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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。
Objective To investigate the effect of iron metabolism on carotid atherosclerosis (CAAS) in patients with T2DM. Methods T2DM patients in Jiangxi province were divided into combined CAAS group (group A) and non-combined CAAS group (group B). In addition, there was CAAS but no diabetes group C, healthy people without diabetes and CAAS group D. Blood glucose, blood lipids, C-P, serum ferritin (SF), serum iron (SI), total iron binding capacity (TIBC) and transferrin saturation (TS) were measured for all participants. Results (1) The indexes of iron metabolism in groups A, B and C were significantly different from those in group D (P <0.01). The differences in the course of iron metabolism between groups A and B and between groups A and C were statistically significant (P <0.05). SF was increased in turn in groups A, B and D 3 and in groups A, C and D 3, the difference was statistically significant. (2) The level of SF in T2DM was not correlated with BMI, TG and TC, but positively correlated with the course of disease, HbA1c, FPG and FC-P (P <0.05). Conclusion The iron metabolism and T2DM have mutual influence. Iron overload may affect the occurrence of CAAS and complications in patients with T2DM. Iron-induced injury may severely damage the islet β-cell reserve function, make blood glucose control more difficult and aggravate concurrently Development of disease.