目的:铁代谢可直接或间接影响2型糖尿病的发生发展。本荟萃分析和系统评价旨在分析血清铁代谢指标与2型糖尿病的相关性。
方法:在PubMed和Embase数据库中搜索有关血清铁代谢指标(铁,铁蛋白,转铁蛋白,hepcidin和可溶性转铁蛋白受体)和自2006年1月以来的2型糖尿病。从纳入的研究中提取相关数据,并进行荟萃分析。
结果:共分析了12项病例对照和队列研究。在12项研究中,图11描述了血清铁蛋白水平与2型糖尿病之间的相关性。血清铁蛋白浓度中位数和高血清铁蛋白浓度与2型糖尿病的风险显着相关(比值比[OR]1.20,95%置信区间[CI]1.08-1.33和OR1.43,95%CI1.29-1.59,分别)。然而,低浓度与2型糖尿病风险无关(OR0.99,95%CI0.89~1.11).血清可溶性转铁蛋白受体与2型糖尿病之间无显著关联,而在中位和高比值亚组中,可溶性转铁蛋白受体与铁蛋白比值与2型糖尿病风险呈显著负相关(OR0.71,95%CI0.51,0.99和OR0.65,95%CI0.45~0.95).
结论:血清铁蛋白升高是2型糖尿病的危险因素之一,可溶性转铁蛋白受体与铁蛋白比值与2型糖尿病风险呈负相关.系统评价显示血清转铁蛋白和铁调素可能与糖尿病的发生发展直接或间接相关。
OBJECTIVE: Iron metabolism can directly or indirectly affect the occurrence and development of type 2 diabetes. This meta-analysis and systematic
review aimed to analyze the association between serum iron metabolism indicators and type 2 diabetes.
METHODS: The databases PubMed and Embase were searched for studies on the correlations between serum iron metabolism indicators (iron, ferritin, transferrin, hepcidin and soluble transferrin receptor) and type 2 diabetes since January 2006. Relevant data were extracted from the included studies, and meta-analysis was carried out.
RESULTS: A total of 12 case-control and cohort studies were analyzed. Of the 12 studies, 11 described the correlation between serum ferritin levels and type 2 diabetes. The median and high serum ferritin concentrations were significantly associated with the risks of type 2 diabetes (odds ratio [OR] 1.20, 95% confidence interval [CI] 1.08-1.33 and OR 1.43, 95% CI 1.29-1.59, respectively). However, the low concentration was not correlated with the risk of type 2 diabetes (OR 0.99, 95% CI 0.89-1.11). No significant association was observed between serum soluble transferrin receptor and type 2 diabetes, whereas the soluble transferrin receptor-to-ferritin ratio was significantly inversely related to the risk of type 2 diabetes in the median and high ratio subgroups (OR 0.71, 95% CI 0.51, 0.99 and OR 0.65, 95% CI 0.45-0.95).
CONCLUSIONS: The elevated serum ferritin was one of the risk factors for type 2 diabetes, and soluble transferrin receptor-to-ferritin ratio was inversely related to the risk of type 2 diabetes. A systematic
review showed that serum transferrin and hepcidin might be directly or indirectly related to the development of diabetes.