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Article(id=1199334721894314939, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1199334721185477563, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.2403.2023.1031, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1668441600000, receivedDateStr=2022-11-15, revisedDate=null, revisedDateStr=null, acceptedDate=1672588800000, acceptedDateStr=2023-01-02, onlineDate=1763873280260, onlineDateStr=2025-11-23, pubDate=1714233600000, pubDateStr=2024-04-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1763873280260, onlineIssueDateStr=2025-11-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1763873280260, creator=13701087609, updateTime=1763873280260, updator=13701087609, issue=Issue{id=1199334721185477563, tenantId=1146029695717560320, journalId=1189873630562394117, year='2024', volume='49', issue='4', pageStart='367', pageEnd='488', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1763873280092, creator=13701087609, updateTime=1763874025072, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1199337845925183534, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1199334721185477563, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1199337845925183535, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1199334721185477563, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=380, endPage=386, ext={EN=ArticleExt(id=1199334722137584575, articleId=1199334721894314939, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Association between serum ferritin levels and body fat distribution in patients with type 2 diabetes mellitus, columnId=1190310109000602400, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Clinical Research, runingTitle=null, highlight=null, articleAbstract=

Objective To explore the relationship between serum ferritin levels and body fat distribution in patients with type 2 diabetes mellitus (T2DM). Methods A retrospective analysis was conducted on 151 patients with T2DM who were hospitalized in the Department of Endocrinology of the First Hospital of Lanzhou University from June to November 2020, and all the patients were divided into high serum ferritin (n=50) and normal serum ferritin (n=101) groups according to their serum ferritin levels. The visceral fat area (VFA), subcutaneous fat area (SFA), liver fat, height, weight and waist circumference (WC) were measured, as well as blood glucose, lipid indexes, body mass index (BMI) and visceral adiposity index (VAI) were also calculated. t-test or nonparametric test was used to compare the differences between the two groups, and the relationship between serum ferritin levels and body fat distribution was analyzed by Pearson or Spearman correlation analysis, multiple linear regression and logistic regression. Results The VAI and WC were significantly higher in high serum ferritin group [3.13(2.16,4.58) and (96.66±7.78) cm] than in normal serum ferritin group [2.66(1.66,3.81) and (91.96±9.75) cm, P<0.05]. The prevalence of central obesity and dyslipidemia was higher in high serum ferritin group (88.0% and 90.0%) than in normal serum ferritin group (68.3% and 75.2%); and the composition ratios of poor glycemic control and insulin resistance (96.0% and 62.0%) were also higher than in normal serum ferritin group (78.2% and 40.6%) (P<0.05), there were no statistically significant differences in BMI, VFA, and SFA levels, as well as antidiabetic drug use and chronic complications of diabetes mellitus between the two groups (P>0.05). Serum ferritin levels in T2DM patients were positively correlated with VAI, WC, triglyceride (TG), fasting blood glucose (FPG), HbA1c, dyslipidemia and serum creatinine (r=0.171, 0.207, 0.187, 0.243, 0.270, 0.162, 0.162; P<0.05), and negatively correlated with age, sex and diabetes course (r=-0.191, -0.434, -0.352; P<0.05). Multivariate linear regression analysis showed that in male T2DM patients, duration of diabetes and FPG were risk factors for increased levels of serum ferritin. However, WC and VAI did not significantly affect serum ferritin levels. In female patients with T2DM, the course of diabetes, TG and VAI were the factors influencing serum ferritin (P<0.05). Conclusion Dyslipidemia and visceral fat accumulation are risk factors for elevated serum ferritin levels in female T2DM patients.

