Praveen M, Jain N, Raizada N, Sharma S, Narang S, Madhu S V
Department of Medicine, University College of Medical Sciences (University of Delhi) & GTB Hospital, Dilshad Garden, Delhi, 110095, India.
Department of Endocrinology, Centre for Diabetes Endocrinology & Metabolism, University College of Medical Sciences (University of Delhi) & GTB Hospital, Dilshad Garden, Delhi, 110095, India.
Diabetes Metab Syndr. 2020 Nov-Dec;14(6):1837-1840. doi: 10.1016/j.dsx.2020.09.020. Epub 2020 Sep 14.
Iron deficiency anaemia, although well reported in diabetic nephropathy, has not been well studied in type 2 diabetes patients in the absence of nephropathy. We studied the prevalence of anaemia and iron deficiency in type 2 diabetes patients without nephropathy.
A total of 89 patients were selected for this study. 24 h urine protein less than 500 mg was used as the criteria to rule out diabetic nephropathy. Complete hemogram, iron profile and high sensitivity C reactive protein (hs CRP) levels were performed in each patient.Functional iron deficiency (FID) was defined as serum ferritin more than 100 μg/l with serum transferrin less than 20% and total iron deficiency state was defined as serum ferritin less than 100 μg/l.
Fifteen patients (16.8%)had anaemia out of which 13 had total iron deficiency and one each had functional iron deficiency and normal iron status respectively. Assessment of the iron status overall showed that 49 patients had TID (55.05%), 16 had FID (17.9%)and 24 (27.05%) had normal iron status. The hs-CRP was significantly higher in those with iron deficiency.
The present study found a high prevalence of iron deficiency anaemia in type 2 diabetic patients even in the absence of nephropathy. Most of the diabetic subjects also displayed an iron deficiency state the cause of which needs further investigation.
缺铁性贫血在糖尿病肾病中已有大量报道,但在无肾病的2型糖尿病患者中尚未得到充分研究。我们研究了无肾病的2型糖尿病患者贫血和缺铁的患病率。
本研究共选取89例患者。以24小时尿蛋白小于500mg作为排除糖尿病肾病的标准。对每位患者进行全血细胞计数、铁代谢指标和高敏C反应蛋白(hs-CRP)水平检测。功能性缺铁(FID)定义为血清铁蛋白大于100μg/l且血清转铁蛋白小于20%,总缺铁状态定义为血清铁蛋白小于100μg/l。
15例患者(16.8%)患有贫血,其中13例为总缺铁,1例为功能性缺铁,1例铁状态正常。总体铁状态评估显示,49例患者存在总缺铁(TID,55.05%),16例存在功能性缺铁(FID,17.9%),24例(27.05%)铁状态正常。缺铁患者的hs-CRP显著更高。
本研究发现,即使在无肾病的情况下,2型糖尿病患者中缺铁性贫血的患病率也很高。大多数糖尿病患者也表现出缺铁状态,其原因有待进一步研究。