第二型糖尿病患者血清鐵蛋白濃度與胰島素敏感性降低相關

Serum ferritin correlates with decreased insulin sensitivity in type 2 diabetes

吳靜宜(Ching-Yi Wu)

指導教授 ： 黃孟娟

高雄醫學大學/醫學院/醫學研究所/碩士(2010年)

摘要

前言：研究指出，身體鐵負荷過量與發炎狀態及心血管疾病具相關性。胰島素敏感性在糖尿病併發症的演變中扮演了一個重要的角色。所以本研究目的，主要探討血清鐵蛋白濃度與胰島素阻抗之相關性。
材料與方法：我們募集了442位第二型糖尿病的患者，我們依血清鐵蛋白濃度由低至高將患者三等分為三組，並以QUICKI (Quantitative insulin sensitivity check index)來評估患者胰島素敏感性。
結果：結果發現，三分位血清鐵蛋白濃度與QUICKI (p=0.014)具負相關、與禁食血糖(142.1, 147.6, 154.2 mg/dl, p=0.027)及糖化血色素(7.8, 8.0, 8.1%, p=0.017)具正相關。而代謝症候群相關參數(血壓、三酸甘油酯)也和三分位血清鐵蛋白具正相關，但與高密度脂蛋白則具負相關。經調整干擾因子後(包含年齡、身體質量指數、性別、血壓、糖化血色素、糖尿病罹病年、抽菸、喝酒、飲食因子、三酸甘油酯、高密度脂蛋白、肌酸酐)以多元線性迴歸分析，三分位血清鐵蛋白濃度與QUICKI呈現負相關(beta = -0.006, p = 0.006)。再將小於等於33百分位QUICKI值定義為胰島素敏感性降低，調整上述所有干擾因子後更進ㄧ步以邏輯回歸分析，結果發現，高血清鐵蛋白濃度其胰島素敏感性降低的危險性為低血清鐵蛋白濃度的1.9倍(OR: 1.91, 95% CI: 1.06-3.44)。
結論：第二型糖尿病患者其血漿鐵蛋白濃度與胰島素敏感性降低是具相關性。

關鍵字

胰島素敏感性 ； 鐵蛋白 ； 第二型糖尿病 ； 成年人胰島素抗性

並列摘要

Background:
Iron overload have been implicated in status of inflammation and cardiovascular events. Insulin plays critical roles in progression of diabetic complication. We cross sectionally examined relationships between serum ferritin and insulin sensitivity in type 2 diabetic patients in Taiwan.
Methods and materials:
We cross sectionally recruited 442 type 2 diabetes and insulin sensitivity was assessed as QUICKI (Quantitative insulin sensitivity check index).
Result:
Tertiles of ferritin were significantly associated with fasting plasma glucose, hemoglobin A1c, and QUICKI as well as insulin resistance as HOMA-IR. Tertiles of ferritin significantly and positively correlated with other metabolic syndrome related parameters including blood pressure, triglyceride, central obesity, HDL-C, fasting plasma glucose. Consumption of red meat and white meat were also significantly different among tertiles of ferritin groups. In multiple linear regression analysis adjusted for known risk factors ( including age, BMI, sex, blood pressure, HbA1c, duration of disease , smoking , drinking habit, TG, HDL-C, Creatinine and various dietary factors), ferritin tertiles correlated negatively with QUICKI at increment of -0.006 (beta=-0.006, p=0.006). In multiple logistic modeling, highest tertiles had about 1.9 fold (OR: 1.91, 95% CI: 1.06-3.44) decreasing insulin sensitivity compared to the lowest tertiles of ferritin.
In conclusion, increased ferritin levels may decrease insulin sensitivity in type 2 diabetes.

並列關鍵字

insulin sensitivity ； ferritin ； type 2 diabetes

參考文獻

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