Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
School of Public Health, Capital Medical University, Beijing, China.
J Diabetes Investig. 2020 May;11(3):707-718. doi: 10.1111/jdi.13170. Epub 2019 Dec 2.
AIMS/INTRODUCTION: The relationship between ferritin and the risk of gestational diabetes mellitus (GDM) has not been established. Thus, we carried out a meta-analysis based on the current literature.
We searched relevant databases on Embase, PubMed, Cochrane Library and Web of Science before 10 May 2019 to determine the relationship between ferritin and the risk of GDM. The relative risks and 95% confidence intervals of GDM risk were summarized using a random effects model. Studies using categories of ferritin as exposure were combined by dose-response analysis. We carried out both linear and non-linear trends. We also carried out subgroup analysis, whether or not the studies adjusted for potential confounders, and meta-regression analysis to explore the source of heterogeneity. Sensitivity analysis was carried out to explore the robustness of the meta-analysis results.
A total of 10 studies involving 4,690 participants were identified. The summary relative risk comparing persons with the highest concentration categories of ferritin with the lowest concentration categories of ferritin was 1.87 (95% confidence interval 1.50-2.34; I = 20.1%). Linear dose-response showed that an increase in ferritin of 10 μg/L increased the risk of GDM by 8% (1.08, 95% confidence interval 1.05-1.13, I = 55.1%; n = 4). A non-linear dose-response relationship also showed a consistently increasing risk of GDM with increased ferritin. No evidence of publication bias was detected.
The findings from this meta-analysis suggest that increased ferritin levels are associated with an increased risk of GDM; however, we require further prospective cohort studies to confirm the results, especially the dose-response relationship between ferritin and GDM.
目的/引言：铁蛋白与妊娠糖尿病（GDM）风险之间的关系尚未确定。因此，我们基于现有文献进行了荟萃分析。
我们在 2019 年 5 月 10 日之前在 Embase、PubMed、Cochrane 图书馆和 Web of Science 上搜索了相关数据库，以确定铁蛋白与 GDM 风险之间的关系。使用随机效应模型总结 GDM 风险的相对风险和 95%置信区间。使用铁蛋白暴露分类的研究通过剂量反应分析进行合并。我们进行了线性和非线性趋势分析。我们还进行了亚组分析，无论研究是否调整了潜在混杂因素，以及荟萃回归分析以探索异质性的来源。进行敏感性分析以探索荟萃分析结果的稳健性。
共纳入 10 项研究，涉及 4690 名参与者。比较铁蛋白最高浓度组与最低浓度组的个体的汇总相对风险为 1.87（95%置信区间 1.50-2.34；I²=20.1%）。线性剂量反应显示，铁蛋白增加 10μg/L 可使 GDM 风险增加 8%（1.08，95%置信区间 1.05-1.13，I²=55.1%；n=4）。非线性剂量反应关系也显示出铁蛋白升高与 GDM 风险增加呈一致的相关性。未发现发表偏倚的证据。
本荟萃分析的结果表明，铁蛋白水平升高与 GDM 风险增加相关；然而，我们需要进一步的前瞻性队列研究来证实这些结果，特别是铁蛋白与 GDM 之间的剂量反应关系。
