| Objective: Type 2 Diabetes Mellitus(T2DM)was a metabolic disease with defect of insulin secretion and insulin resistance, characterized by hyperglycemia. In the world, the growth rate of diabetics was about 10% each year. In our country, there would be about 1.2 million people to become to diabetics every year. Currently the disability and mortality caused by diabetes and its chronic complications were only less than that caused by cardiovascular diseases and cancer, which was threatening the human health and lowing down the life quality of the patients. Diabetes was mainly caused by genetic and environmental factors. In recent years, more and more scholars pay attention to the relationship between type 2 diabetes mellitus and microelement. Iron is one of the essential microelements in the body. It plays an important role in maintaining the cell growth and metabolism normally. Serum ferritin is a kind of a brown protein complex which contains the most iron. As an iron storage form, it is synthetized by liver cells. Serum ferritin mainly exists in liver, spleen and bone marrow, one third in liver. Serum ferritin reflects iron storage, and it is an important index to judgment iron deficiency and overload. The abnormal metabolic of serum ferritin may be involved in the occurrence and development of T2DM.In this study, the effect of serum ferritin in T2DM and its chronic complications was investigated through observing the difference of serum ferritin level in the healthy people, diabetes with or without chronic complications and researching the relationship between serum ferritin and fasting blood glucose(FPG), glycosylated hemoglobin(HbA1c), fasting insulin(FINS),insulin resistance index (ROMA-IR), insulin sensitive index(ISI), total cholesterol(TC), triglyceride(TG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein– cholesterol(HDL-C). It provides theory base in prevention and treatment of T2DM and its chronic complications in clinic.Methods: According to standards of diabetic diagnosis and typing put forward by WHO in 1999, a total of 150 patients with T2DM were randomly recruited .These patients were divided into two groups: 30 cases T2DM without chronic complications(group B) and 120 cases T2DM with chronic complications(group C). Group C were further divided into four subgroups: 34 cases with diabetic microangiopathy, 32 cases with diabetic macroangiopathy, 26 cases with diabetic peripheral neuropathy, 28 cases with nonalcoholic fatty liver. At the same time, 30 healthy people (group A) were taken from heath examination people in our hospital. After fasting 12 hours overnight, 5ml blood sample was collected from the elbow vein and separated routinely. Serum was stored at -80℃f or the detection of biochemical marker such as SF,FPG,HbA1c,FINS,TC,TG,LDL-C,HDL-C.1 The detection for serum ferritin level: measured by automatic biochemistry analyzer (DX1800) through chemiluminescence.2 Easurement of the clinical and biochemical markers:①Height and weight were measured. Body mass index (BMI) was calculated (BMI= Height/weight2);②Blood glucose, lipids and hepatic function were measured by all automatic biochemistry analyzer ;③HbA1c were determined by DCA2000+;④Fasting blood insulin was measured by radioimmunoassay. HOMA-IR and ISI were calculated (HOMA-IR =ln(FINS×FPG)/22.5, ISI = - ln (FINS×FPG)).3 Statistical methods: the data were analyzed by statistical software SPSS17.0. Each variable was checked by normal distribution and homogeneity test of variance. Measurement data were presented by mean±standard deviations (χ±s). Analysis of variance (ANOVA) was applied in the comparison among groups, and SNK-q test was used in the comparison between two groups. The measurement data which did not match with the normal distribution was presented by median (percentile rank). In the research of the relationship between SF and other variables, Pearson correlation analysis was used in the variables which matched with normal distribution. And Spearman correlation analysis was used in the variables which did not match with normal distribution. The risk of SF and other variables in T2DM and its chronic complications were analyzed by Logistic multiple stepwise regression. When P <0.05, the variance has significance in statistics.Results:1 There was no significant difference in age ,sex constituent ratio, BMI among group A, group B and group C . The three groups were comparable. There was also no significant difference in course of disease between group B and group C. They were comparable, too. (Table 1)2 TC,TG,LDL-C,FPG in group B and group C were significantly higher than those in group A (P <0.01), and compared with group B, group C was much higher in TC,TG,LDL-C,FPG. HDL-C in group B and group C was significantly lower than that in group A (P <0.01), and group C was lower than group C in HDL-C level. Group C had a higher level in HbA1c and HOMA-IR, and lower level in ISI than group B (P <0.01). (Table 2)3 Serum ferritin level in group B was(187.27±55.96)μg/L which was much higher than group A(96.92±28.14)μg/L (P <0.01). And SF in group C was (241.17±75.02)μg/L which was significantly higher than group A and group B (P <0.01). (Table 2, Fig. 1)4 Comparison of Subgroups in group C: There was no significant difference among subgroups in Serum ferritin level (P=0.064). (Table 3)5 Serum ferritin was in positive correlation with TC,LDL-C,HbA1C,FINS,HOMA - IR(r : 0.48,0.33,0.27,0.53,0.34,0.63;P : 0.002,0.009,0.041,0.002,0.009,0.001), but in negative correlation with HDL-C and ISI(r : -0.42,-0.66;P : 0.003,0.001). Serum ferritin was unrelated with TG and FPG(r =0.13;P =0.085. (Table 4, Fig. 2-9)6 Logistic multiple stepwise regression analysis: With T2DM or not as the dependant variable, SF,TC,LDL-C were the risk factors of T2DM. And with chronic complications or not as the dependant variable, SF,TC,LDL-C, HbA1c,FINS,HOMA-IR were the risk factors of its chronic complications.(Table 5,6)Conclusions:1 Serum ferritin in type 2 diabetes was higher, especially in T2DM with chronic complications.2 High level of serum ferritin was an independent risk factor related the occurrence and development of T2DM and its chronic complication. And it may be a new index to predict T2DM in clinic.3 It would provide a new idea to treat T2DM and its chronic complications by decreasing serum ferritin to normal level. |
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