Klisic Aleksandra, Kavaric Nebojsa, Kotur Jelena, Ninic Ana
Primary Health Care Center, University of Montenegro, Faculty of Medicine, Podgorica, Montenegro.
Department for Medical Biochemistry, University of Belgrade, Faculty of Pharmacy, Belgrade, Serbia.
Arch Med Sci. 2021 May 10;19(4):987-994. doi: 10.5114/aoms/132757. eCollection 2023.
Markers of iron homeostasis are related to insulin resistance (IR) in adults. However, studies in children and adolescents are scarce and show contradictory results. The aim was to evaluate the potential relationship between iron status markers and IR. Additionally, no previous study has explored the mutual effect of biomarkers of iron homeostasis and inflammation (i.e. high sensitivity C-reactive protein (hsCRP)), and adipokines (i.e. retinol-binding protein 4 (RBP4)) on IR in the cohort of adolescent girls.
A total of 60 girls age between 16 and 19 years were included in the study. Serum levels of ferritin, transferrin, soluble transferrin receptor (sTfR), hsCRP, and RBP4 were measured by immunonephelometry. Homeostasis model assessment of insulin resistance (HOMA-IR) and iron homeostasis indexes were calculated. Univariate and multivariate binary logistic regression analysis were used to investigate the possible independent associations of the examined biomarkers. Principal component analysis was used to examine their mutual effect on HOMA-IR in the studied girls.
Ferritin, sTfR, hsCRP and RBP4 were significant predictors for higher HOMA-IR in univariate analysis ( = 0.020, = 0.009, = 0.007, = 0.003, respectively). Multivariate regression analysis after adjustment for waist circumference (WC) showed that serum sTfR levels remained positively associated with higher HOMA-IR ( = 0.044). Factorial analysis revealed that the obesity-inflammation related factor (i.e., WC and hsCRP) and adipokine-acute phase protein related factor (i.e., RBP4 and ferritin) showed significant differences between HOMA-IR < 2.5 and HOMA-IR ≥ 2.5.
Serum sTfR levels are independently associated with HOMA-IR, whereas higher serum ferritin levels together with higher RBP4 are related to higher HOMA-IR in adolescent girls.
铁稳态标志物与成年人的胰岛素抵抗（IR）相关。然而，关于儿童和青少年的研究较少，且结果相互矛盾。本研究旨在评估铁状态标志物与IR之间的潜在关系。此外，以往尚无研究探讨铁稳态生物标志物与炎症（即高敏C反应蛋白（hsCRP））以及脂肪因子（即视黄醇结合蛋白4（RBP4））对青春期女孩队列中IR的相互影响。
本研究共纳入60名年龄在16至19岁之间的女孩。采用免疫比浊法测定血清铁蛋白、转铁蛋白、可溶性转铁蛋白受体（sTfR）、hsCRP和RBP4水平。计算胰岛素抵抗的稳态模型评估（HOMA-IR）和铁稳态指标。采用单因素和多因素二元逻辑回归分析来研究所检测生物标志物的可能独立关联。主成分分析用于检验它们对所研究女孩HOMA-IR的相互影响。
在单因素分析中，铁蛋白、sTfR、hsCRP和RBP4是HOMA-IR升高的显著预测因子（分别为P = 0.020、P = 0.009、P = 0.007、P = 0.003）。在调整腰围（WC）后的多因素回归分析显示，血清sTfR水平仍与较高的HOMA-IR呈正相关（P = 0.044）。因子分析显示，肥胖-炎症相关因子（即WC和hsCRP）以及脂肪因子-急性期蛋白相关因子（即RBP4和铁蛋白）在HOMA-IR < 2.5和HOMA-IR≥2.5之间存在显著差异。
血清sTfR水平与HOMA-IR独立相关，而较高的血清铁蛋白水平与较高的RBP4水平共同与青春期女孩较高的HOMA-IR相关。
