目的 探讨中国成人血清铁蛋白（serum ferritin,SF)与糖代谢相关指标（空腹血糖、空腹胰岛素、糖化血红蛋白、胰岛素抵抗指数等)的关联。方法 以2009年中国居民健康与营养调查（China Health and Nutrition Survey,CHNS)的人群为研究对象,研究对象按性别分层,根据SF水平的四分位数分为四组。采用Logistic回归研究SF与糖代谢相关指标的风险关联,限制性立方样条法探索其剂量反应关系。 结果 本研究总共纳入了7271名研究对象,其中男性3276人,女性3995人,男性SF水平显著高于女性;在男性中,与最低SF水平组（Q1)相比,最高SF水平组（Q4)发生高血糖、糖化血红蛋白异常、胰岛素抵抗风险更高（Ptrend<0.05),且存在线性剂量反应关联（Poverall<0.05,Pnonlinear>0.05);在女性中,与较低SF水平组（Q2)相比,最高SF水平组（Q4)发生高血糖、胰岛素抵抗、高胰岛素血症以及糖化血红蛋白异常风险更高（Ptrend<0.05),且SF与前三个指标存在非线性剂量反应关联（Poverall<0.05,Pnonlinear<0.05),但与糖化血红蛋白异常之间存在线性剂量反应关联（Poverall<0.05,Pnonlinear>0.05)。结论 中国成年人SF水平与糖代谢相关指标之间存在剂量反应关联;对于高血糖者,建议SF应维持在现行正常范围内的较低水平。
Abstract
Objective To investigate the association of serum ferritin (SF) with glycemic parameters, including fasting glucose, fasting insulin, glycosylated hemoglobin, and insulin resistance index. Methods The subjects of the 2009 China Health and Nutrition Survey (CHNS) were stratified by sex and divided into four groups according to the quartile of SF level. Logistic regression was used to study the risk association between SF and glucose metabolism-related indexes, and the dose-response relationship was explored by restricted cubic spline. Results A total of 7271 subjects participants were included in this studyin which 3276 were males and 3995 were females and serum ferritin levels were significantly higher in males than females. In males, the highest SF level group (Q4) had a higher risk of hyperglycemia, glycated hemoglobin abnormalities, and insulin resistance compared with the lowest SF level group (Q1) (Ptrend<0.05) with a linear dose-response association (Poverall<0.05, Pnonlinear>0.05). In females, the highest SF level group (Q4) had a higher risk of hyperglycemia, insulin resistance, hyperinsulinemia, and glycated hemoglobin abnormality compared with the lower SF level group (Q2) (Ptrend<0.05). There was a nonlinear dose-response association between SF and the first three indicaters (Poverall<0.05, Pnonlinear<0.05) and a linear dose-response association with glycated hemoglobin abnormalities (Poverall<0.05, Pnonlinear>0.05). Conclusion There is a dose-response association between SF level and glycemic parameters in Chinese adult. For those with hyperglycemia, it isrecommended that SF should be maintained at a lower level within the current normal range.
关键词
血清铁蛋白 /
糖代谢 /
高血糖 /
胰岛素抵抗 /
高胰岛素血症
Key words
serum erritin /
glucose metabolism /
hyperglycaemia /
insulin resistance /
hyperinsulinaemia
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