江西地区铁代谢对糖尿病患者颈动脉粥样硬化的影响

摘要

目的 探讨铁代谢对T2DM患者颈动脉粥样硬化(CAAS)的影响. 方法 对江西地区T2DM患者分为合并CAAS组(A组),不合并CAAS组(B组),另以有CAAS但无糖尿病者为C组,健康体检无糖尿病、CAAS者为D组.对所有人选者均行血糖、血脂、C-P、血清铁蛋白(SF)、血清铁(SI)、总铁结合力(TIBC)、转铁蛋白饱和度(TS)检测. 结果 (1)A、B、C各组铁代谢指标与D组差异均存在统计学意义(P＜0.01);A、B组间及A、C组间的病程、铁代谢指标差异有统计学意义(P＜0.05);SF在A、B、D3组及A、C、D3组患者中依次升高,差异有统计学意义.(2)T2DM的SF水平与BMI、TG、TC无相关性,与病程、HbA1c、FPG、FC-P呈正相关(P＜0.05). 结论 铁代谢与T2DM之间存在着相互影响;铁过量可能会影响到T2DM患者CAAS及并发症的发生;铁诱导的损伤可能会使胰岛β细胞储备功能严重受损,血糖控制更加困难,加重并发症的发展.%Objective To explore the influence of iron metabolism on T2DM patients with carotid atherosclerosis (CAAS). Methods The patients in Jiangxi region with T2DM were divided into the DM+ CAAS group (group A), DM group (group B) , and CAAS without DM group (group C). The healthy people without DM and CAAS were attributed to non-DM + non-CAAS group (group D). The blood glucose, blood lipids, C-peptide, serum ferritin (SF), serum iron (SI), total iron binding capacity (TIBC), and transferrin saturation (TS) were tested in all the subjects. Results (1)The iron metabolism indicators of group A, B, and C were significantly different from those of the group D (P<0. 01). The course of disease and the iron metabolism indicators between the groups A and B and between the groups A and C were significantly different (P<0. 05). The level of SF was increased in an order of the groups A, B, and D and of the groups A, B, and D, and the difference was statistically significant. (2)The SF level of T2DM had no correlation with BMI, TG, and Tci but it had a positive correlation with the course of disease and with the level of HbA1c FPG, and FC-P (P<0. 05). Conclusions There is an interaction between T2DM and iron metabolism, iron overload might affect CAAS and complications of patients with T2DM, and iron-induced damages might lead to severely impaired reserved function of islet β-cells, making the blood glucose control more difficult, thus quickening the development of complications.