·糖尿病大血管病变·

　　基金项目：江西省科技厅科研基金重点资助项目(20111BBG70018-4)

　　作者单位： 330006南昌大学第二附属医院内分泌科(颜玲仙、熊燕、赖晓阳、张美英、章春泉、沈云峰);南昌市中西医结合医院内分泌科(张太阳)

　　通讯作者：熊燕，E-mail：xiongyan6665662@sina.com

　　江西地区铁代谢对糖尿病患者颈动脉粥样硬化的影响

　　颜玲仙 熊燕 张太阳 赖晓阳 张美英 章春泉 沈云峰

　　【摘要】目的探讨铁代谢对T2DM患者颈动脉粥样硬化(CAAS)的影响。方法对江西地区T2DM患者分为合并CAAS组(A组)，不合并CAAS组(B组)，另以有CAAS但无糖尿病者为C组，健康体检无糖尿病、CAAS者为D组。对所有入选者均行血糖、血脂、C-P、血清铁蛋白(SF)、血清铁(SI)、总铁结合力(TIBC)、转铁蛋白饱和度(TS)检测。结果(1)A、B、C各组铁代谢指标与D组差异均存在统计学意义(P<0.01);A、B组间及A、C组间的病程、铁代谢指标差异有统计学意义(P<0.05);SF在A、B、D 3组及A、C、D 3组患者中依次升高，差异有统计学意义。(2)T2DM的SF水平与BMI、TG、TC无相关性，与病程、HbA1c、FPG、FC-P呈正相关(P<0.05)。结论铁代谢与T2DM之间存在着相互影响;铁过量可能会影响到T2DM患者CAAS及并发症的发生;铁诱导的损伤可能会使胰岛β细胞储备功能严重受损，血糖控制更加困难，加重并发症的发展。

　　【关键词】铁代谢障碍;糖尿病;动脉粥样硬化

　　doi:10.3969/j.issn.1006-6187.2012.05.007

　　Influence of iron metabolism on diabetes patients with carotid atherosclerosis in Jiangxi regionYAN Ling-xian, XIONG Yan, ZHANG Tai-yang, et al. Department of Endocrinology, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, China

　　Corresponding author: XIONG Yan, E-mail:xiongyan6665662@sina.com

　　【Abstract】ObjectiveTo explore the influence of iron metabolism on T2DM patients with carotid atherosclerosis (CAAS).MethodsThe patients in Jiangxi region with T2DM were divided into the DM+CAAS group (group A), DM group (group B), and CAAS without DM group (group C). The healthy people without DM and CAAS were attributed to non-DM + non-CAAS group (group D). The blood glucose, blood lipids, C-peptide, serum ferritin (SF), serum iron (SI), total iron binding capacity (TIBC), and transferrin saturation (TS) were tested in all the subjects.Results(1)The iron metabolism indicators of group A, B, and C were significantly different from those of the group D (P<0.01). The course of disease and the iron metabolism indicators between the groups A and B and between the groups A and C were significantly different (P<0.05). The level of SF was increased in an order of the groups A, B, and D and of the groups A, B, and D, and the difference was statistically significant. (2)The SF level of T2DM had no correlation with BMI, TG, and TC; but it had a positive correlation with the course of disease and with the level of HbA1c, FPG, and FC-P (P<0.05). ConclusionsThere is an interaction between T2DM and iron metabolism, iron overload might affect CAAS and complications of patients with T2DM, and iron-induced damages might lead to severely impaired reserved function of islet β-cells, making the blood glucose control more difficult, thus quickening the development of complications.

　　【Key words】 Iron metabolism disorders; Diabetes mellitus; Atherosclerosis