Department of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China.
Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, China.
Nutr Diabetes. 2024 Sep 27;14(1):77. doi: 10.1038/s41387-024-00338-7.
Ferritin, a key indicator of body iron levels, has been reported to associate with type 2 diabetes (T2DM) and the onset of Gestational diabetes mellitus (GDM). However, limited research explores the association between mid-pregnancy ferritin levels and the risk of postpartum abnormal glucose metabolism (AGM) in patients with GDM.
A retrospective cohort study was conducted in 1514 women with GDM recruited from January 2016 to January 2021, and 916 women were included. Demographic characteristics, medical history and family history, pregnancy complications were recorded. Multiple logistic regression models were performed to assess the association between mid-pregnancy ferritin levels and the risk of postpartum AGM.
Following the postpartum oral glucose tolerance test, 307 (33.5%) exhibited AGM. The AGM group had higher mid-pregnancy serum ferritin levels [AGM vs NGT: 23 (11.7, 69) µg/L vs 17.80 (9.85, 40.7) µg/L, P < 0.001] and had a larger proportion of women with ferritin levels ≥30 µg/L (AGM vs NGT: 43.6% vs 31.4%, P < 0.001). Logistic regression analysis demonstrated that women with ferritin levels≥ 30 µg/L had a 1.566 times higher risk of developing postpartum AGM.
These findings indicate that elevated mid-pregnancy ferritin levels are significantly and independently associated with increased postpartum AGM risk in women with previous GDM. Consequently, cautious consideration is necessary for prescribing iron supplements in prenatal care, particularly for non-anemic women with GDM at high risk of developing diabetes after delivery.
铁蛋白是机体铁含量的关键指标，据报道与 2 型糖尿病（T2DM）和妊娠期糖尿病（GDM）的发病有关。然而，有限的研究探讨了妊娠中期铁蛋白水平与 GDM 患者产后异常葡萄糖代谢（AGM）风险之间的关系。
回顾性队列研究纳入了 2016 年 1 月至 2021 年 1 月期间招募的 1514 名 GDM 患者，其中 916 名患者入组。记录了人口统计学特征、病史和家族史、妊娠并发症。采用多因素 logistic 回归模型评估妊娠中期铁蛋白水平与产后 AGM 风险的关系。
产后口服葡萄糖耐量试验后，307 例（33.5%）发生 AGM。AGM 组妊娠中期血清铁蛋白水平较高[AGM 与 NGT：23（11.7，69）µg/L 比 17.80（9.85，40.7）µg/L，P<0.001]，铁蛋白水平≥30µg/L 的患者比例也较大[AGM 与 NGT：43.6%比 31.4%，P<0.001]。logistic 回归分析表明，铁蛋白水平≥30µg/L 的女性产后发生 AGM 的风险增加 1.566 倍。
这些发现表明，妊娠中期铁蛋白水平升高与既往 GDM 妇女产后 AGM 风险增加显著相关且独立相关。因此，在产前保健中，对于有发生糖尿病风险的 GDM 非贫血高风险女性，谨慎考虑铁补充剂的使用是必要的。
