摘要
目的探讨血清铁蛋白与胰岛素抵抗及代谢综合征发生风险的关系,为代谢综合征的早期预防与控制提供理论依据。方法数据来源于2015年深圳市南山区开展的慢性病与营养监测调查,采用多阶段整群随机抽样方法选取651名18岁及以上居民为研究对象进行问卷调查、体格检查和生化检测。采用易侕软件和R软件进行方差分析和χ^2检验。采用多因素logistic回归分析血清铁蛋白与胰岛素抵抗及代谢综合征之间的关联。结果本研究共纳入650名信息完善者,男性血清铁蛋白的几何均值(192.91 ng/ml,95%CI:178.49~208.50 ng/ml)高于女性(59.32 ng/ml,95%CI:53.10~66.26 ng/ml),差异有统计学意义(P<0.05)。将男性和女性研究对象根据血清铁蛋白实际值分别分为3组,其中男性300人分为血清铁蛋白低组(7.79~146.67 ng/ml)100人、血清铁蛋白中间组(146.68~262.88 ng/ml)100人、血清铁蛋白高组(262.89~1941.51 ng/ml)100人;女性350人分为血清铁蛋白低组(2.35~43.10 ng/ml)117人、血清铁蛋白中间组(43.11~109.88 ng/ml)116人、血清铁蛋白高组(109.89~673.33 ng/ml)117人。不同血清铁蛋白组研究对象的胰岛素抵抗以及代谢综合征患病率差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,经混杂因素调整,男性血清铁蛋白高组胰岛素抵抗(OR=2.53,95%CI:1.31~4.89)和代谢综合征(OR=2.15,95%CI:1.17~3.93)的患病风险较高,均有统计学意义(P<0.05)。进一步调整胰岛素抵抗之后,男性血清铁蛋白水平与代谢综合征的相关性无统计学意义(P>0.05)。而女性血清铁蛋白水平与胰岛素抵抗及代谢综合征的相关性均无统计学意义(P>0.05)。结论男性血清铁蛋白增高与胰岛素抵抗相关,胰岛素抵抗可能是介导血清铁蛋白与代谢综合征的中间桥梁,值得进一步探讨和研究。
Objective To explore the correlation between serum ferritin and insulin resistance or the development of metabolic syndrome,and to provide the basis for early prevention and control of metabolic syndrome.Methods Date were from the China Health and Nutrition Survey which was conducted among residents of the Nanshan District in Shenzhen in 2015.A multi-stage random sampling method was used to select 651 residents(≥18 years old)as the subjects,the investigation was performed by questionnaire,physical examination and biochemical test.The analysis of variance andχ^2 test were used to analyze the data,the used software was Empower States software and R software.Multivariate logistic regression analysis was used to analyze the correlation between serum ferritin and the insulin resistance or the development of metabolic syndrome.Results There were 650 subjects with complete information in this study,the geometric mean value(192.91 ng/ml,95%CI:178.49-208.50 ng/ml)of serum ferritin in males was significantly higher than that(59.32 ng/ml,95%CI:53.10-66.26 ng/ml)in females(P<0.05).According to serum ferritin level,male or female subjects were divided into 3 subgroups,respectively.The male group(300 subjects)was divided into low serum ferritin subgroup(7.79-146.67 ng/ml,100 subjects),middle serum ferritin subgroup(146.68-262.88 ng/ml,100 subjects)and high serum ferritin subgroup(262.89-1941.51 ng/ml,100 subjects);also the female group(350 subjects)was divided into low serum ferritin subgroup(2.35-43.10 ng/ml,117 subjects),middle serum ferritin subgroup(43.11-109.88 ng/ml,116 subjects)and high serum ferritin subgroup(109.89-673.33 ng/ml,117 subjects).There were statistically significant differences of the morbidities of insulin resistance and metabolic syndrome in different serum ferritin subgroups(P<0.05).Multivariate logistic regression analysis showed that after adjusting confounding factors,the risk of insulin resistance(OR=2.53,95%CI:1.31-4.89)and metabolic syndrome(OR=2.15,95%CI:1.17-3.93)in male high serum ferritin subgroup was higher(P<0.05).After further adjusting insulin resistance,the correlation between serum ferritin and metabolic syndrome in males was not statistically significant(P>0.05).The correlation between serum ferritin and insulin resistance or metabolic syndrome in females was not statistically significant(P>0.05).Conclusion Elevated serum ferritin in males is positively correlated to insulin resistance,the insulin resistance may be the intermediate bridge between serum ferritin and metabolic syndrome.
作者
欧阳斌发
周娟
赵丹
徐健
郝丽萍
彭晓琳
OUYANG Bin-fa;ZHOU Juan;ZHAO Dan;XU Jian;HAO Li-ping;PENG Xiao-lin(Department of Oncology,Injury Prevention and Nutrition,Shenzhen Nanshan Centre for Chronic Disease Control,Shenzhen,Guangdong Province 518051,China)
出处
《中国慢性病预防与控制》
CAS
CSCD
北大核心
2020年第3期165-170,共6页
Chinese Journal of Prevention and Control of Chronic Diseases
基金
深圳市卫计委资助项目(SZSJ2017001)
深圳市南山区科技创新局资助项目(2018039)
深圳市科创委基础研究项目(JCYJ20180302144310603)
中国营养学会营养科研基金———帝斯曼专项科研基金(CNS-DSM2018A34)。