, correspAuthors=Jing-Fang Liu, authorNote=null, correspAuthorsNote=
E-mail:
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目的 探讨2型糖尿病(T2DM)患者血清铁蛋白水平与体脂分布的关系。方法 收集2020年6-11月在兰州大学第一医院内分泌科住院的151例T2DM患者进行回顾性分析。所有患者根据血清铁蛋白水平分为高血清铁蛋白组(n=50)与正常血清铁蛋白组(n=101)。测量两组患者的血糖、血脂，以及内脏脂肪面积(VFA)、皮下脂肪面积(SFA)、肝脂肪、身高、体重和腰围(WC)，计算体重指数(BMI)和内脏肥胖指数(VAI)，并进行组间比较；采用Pearson或Spearman相关性分析及多元线性回归分析血清铁蛋白水平与体脂分布的相关性。结果 高血清铁蛋白组VAI和WC均明显高于正常血清铁蛋白组[分别为3.13(2.16，4.58) vs. 2.66(1.66，3.81)，(96.66±7.78) cm vs. (91.96±9.75) cm，P<0.05]。高血清铁蛋白组中心性肥胖和血脂异常的患病率明显高于正常血清铁蛋白组(分别为88.0% vs. 68.3%，90.0% vs. 75.2%，P<0.05)，且血糖控制差、胰岛素抵抗的构成比也高于正常血清铁蛋白组(分别为96.0% vs. 78.2%、62.0% vs. 40.6%，P<0.05)，而两组间BMI、VFA、SFA水平，以及降糖药物使用情况和糖尿病慢性并发症差异无统计学意义(P>0.05)。T2DM患者血清铁蛋白水平与VAI、WC、三酰甘油(TG)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血脂异常、血清肌酐(SCr)呈正相关(r=0.171、0.207、0.187、0.243、0.270、0.162、0.162，P<0.05)，与年龄、性别和糖尿病病程呈负相关(r=-0.191、-0.434、-0.352，P<0.05)。多元线性回归显示，在男性T2DM患者中，糖尿病病程和FPG是血清铁蛋白水平增高的危险因素，但WC及VAI对血清铁蛋白的影响不明显；而在女性T2DM患者中，糖尿病病程、TG和VAI是血清铁蛋白水平增高的危险因素(P<0.05)。结论 女性T2DM患者的血脂紊乱和内脏脂肪增加是血清铁蛋白水平增高的危险因素。

, correspAuthors=刘靖芳, authorNote=null, correspAuthorsNote=
刘靖芳，E-mail：
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陈重阳，硕士研究生，主要从事糖尿病及其并发症发病机制研究

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陈重阳，硕士研究生，主要从事糖尿病及其并发症发病机制研究

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陈重阳，硕士研究生，主要从事糖尿病及其并发症发病机制研究

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Diabetes Care, 2016, 39(1): 82-91., articleTitle=Insulin resistance and inflammation in hypogonadotropic hypogonadism and their reduction after testosterone replacement in men with type 2 diabetes, refAbstract=null)], funds=[Fund(id=1199334728752001154, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, awardId=81960155, language=EN, fundingSource=National Natural Science Foundation of China(81960155), fundOrder=null, country=null), Fund(id=1199334728869441677, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, awardId=81960155, language=CN, fundingSource=国家自然科学基金(81960155), fundOrder=null, country=null), Fund(id=1199334728944939154, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, awardId=20JR10RA690, language=EN, fundingSource=Natural Science Foundation of Gansu Province(20JR10RA690), fundOrder=null, country=null), Fund(id=1199334729028825242, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, awardId=20JR10RA690, language=CN, fundingSource=甘肃省自然科学基金(20JR10RA690), fundOrder=null, country=null), Fund(id=1199334729121099938, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, awardId=ldyyyn2020-01, language=EN, fundingSource=Internal Hospital Foundation of the First Hospital of Lanzhou University(ldyyyn2020-01), fundOrder=null, country=null), Fund(id=1199334729246929069, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, awardId=ldyyyn2020-01, language=CN, fundingSource=兰州大学第一医院院内基金(ldyyyn2020-01), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1199334723844666313, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, xref=1, ext=[AuthorCompanyExt(id=1199334723853054922, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, companyId=1199334723844666313, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu 730000, China), AuthorCompanyExt(id=1199334723857249227, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, companyId=1199334723844666313, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1兰州大学第一临床医学院，甘肃兰州 730000)]), AuthorCompany(id=1199334723932746701, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, xref=2, ext=[AuthorCompanyExt(id=1199334723941135310, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, companyId=1199334723932746701, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2Department of Endocrinology, the First Hospital of Lanzhou University, Lanzhou, Gansu 730000, China), AuthorCompanyExt(id=1199334723949523919, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, companyId=1199334723932746701, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2兰州大学第一医院内分泌科，甘肃兰州 730000)])], figs=[ArticleFig(id=1199334727661482054, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, language=EN, label=Tab.1, caption=

Comparison of clinical data between two groups of T2DM patients

, figureFileSmall=null, figureFileBig=null, tableContent=
指标高血清铁蛋白组(n=50)正常血清铁蛋白组(n=101)P
年龄(岁, $\bar{x}±s$)55.3±12.060.0±7.90.015

