Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai, China.
Front Endocrinol (Lausanne). 2023 Jul 19;14:1067655. doi: 10.3389/fendo.2023.1067655. eCollection 2023.
Previous studies showed conflicting results linking body iron stores to the risk of gestational diabetes mellitus (GDM) and dyslipidemia. We aim to investigate the relationship between serum ferritin, and the prevalence of GDM, insulin resistance (IR) and hypertriglyceridemia.
A total of 781 singleton pregnant women of gestation in Shanghai General Hospital took part in the retrospective cohort study conducted. The participants were divided into four groups by quartiles of serum ferritin levels (Q1-4). Binary logistic regressions were used to examine the strength of association between the different traits and the serum ferritin (sFer) quartiles separately, where Q1 (lowest ferritin quartile) was taken as the base reference. One-way ANOVA was adopted to compare the averages of the different variables across Sfer quartiles.
Compared with the lowest serum ferritin quartile (Q1), the ORs for Q3, and Q4 in our population were 1.79 (1.01-2.646), and 2.07 (1.089-2.562) respectively and this trend persisted even after adjusted for age and pre-BMI. Women with higher serum ferritin quartile including Q3 (OR=2.182, 95%CI=1.729-5.527, P=0.003) and Q4(OR=3.137, 95%CI=3.137-8.523, P<0.01)are prone to develop insulin resistance disorders. No significant difference was observed between sFer concentrations and gestational hypertriglyceridemia(GTG) in the comparison among these 4 groups across logistic regressions but TG was found positively correlated with increased ferritin values in the second trimester.
Increased concentrations of plasma ferritin in early pregnancy are significantly and positively associated with insulin resistance and incidence of GDM but not gestational dyslipidemia. Further clinical studies are warranted to determine whether it is necessary to encourage pregnant women to take iron supplement as a part of routine antenatal care.
先前的研究结果显示，体内铁储存与妊娠糖尿病（GDM）和血脂异常的风险之间存在矛盾。我们旨在研究血清铁蛋白与 GDM、胰岛素抵抗（IR）和高甘油三酯血症的患病率之间的关系。
本研究采用回顾性队列研究，共纳入上海某医院的 781 名单胎妊娠孕妇。根据血清铁蛋白水平四分位数（Q1-4）将参与者分为四组。采用二元逻辑回归分别检查不同特征与血清铁蛋白（sFer）四分位之间的关联强度，其中 Q1（最低铁蛋白四分位）作为基础参考。采用单因素方差分析比较不同 sFer 四分位组之间的变量平均值。
与最低血清铁蛋白四分位（Q1）相比，我们人群中 Q3 和 Q4 的 OR 值分别为 1.79（1.01-2.646）和 2.07（1.089-2.562），这种趋势在调整年龄和预 BMI 后仍然存在。较高血清铁蛋白四分位组（Q3：OR=2.182，95%CI=1.729-5.527，P=0.003；Q4：OR=3.137，95%CI=3.137-8.523，P<0.01）的女性更容易发生胰岛素抵抗紊乱。在这些四分位组之间的逻辑回归比较中，sFer 浓度与妊娠性高甘油三酯血症（GTG）之间无显著差异，但在第二个三个月中发现 TG 与铁蛋白值的升高呈正相关。
孕早期血浆铁蛋白浓度升高与胰岛素抵抗和 GDM 的发生率显著正相关，但与妊娠血脂异常无关。需要进一步的临床研究来确定是否有必要鼓励孕妇作为常规产前保健的一部分补充铁剂。
