 for trend) in men, and from 5.40 (95% CI: 3.38-8.63; P<0.001 for trend) to 1.43 (95% CI: 0.83-2.43; P = 0.498 for trend) in women, and the ORs for IR was decreased from 1.86 (95% CI: 1.57-2.20; P<0.001 for trend) to 1.25 (95% CI: 1.05-1.50; P = 0.114 for trend) in men, and from 1.93 (95% CI: 1.63-2.28; P<0.001 for trend) to 1.24 (95% CI: 1.01-1.51; P = 0.012 for trend) in women.
Our results provide evidence that serum ferritin levels are significantly associated with lipid parameters, independent of glucose metabolism disorders and components of metabolic syndrome (MetS). Thus, serum ferritin plays a key role in energy metabolism disorders and may affect glucose metabolism through lipid metabolism.
多项研究表明,循环铁蛋白水平升高与能量代谢紊乱有关。但均未给出明确的病理机制。我们旨在探讨血清铁蛋白水平与血脂异常之间的独立关系。
我们利用中国健康与营养调查(2009年CHNS)的数据,根据血清铁蛋白的性别特异性四分位数,进行多变量逻辑回归分析,以估计血脂异常、血脂参数、胰岛素抵抗稳态模型评估(HOMA-IR)及糖尿病风险的比值比(OR)。我们使用三种模型来估计相关性强度。基本模型(模型1)未进行调整,模型2和模型3针对人口统计学、人体测量学和生活方式混杂因素进行了调整。
在男性和女性中,随着铁蛋白四分位数的升高,高甘油三酯水平、总胆固醇水平和低密度脂蛋白胆固醇水平的OR值逐渐增加而高密度脂蛋白胆固醇水平的OR值降低(趋势P<0.001)。在不同逻辑回归模型中对混杂因素进行调整后,结果保持不变。在模型1中,血清铁蛋白水平最高四分位数组的糖尿病风险和高HOMA-IR水平的OR值显著增加,但在调整血脂参数后,男性糖尿病风险的OR值从1.91(95%CI:1.37-2.67;趋势P<0.001)降至1.48(95%CI:1.03-2.12;趋势P = 0.036),女性从5.40(95%CI:3.38-8.63;趋势P<0.001)降至1.43(95%CI:0.83-2.43;趋势P = 0.498),男性胰岛素抵抗的OR值从1.86(95%CI:1.57-2.20;趋势P<0.001)降至1.25(95%CI:1.05-1.50;趋势P = 0.114),女性从1.93(95%CI:1.63-2.28;趋势P<0.001)降至1.24(95%CI:1.01-1.51;趋势P = 0.012)。
我们的结果提供了证据表明血清铁蛋白水平与血脂参数显著相关,独立于糖代谢紊乱和代谢综合征(MetS)的组成成分。因此,血清铁蛋白在能量代谢紊乱中起关键作用,并且可能通过脂质代谢影响糖代谢。