1Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China.
Department of Endocrinology and Metabolism, Shanghai Songjiang District Central Hospital, Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine (Preparatory Stage), Shanghai, China.
Front Endocrinol (Lausanne). 2022 Sep 5;13:942412. doi: 10.3389/fendo.2022.942412. eCollection 2022.
There is still a debate about the relationship between serum iron and metabolic dysfunction-associated fatty liver disease (MAFLD). Furthermore, few relevant studies were conducted in type 2 diabetes mellitus (T2DM). Therefore, this study aimed to explore the association of serum iron levels with MAFLD in Chinese patients with T2DM.
This cross-sectional, real-world study consisted of 1,467 Chinese T2DM patients. MAFLD was diagnosed by abdominal ultrasonography. Based on serum iron quartiles, the patients were classified into four groups. Clinical characteristics were compared among the four groups, and binary logistic analyses were used to assess the associations of serum iron levels and quartiles with the presence of MAFLD in T2DM.
After adjusting for gender, age, and diabetes duration, significantly higher prevalence of MAFLD was found in the second (45.7%), third (45.2%), and fourth (47.0%) serum iron quartiles than in the first quartiles (26.8%), with the highest MAFLD prevalence in the fourth quartile ( < 0.001 for trend). Moreover, increased HOMA2-IR ( = 0.003 for trend) and decreased HOMA2-S ( = 0.003 for trend) were observed across the serum iron quartiles. Fully adjusted binary logistic regression analyses indicated that both increased serum iron levels (OR: 1.725, 95% CI: 1.427 to 2.085, < 0.001) and quartiles ( < 0.001 for trend) were still closely associated with the presence of MAFLD in T2DM patients even after controlling for multiple confounding factors.
There is a positive correlation between the presence of MAFLD and serum iron levels in T2DM patients, which may be attributed to the close association between serum iron and insulin resistance. Serum iron levels may act as one of the indicators for evaluating the risk of MAFLD in T2DM individuals.
关于血清铁与代谢相关脂肪性肝病（MAFLD）之间的关系仍存在争议。此外，在 2 型糖尿病（T2DM）患者中进行的相关研究较少。因此，本研究旨在探讨中国 T2DM 患者血清铁水平与 MAFLD 的关系。
本横断面真实世界研究纳入了 1467 例中国 T2DM 患者。MAFLD 通过腹部超声诊断。根据血清铁四分位数，将患者分为四组。比较四组之间的临床特征，并使用二元逻辑分析评估血清铁水平和四分位数与 T2DM 患者 MAFLD 发生的相关性。
在校正性别、年龄和糖尿病病程后，第二（45.7%）、第三（45.2%）和第四（47.0%）血清铁四分位数的 MAFLD 患病率显著高于第一四分位数（26.8%），第四四分位数的 MAFLD 患病率最高（趋势检验 P<0.001）。此外，血清铁四分位数之间还观察到 HOMA2-IR 增加（趋势检验 P=0.003）和 HOMA2-S 降低（趋势检验 P=0.003）。经完全校正的二元逻辑回归分析表明，血清铁水平升高（OR：1.725，95%CI：1.427 至 2.085，P<0.001）和四分位数（趋势检验 P<0.001）与 T2DM 患者 MAFLD 的发生仍密切相关，即使在控制了多种混杂因素后也是如此。
T2DM 患者 MAFLD 的发生与血清铁水平呈正相关，这可能归因于血清铁与胰岛素抵抗之间的密切关系。血清铁水平可能是评估 T2DM 个体 MAFLD 风险的指标之一。
