Department of Endocrinology, Shengjing Hospital of China Medical University, No. 39, Huaxiang Road, Tiexi District, Shenyang, 110022, Liaoning, China.
Eur J Nutr. 2024 Feb;63(1):67-78. doi: 10.1007/s00394-023-03250-5. Epub 2023 Sep 29.
Iron metabolism has been found to be closely related to gestational diabetes mellitus (GDM). Excessive ferritin levels were shown to be related to an increased risk of GDM because of iron overload which may lead to insulin resistance and β-cell injury by enhancing oxidative stress and inflammatory responses. On the contrary, insufficient ferritin levels can cause a number of obstetric complications, such as high incidence rates of anaemia and gestational hypertension. Therefore, high or low ferritin levels may have adverse effects on the mother and the foetus, putting clinicians in a dilemma when giving pregnant women iron supplements. This also explains why there have been more conflicting findings in the studies on dietary or oral iron supplementation during pregnancy. Hence, there is an urgent need for more evidence and strategies for appropriate recommendations for ferritin levels and iron supplementation during pregnancy to prevent iron insufficiency without causing iron overload and increasing the risk of GDM. Therefore, we gave an updated review on the association of GDM with ferritin metabolism, ferritin levels and iron supplementation based on the summary of the latest research.
铁代谢与妊娠期糖尿病（GDM）密切相关。铁过载会导致过多的铁蛋白水平，从而增加 GDM 的风险，因为这可能通过增强氧化应激和炎症反应导致胰岛素抵抗和β细胞损伤。相反，铁蛋白水平不足会导致多种产科并发症，如贫血和妊娠高血压的发生率较高。因此，铁蛋白水平过高或过低可能对母亲和胎儿都有不良影响，这使得临床医生在给孕妇补铁时陷入两难境地。这也解释了为什么在怀孕期间饮食或口服补铁的研究中出现了更多相互矛盾的发现。因此，迫切需要更多的证据和策略，以适当推荐妊娠期铁蛋白水平和铁补充剂，以预防铁不足而不会导致铁过载和增加 GDM 的风险。因此，我们根据最新研究的总结，对 GDM 与铁蛋白代谢、铁蛋白水平和铁补充剂的关系进行了更新综述。
