Diabetes Care:血清铁蛋白与2型糖尿病患病率相关

　　来自荷兰阿姆斯特丹大学的一项以人口为基础的、多种族的横断面研究表明，对于多种族人群，血清铁蛋白与2型糖尿病患病率，及空腹血糖水平存在正相关关系，这种相关性似乎在女性比男性更为显著。对于不同族群之间性别差异的变异进一步评估是必要的。研究在2012年11月19日在线发表于《糖尿病护理》（Diabetes Care）杂志。

　　适度的体内铁储存水平升高，尽管低于血色素沉着症相关的通常水平，但与糖尿病的病因可能有所关联。研究表明，铁状态（依据血清铁蛋白测定）因性别不同可能表现为显著差异，但已报道的结果并不一致。该研究旨在评价包括非洲苏里南人、南亚苏里南人，以及源自荷兰的男性和女性人群中，血清铁蛋白与2型糖尿病的患病率以及空腹血糖浓度之间的相关性。

　　研究共纳入508例荷兰族裔受试者，597例非洲苏里南人受试者，和339例南亚苏里南人受试者，年龄为35-60岁。2型糖尿病定义为空腹血糖水平≥7.0 mmol/L或自我报告的2型糖尿病诊断。

　　结果表明，血清铁蛋白与2型糖尿病，空腹血糖呈正相关，但性别不同时，该相关性也存在差异。对于所有种族的女性受试者，血清铁蛋白浓度与2型糖尿病均呈正相关关系[比值比（OR）荷兰民族：1.07 （95％可信区间CI 1.01-1.13）；南亚苏里南：1.05 （1.00-1.10）；非洲苏里南：1.05 （1.01-1.10）]，但男性受试者不存在这种相关关系。血清铁蛋白与空腹血糖水平的相关关系，在女性受试者较男性受试者也更为显著。此外，对于非洲苏里南人群，血清铁蛋白和空腹血糖之间、而非2型糖尿病的关联程度中存在的性别差异，比其他族群更为显著（交互作用P值≤0.0001）。

Sex Differences in the Association Between Serum Ferritin and Fasting Glucose in Type 2 Diabetes Among South Asian Surinamese, African Surinamese, and Ethnic Dutch

The population-based SUNSET study

OBJECTIVE 

Moderately elevated iron stores below the levels commonly associated with hemochromatosis have been implicated in the etiology of diabetes. Studies suggest that iron status (measured by serum ferritin) differs significantly according to sex, but inconsistent findings have been reported. Our aim is to test the association between serum ferritin and the prevalence of type 2 diabetes and fasting glucose concentrations in a population-based, multiethnic, cross-sectional study including men and women of African Surinamese, South Asian Surinamese, and ethnic Dutch origin.

RESEARCH DESIGN AND METHODS 

We analyzed data on 508 ethnic Dutch, 597 African Surinamese, and 339 South Asian Surinamese aged 35–60 years. Type 2 diabetes was defined as a fasting plasma glucose level ≥7.0 mmol/L or a self-reported diagnosis.

RESULTS 

Serum ferritin was positively associated with type 2 diabetes and fasting glucose, but differences in the associations according to sex were observed. Serum ferritin concentration was positively associated with type 2 diabetes among women in all ethnic groups (odds ratio [OR] ethnic Dutch: 1.07 [95% CI 1.01–1.13]; OR South Asian Surinamese: 1.05 [1.00–1.10]; OR African Surinamese: 1.05 [1.01–1.10]), but not among men. Serum ferritin was also more strongly associated with fasting glucose in women than in men. Moreover, the magnitude of sex differences in the association between serum ferritin and fasting glucose, but not type 2 diabetes, was more pronounced in the African Surinamese group than in the other ethnic groups (P for interaction ≤0.0001).

CONCLUSIONS 

We found a positive association between serum ferritin and type 2 diabetes and fasting glucose in our multiethnic population, which appeared stronger among women than men. Further evaluation of the variation in sex differences between ethnic groups is warranted, particularly among the African Surinamese, to understand the mechanisms behind these sex differences.