糖尿病病程[年, M(Q1,

Q3)]

4.00(0.42, 10.00)3.00(10.00, 15.00)0.003
SBP(mmHg, $\bar{x}±s$)130.12±15.99132.93±17.620.343
DBP(mmHg, $\bar{x}±s$)80.12±12.6878.40±10.740.384
TC(mmol/L, $\bar{x}±s$)4.53±0.944.08±0.940.007
TG[mmol/L, M(Q1, Q3)]2.04(1.43, 2.80)1.55(1.11, 2.13)0.002
HDL(mmol/L, $\bar{x}±s$)0.97±0.151.01±0.190.157
LDL(mmol/L, $\bar{x}±s$)3.02±0.692.69±0.750.010
FPG(mmol/L, $\bar{x}±s$)9.95±3.338.50±2.490.008
2hPG(mmol/L, $\bar{x}±s$)17.24±5.2816.74±4.870.566
HbA1c(%, $\bar{x}±s$)10.09±2.228.55±2.04<0.001
HMOA-IR[M(Q1, Q3)]3.49(2.10, 4.69)2.46(1.95, 3.93)0.064
BUN(mmol/L, $\bar{x}±s$)5.65±1.385.90±1.650.376
SCr(umol/L, $\bar{x}±s$)67.64±12.4162.87±12.370.027
25-OH-D3(ng/ml, $\bar{x}±s$)10.54±5.1711.04±5.060.569
BMI(kg/m2, $\bar{x}±s$)25.55±2.9824.63±3.310.101
WC(cm, $\bar{x}±s$)96.66±7.7891.96±9.750.003
VAI[M(Q1, Q3)]3.13(2.16, 4.58)2.66(1.66, 3.81)0.035
VFA(cm2, $\bar{x}±s$)112.78±35.86104.76±35.080.191
SFA(cm2, $\bar{x}±s$)215.00±51.03203.09±67.080.228
), ArticleFig(id=1199334727757951051, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, language=CN, label=表1, caption=

两组T2DM患者临床资料比较

, figureFileSmall=null, figureFileBig=null, tableContent=
指标高血清铁蛋白组(n=50)正常血清铁蛋白组(n=101)P
年龄(岁, $\bar{x}±s$)55.3±12.060.0±7.90.015

糖尿病病程[年, M(Q1,

Q3)]

4.00(0.42, 10.00)3.00(10.00, 15.00)0.003
SBP(mmHg, $\bar{x}±s$)130.12±15.99132.93±17.620.343
DBP(mmHg, $\bar{x}±s$)80.12±12.6878.40±10.740.384
TC(mmol/L, $\bar{x}±s$)4.53±0.944.08±0.940.007
TG[mmol/L, M(Q1, Q3)]2.04(1.43, 2.80)1.55(1.11, 2.13)0.002
HDL(mmol/L, $\bar{x}±s$)0.97±0.151.01±0.190.157
LDL(mmol/L, $\bar{x}±s$)3.02±0.692.69±0.750.010
FPG(mmol/L, $\bar{x}±s$)9.95±3.338.50±2.490.008
2hPG(mmol/L, $\bar{x}±s$)17.24±5.2816.74±4.870.566
HbA1c(%, $\bar{x}±s$)10.09±2.228.55±2.04<0.001
HMOA-IR[M(Q1, Q3)]3.49(2.10, 4.69)2.46(1.95, 3.93)0.064
BUN(mmol/L, $\bar{x}±s$)5.65±1.385.90±1.650.376
SCr(umol/L, $\bar{x}±s$)67.64±12.4162.87±12.370.027
25-OH-D3(ng/ml, $\bar{x}±s$)10.54±5.1711.04±5.060.569
BMI(kg/m2, $\bar{x}±s$)25.55±2.9824.63±3.310.101
WC(cm, $\bar{x}±s$)96.66±7.7891.96±9.750.003
VAI[M(Q1, Q3)]3.13(2.16, 4.58)2.66(1.66, 3.81)0.035
VFA(cm2, $\bar{x}±s$)112.78±35.86104.76±35.080.191
SFA(cm2, $\bar{x}±s$)215.00±51.03203.09±67.080.228
), ArticleFig(id=1199334727892168783, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, language=EN, label=Tab.2, caption=

