2형 당뇨병 발생위험인자로서의 혈청 Ferritin의 의의

Serum Ferritin as a Risk Factor in Type 2 Diabetes Mellitus

  • 김정현 (연세대학교 의과대학 소아과학교실) ;
  • 김호성 (연세대학교 의과대학 소아과학교실) ;
  • 김덕희 (연세대학교 의과대학 소아과학교실)
  • Kim, Jeong Hyeon (Department of Pediatrics, College of Medicine, Yonsei University) ;
  • Kim, Ho Seong (Department of Pediatrics, College of Medicine, Yonsei University) ;
  • Kim, Deok Hui (Department of Pediatrics, College of Medicine, Yonsei University)
  • 투고 : 2005.07.07
  • 심사 : 2005.09.13
  • 발행 : 2005.11.15

초록

목 적 : 체내에 축적된 철은 간에서 인슐린제거를 늦게 해 고인슐린혈증을 유발하며, 인슐린 작용을 저해시키고 이로 인해 당신생이 증가해 이차적으로 당뇨병을 유발할 수 있는 것으로 알려져 있다. 따라서 체내의 저장 철을 알 수 있는 가장 좋은 지표인 ferritin을 측정해 2형 당뇨병 발생과의 연관성을 조사하기 위한 연구를 시행하였다. 방 법 : 연세의료원에서 진료받고 있는 1형 당뇨 환자군 36명, 2형 당뇨 환자군 8명, 내당능 장애군 18명을 대상으로 하였으며, 2004년 학교 신체 검사에서 정상 대조군 29명을 선정하여, ferritin과 기타 혈청학적 및 임상적 검사를 실시하였다. 결 과 : 1) 정상대조군, 내당능 장애군, 2형 당뇨 환자군에서 평균 Log ferritin은 각각 $1.33{\pm}0.32$, $1.63{\pm}0.19$, $1.90{\pm}0.30$였으며 정상 대조군에 비해 내당능 장애군(P<0.01)과 2형 당뇨 환자군(P<0.01)에서 유의하게 증가되어 있었다. 2) Log ferritin과 각 변수인자와의 상관관계는 체질량 지수(P<0.01), 수축기 혈압(P<0.01), 공복시 혈당(P<0.01), 공복시 인슐린(P<0.01)과 유의한 관계를 보였다. 결 론 : 정상 대조군에 비해 내당능 장애군과 2형 당뇨 환자군에서 ferritin이 의미 있게 높았으며 ferritin의 증가는 인슐린 저항성과 2형 당뇨병 발생의 유발인자로서의 가능성을 시사한다.

Purpose : Iron accumulation interferes with hepatic insulin extraction and affects insulin synthesis and secretion. The purpose of this study is to investigate the correlation between serum ferritin and type 2 diabetes mellitus. Methods : We compared the serum ferritin level among 18 patients in an impaired glucose tolerance (IGT) group, 36 in a type 1 diabetes group, eight in a type 2 diabetes group and 29 in a healthy control group. The correlation between serum ferritin levels and sex, body mass indices(BMI), blood pressure(BP), serum fasting sugar level and serum fasting insulin level were also analyzed. Results : The mean log ferritin were $1.33{\pm}0.32$(healthy control group), $1.63{\pm}0.19$(IGT group) and $1.90{\pm}0.30$(type 2 diabetes group). In the IGT group, log ferritin was higher than in the healthy control group(P=0.001). The log ferritin of the type 2 diabetes group was higher than that of the healthy control group(P=0.001). Comparing log ferritin to other factors, log ferritin had a significant positive correlation with body mass indices(P<0.001), systolic blood pressure(P=0.001), and fasting glucose(P=0.001), fasting insulin(P=0.002). Conclusion : Compared to the normal healthy group, serum ferritin concentrations were significantly higher in the IGT group and the type 2 diabetes group. The elevation of serum ferritin concentration may be a risk factor of type 2 diabetes mellitus.

키워드

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