2型糖尿病患者血清铁代谢相关指标检测意义

摘要

目的：探讨2型糖尿病患者血清铁调素（Hepcidin）、铁蛋白（SF）、转铁蛋白受体（sTfR）和血清铁（SI）的变化与临床意义。方法130例2型糖尿病患者，分为两组，A 组为微量蛋白尿组45例（mAlb30～300 mg／24 h），B 组为正常蛋白尿组85例（mAlb＜30 mg／24 h），另选同期45例健康体检者为对照 C 组。各组均取空腹晨血5 ml 离心取血清检测铁调素，SF，sTfR 和 SI 含量。结果A 组患者血清铁调素和 SF 水平（42.27±32.12 ng／ml，211.6±107.2 ng／ml）均显著高于B 组（26.12±18.36 ng／ml，179.1±109.7 ng／ml；P 均＜0.05）和 C 组（9.47±1.65 ng／ml，84.41±47.10 ng／ml），（P 均＜0.01）；B 组患者铁调素和 SF 水平显著高于 C 组（P 均＜0.01）。各组之间 SI 水平（15.26μmol／L，18.65μmol／L，17.71μmol／L）和 sTfR 水平（1.12μg／L，1.05μg／L，1.16μg／L）差异均无统计学意义（t ＝0.469～1.176，P 均＞0.05）。相关分析显示，2型糖尿病患者铁调素与 SF 呈显著正相关（r＝0.329，P ＜0.05），铁调素与 sTfR，SI 无显著相关性（r＝0.169，P ＞0.05；r＝－0.149，P ＞0.05）。结论2型糖尿病患者体内存在以血清铁调素、SF 增高为主的铁超负荷和铁代谢紊乱，并与尿微量清蛋白的排泄呈正相关。因此，检测血清铁调素和 SF 可作为糖尿病早期肾功能损伤的重要预测因子。%Objective To investigate the change and clinical significance of serum hepcidin,serum ferritin (SF),transferrin re-ceptor (sTfR)and serum iron (SI)in patients in type 2 diabetes(T2DM).Methods 130 patients with T2DM were divided into 2 groups according to the 24 hour urine microalbumin (mAlb)quantitative:group A for trace microalbumin group 45 ca-ses (mAlb30~300 mg/24 h),group B for normal albuminuria group of 85 cases,an alternate period of 45 cases of healthy physical examination for group C (control group).Results Serum hepcidin and SF of group A (42.27±32.12 ng/ml,211.6 ±107.2 ng/ml)were significantly higher than those in group B (26.12 ± 18.36 ng/ml,179.1 ± 109.7 ng/ml)and the healthy control group (P <0.05),hepcidin and SF of group B was significantly higher than that of the control group (9.47 ±1.65 ng/ml,84.41±47.10 ng/ml,P <0.01),SI and transferrin receptor(sTfR)has no statistical significance between the three groups (P >0.05).Correlation analysis showed that patients with type 2 diabetes hepcidin was positively related with SF (P <0.05),hepcidin and sTfR,SI had no significant correlation.Conclusion These results indicated that there existed serum hepcidin and SF increased iron overload and iron metabolism disorder in type 2 diabetes.Therefore,detection of serum iron and SF can be used as a predictor of diabetes early renal damage.