1 型糖尿病患儿和青少年的铁蛋白水平：与微血管并发症和血糖控制的关系。

Ferritin levels in children and adolescents with type 1 diabetes mellitus: relationship with microvascular complications and glycemic control.

机构信息

Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt.

Department of Pediatrics, Faculty of Medicine, Assiut University, Assiut, Egypt,

出版信息

Arch Endocrinol Metab. 2021 May 18;64(6):720-725. doi: 10.20945/2359-3997000000279.

DOI:10.20945/2359-3997000000279

PMID:34033281

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10528614/

Abstract

OBJECTIVE

Evaluate ferritin levels in children and adolescents with type 1 diabetes mellitus and its relation to diabetic microvascular complications, and metabolic control.

METHODS

This study included 180 children and adolescents with type 1 diabetes mellitus (T1DM) with a mean age of 14.9 ± 3.1 years and 180 apparently normal children matched for age and sex (control group). All children were evaluated with full history taking, thorough clinical examination, laboratory assessment of high-sensitivity C-reactive protein and hemoglobin A1c (HbA1c), and evaluation of the presence of microvascular complications. Serum ferritin levels were measured using electrochemiluminescence immunoassay. The patients were divided into two groups according to the presence or absence of microvascular complications.

RESULTS

Serum ferritin levels were significantly higher in patients with T1DM in both groups compared with healthy controls (p < 0.001). Additionally, patients with microvascular complications had higher serum ferritin concentrations than those without microvascular complications (p < 0.001). Patients with microalbuminuria showed higher ferritin levels compared with patients without microalbuminuria (p < 0.05). Stepwise regression analysis revealed that levels of HbA1c and urinary albumin excretion were independently related to ferritin levels (p < 0.001 for both). On receiver operating characteristic (ROC) curve analysis, a ferritin cutoff value of 163.6 ng/mL differentiated patients with microvascular complications from those without microvascular complications with a sensitivity of 92.1% and specificity of 93.4%.

CONCLUSION

Serum ferritin levels are elevated in T1DM, particularly in patients with microvascular complications.

摘要

目的

评估 1 型糖尿病（T1DM）患儿和青少年的铁蛋白水平及其与糖尿病微血管并发症和代谢控制的关系。

方法

本研究纳入了 180 名平均年龄为 14.9±3.1 岁的 T1DM 患儿（T1DM 组）和 180 名年龄和性别相匹配的正常儿童（对照组）。所有儿童均进行了详细的病史采集、全面的临床检查、高敏 C 反应蛋白和糖化血红蛋白（HbA1c）的实验室评估以及微血管并发症的评估。采用电化学发光免疫分析法测定血清铁蛋白水平。根据是否存在微血管并发症将患者分为两组。

结果

T1DM 组患者的血清铁蛋白水平均显著高于对照组（p<0.001）。此外，合并微血管并发症的患者血清铁蛋白浓度高于无微血管并发症的患者（p<0.001）。微量白蛋白尿患者的铁蛋白水平高于无微量白蛋白尿患者（p<0.05）。逐步回归分析显示，HbA1c 和尿白蛋白排泄水平与铁蛋白水平独立相关（均 p<0.001）。在受试者工作特征（ROC）曲线分析中，铁蛋白截断值为 163.6ng/mL 时，可区分有微血管并发症和无微血管并发症的患者，其敏感性为 92.1%，特异性为 93.4%。