目的：探讨血清铁蛋白（SF）与2型糖尿病患者糖脂代谢、氧化应激和胰岛素抵抗的关系。方法选取研究对象90例，其中2型糖尿病组32例、糖耐量减低（IGT）30例和健康对照组28例。收集和记录患者的一般资料，采用放免法测定 SF 和空腹胰岛素（FIns），全自动生化仪测定空腹血糖（FPG）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）和血肌酐（SCr）等生化指标，高压液相法测定糖化血红蛋白（HbA1 c），比色法测定超氧化物歧化酶（SOD）活性及丙二醛（MDA）、谷胱甘肽过氧化物酶（GSH －Px）含量。结果2型糖尿病组 SF 水平[（184．2±3．12）μg／L]高于 IGT 组[（171．5±2．61）μg／L]，而IGT 组高于健康对照组[（104．1±1．87）μg／L]，差异有统计学意义（P ＜0．05）。SF 与 FIns、MDA、胰岛素抵抗指数、TG、TC 和糖化血红蛋呈正相关（r ＝0．7145，P ＜0．05；r ＝0．5637，P ＜0．05；r ＝0．6358，P ＜0．05；r ＝0．8320， P ＜0．05；r ＝0．5283，P ＜0．01；r ＝0．6243，P ＜0．01）。与 SOD 活性、GSH-Px 含量呈负相关（r ＝0．3413，P ＜0．05；r ＝0．3153，P ＜0．05）。结论2型糖尿病患者体内铁贮备增多；铁超负荷促使氧化应激发生进而导致胰岛素抵抗。%Objective To evaluate the relationship between serum ferritin (SF)and glucose and lipoprotein lipids metabolism,oxidative stress,insulin resistant in type 2 diabetes mellitus.Methods Ninty subjects were select-ed,including 28 controls,30 impaired glucose tolerance(IGT)and 32 type 2 diabetes.The general data (age,height, weight and family history)were collected.The levels of serum ferritin and fasting insulin(FIns)were detected by im-muno-turbidimetry.Serum creatinine(SCr),lipid and fasting plasm glucose(FPG)were detected by automatic bio-chemical analazer.HbA1 c was detected by high pressure liquid chromato-graphy.SOD,MDA and GSH-Px were detec-ted by colorimetry.Results The levels of serum ferritin in patients with type 2 diabetes were significantly higher than that in impaired the glucose tolerance group and healthy subjects[(184.2 ±3.12)μg/L VS.(171.5 ±2.61)μg/L VS.(104.1 ±1.87)μg/L],there were statistical differences(P <0.05).Serum ferritin was positively correlated with FIns,index of insulin resistance(HOMA-IR),TG,TC,HbA1 c and MDA (r =0.7145,P <0.05;r =0.5637,P <0.05;r =0.6358,P <0.05;r =0.8320,P <0.05;r =0.5283,P <0.01;r =0.6243,P <0.01),and negatively correla-ted with SOD,GSH-Px(r =0.3413,P <0.05;r =0.3153,P <0.05).Conclusions The iron stores is increased in pa-tients with type 2 diabetes,iron overload can cause oxidative stress and insulin resistance.
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