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孕妇铁水平及其与妊娠期糖尿病的关联：一项系统评价和荟萃分析。

Maternal Iron Levels and Association With Gestational Diabetes: A Systematic Review and Meta-Analysis.

作者信息

Wang Jinguang, Chen Zhen-Yu, Shen Jian, Ni Huan-Juan, Sun Jingli

机构信息

Department of Obstetrics and Gynecology, General Hospital of Northern Theater Command, No. 83, Wenhua Road, Shenhe District, Shenyang 110016, China.

出版信息

J Nutr Metab. 2025 Apr 24;2025:1772306. doi: 10.1155/jnme/1772306. eCollection 2025.

DOI:10.1155/jnme/1772306
PMID:40313887
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12045692/
Abstract

This systematic review aimed to assess the association of iron level with gestational diabetes mellitus (GDM) risk. The relevant articles published between January 1, 1995 and January 17, 2023 were identified through a systematic literature search. This study used random effects to summarize the relative risks (RRs) 95% confidence intervals (CIs) of GDM risk and standardized mean differences. This study investigated the association of ferritin exposure with GDM combined with dose-response analysis and explored both linear and nonlinear trends. This meta-analysis selected 30 studies with serum ferritin (SF), 18 studies with serum iron (SI), 4 studies with serum transferrin receptor (sTfR), 5 studies with total iron binding capacity (TIBC), and 4 studies with transferrin (TRF). The summarized RRs comparing persons with the highest concentration categories of SF with the lowest concentration categories of SF with an unadjusted odds ratio were 2.05 (1.67-2.53;  = 62.8%, < 0.001,  = 6.76, < 0.001) and with an adjusted odds ratio were 1.82 (1.54-2.14;  = 12.9%, =0.312,  = 7.21, < 0.001). Linear dose-response showed that an increase in SF of 5 μg/L increased the risk of GDM by 2.66% (1.026 [95% CI: 1.017, 1.036],  = 5). The nonlinear dose-response relationship also indicates that the increased SF is consistently associated with an increasing risk of GDM. High ferritin, high iron levels, and low TIBC are associated with an increased risk of GDM.

摘要

本系统评价旨在评估铁水平与妊娠期糖尿病（GDM）风险之间的关联。通过系统的文献检索，确定了1995年1月1日至2023年1月17日期间发表的相关文章。本研究采用随机效应模型总结GDM风险的相对风险（RRs）、95%置信区间（CIs）和标准化均数差。本研究通过剂量反应分析研究了铁蛋白暴露与GDM的关联，并探讨了线性和非线性趋势。本荟萃分析纳入了30项关于血清铁蛋白（SF）的研究、18项关于血清铁（SI）的研究、4项关于血清转铁蛋白受体（sTfR）的研究、5项关于总铁结合力（TIBC）的研究以及4项关于转铁蛋白（TRF）的研究。未调整比值比时，将SF浓度最高组与最低组人群进行比较，汇总RRs为2.05（1.67 - 2.53；I² = 62.8%，P < 0.001，Z = 6.76，P < 0.001）；调整比值比后，汇总RRs为1.82（1.54 - 2.14；I² = 12.9%，P = 0.312，Z = 7.21，P < 0.001）。线性剂量反应显示，SF每增加5μg/L，GDM风险增加2.66%（1.026 [95% CI：1.017，1.036]，P = 5）。非线性剂量反应关系也表明，SF升高与GDM风险增加始终相关。高铁蛋白、高铁水平和低TIBC与GDM风险增加相关。

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