Comparison of composition ratios of different indexes between the high serum ferritin and normoferritin groups [n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
指标高血清铁蛋白组(n=50)正常血清铁蛋白组(n=101)P
性别<0.001
男42(84.0)56(55.4)
女8(16.0)45(44.6)
血糖控制0.005
好2(4.0)22(21.8)
差48(96.0)79(78.2)
胰岛素抵抗0.013
有31(62.0)41(40.6)
无19(38.0)60(59.4)
高血压0.689
有29(58.0)62(61.4)
无21(42.0)39(38.6)
血脂异常0.033
有45(90.0)76(75.2)
无5(10.0)25(24.8)
脂肪肝0.946
有29(58.0)58(57.4)
无21(42.0)43(42.6)
体重0.410
正常18(36.0)47(46.5)
超重23(46.0)36(35.6)
肥胖9(18.0)18(17.8)
中心性肥胖0.009
是44(88.0)69(68.3)
否6(12.0)32(36.7)
糖尿病肾病0.199
有19(38.0)28(27.7)
无31(62.0)73(72.3)
视网膜病变0.401
有46(93.9)99(98.0)
无3(6.1)2(2.0)
周围神经病变0.149
正常4(8.2)3(3.0)
轻度19(38.8)29(28.7)
中度14(28.6)46(45.5)
重度12(24.5)23(22.8)
骨量异常0.911
正常18(36.0)33(32.7)
骨量减少7(14.0)14(13.8)
骨质疏松25(50.0)54(53.5)
降糖方案0.905
二甲双胍4(21.1)11(28.2)
二甲双胍+DPP-Ⅳi4(21.1)4(10.3)
二甲双胍+SGLT-2i1(5.3)5(12.8)
二甲双胍+磺酰脲类1(5.3)4(10.3)
二甲双胍+糖苷酶抑制剂5(26.3)8(20.5)
二甲双胍+胰岛素1(5.3)2(5.1)
二甲双胍+胰岛素+DPP-Ⅳi1(5.3)2(5.1)
二甲双胍+胰岛素+SGLT-2i2(10.5)3(7.7)
), ArticleFig(id=1199334728030580819, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, language=CN, label=表2, caption=

两组间不同指标构成比的比较[例(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
指标高血清铁蛋白组(n=50)正常血清铁蛋白组(n=101)P
性别<0.001
男42(84.0)56(55.4)
女8(16.0)45(44.6)
血糖控制0.005
好2(4.0)22(21.8)
差48(96.0)79(78.2)
胰岛素抵抗0.013
有31(62.0)41(40.6)
无19(38.0)60(59.4)
高血压0.689
有29(58.0)62(61.4)
无21(42.0)39(38.6)
血脂异常0.033
有45(90.0)76(75.2)
无5(10.0)25(24.8)
脂肪肝0.946
有29(58.0)58(57.4)
无21(42.0)43(42.6)
体重0.410
正常18(36.0)47(46.5)
超重23(46.0)36(35.6)
肥胖9(18.0)18(17.8)
中心性肥胖0.009
是44(88.0)69(68.3)
否6(12.0)32(36.7)
糖尿病肾病0.199
有19(38.0)28(27.7)
无31(62.0)73(72.3)
视网膜病变0.401
有46(93.9)99(98.0)
无3(6.1)2(2.0)
周围神经病变0.149
正常4(8.2)3(3.0)
轻度19(38.8)29(28.7)
中度14(28.6)46(45.5)
重度12(24.5)23(22.8)
骨量异常0.911
正常18(36.0)33(32.7)
骨量减少7(14.0)14(13.8)
骨质疏松25(50.0)54(53.5)
降糖方案0.905
二甲双胍4(21.1)11(28.2)
二甲双胍+DPP-Ⅳi4(21.1)4(10.3)
二甲双胍+SGLT-2i1(5.3)5(12.8)
二甲双胍+磺酰脲类1(5.3)4(10.3)
二甲双胍+糖苷酶抑制剂5(26.3)8(20.5)
二甲双胍+胰岛素1(5.3)2(5.1)
二甲双胍+胰岛素+DPP-Ⅳi1(5.3)2(5.1)
二甲双胍+胰岛素+SGLT-2i2(10.5)3(7.7)
), ArticleFig(id=1199334728181575776, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, language=EN, label=Tab.3, caption=

Correlation between ferritin levels and other indicators in patients with type 2 diabetes mellitus

, figureFileSmall=null, figureFileBig=null, tableContent=
变量rP
年龄-0.1910.019
性别-0.434<0.001
糖尿病病程-0.352<0.001
TC0.1100.179
TG0.1870.022
LDL0.1140.164
血脂异常0.1620.047
FPG0.2430.003
HbA1c0.2700.001
血糖控制0.1410.084
胰岛素抵抗0.0570.483
SCr0.1620.047
WC0.2070.011
VAI0.1710.036
中心性肥胖0.1570.054
), ArticleFig(id=1199334728265461862, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, language=CN, label=表3, caption=

T2DM患者铁蛋白水平与其他各指标的相关性

, figureFileSmall=null, figureFileBig=null, tableContent=
变量rP
年龄-0.1910.019
性别-0.434<0.001
糖尿病病程-0.352<0.001
TC0.1100.179
TG0.1870.022
LDL0.1140.164
血脂异常0.1620.047
FPG0.2430.003
HbA1c0.2700.001
血糖控制0.1410.084
胰岛素抵抗0.0570.483
SCr0.1620.047
WC0.2070.011
VAI0.1710.036
中心性肥胖0.1570.054
), ArticleFig(id=1199334728382902382, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, language=EN, label=Tab.4, caption=

Multiple linear regression analysis of serum ferritin and predictive variables in different genders

, figureFileSmall=null, figureFileBig=null, tableContent=
性别模型预测变量β(95%CI)P
男性1年龄-0.084(-6.095~2.647)0.435
糖尿病病程-0.234(-14.772~-0.810)0.029
WC0.154(-1.208~8.889)0.134
TC0.211(-245.086~335.400)0.758
TG-0.467(-232.274~129.072)0.572
LDL-0.245(-417.800~279.623)0.695
FPG0.209(-4.898~34.792)0.138
HbA1c0.097(-15.796~33.430)0.478
SCr0.046(-3.240~5.196)0.646
VAI0.616(-56.079~136.419)0.409
2糖尿病病程-0.242(-14.210~-1.894)0.011
WC0.156(-0.730~8.505)0.098
FPG0.243(4.157~30.551)0.011
VAI0.174(-0.722~23.465)0.065
女性1年龄-0.010(-5.068~4.763)0.950
糖尿病病程-0.469(-10.228~-1.936)0.005
WC-0.132(-4.448~1.620)0.352
TC-0.718(-268.264~93.380)0.335
TG1.477(7.054~300.073)0.040
LDL0.648(-108.690~307.436)0.341
FPG0.150(-8.390~21.161)0.388
HbA1c-0.117(-27.249~13.099)0.483
SCr0.195(-1.118~4.748)0.219
VAI-1.217(-102.230~5.957)0.080
2糖尿病病程-0.357(-8.011~-1.241)0.008
TG1.197(26.917~221.980)0.013
VAI-0.950(-75.204~-0.010)0.050
), ArticleFig(id=1199334728525508728, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1199334721894314939, language=CN, label=表4, caption=

不同性别人群血清铁蛋白与预测变量的多元线性回归分析

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性别模型预测变量β(95%CI)P
男性1年龄-0.084(-6.095~2.647)0.435
糖尿病病程-0.234(-14.772~-0.810)0.029
WC0.154(-1.208~8.889)0.134
TC0.211(-245.086~335.400)0.758
TG-0.467(-232.274~129.072)0.572
LDL-0.245(-417.800~279.623)0.695
FPG0.209(-4.898~34.792)0.138
HbA1c0.097(-15.796~33.430)0.478
SCr0.046(-3.240~5.196)0.646
VAI0.616(-56.079~136.419)0.409
2糖尿病病程-0.242(-14.210~-1.894)0.011
WC0.156(-0.730~8.505)0.098
FPG0.243(4.157~30.551)0.011
VAI0.174(-0.722~23.465)0.065
女性1年龄-0.010(-5.068~4.763)0.950
糖尿病病程-0.469(-10.228~-1.936)0.005
WC-0.132(-4.448~1.620)0.352
TC-0.718(-268.264~93.380)0.335
TG1.477(7.054~300.073)0.040
LDL0.648(-108.690~307.436)0.341
FPG0.150(-8.390~21.161)0.388
HbA1c-0.117(-27.249~13.099)0.483
SCr0.195(-1.118~4.748)0.219
VAI-1.217(-102.230~5.957)0.080
2糖尿病病程-0.357(-8.011~-1.241)0.008
TG1.197(26.917~221.980)0.013
VAI-0.950(-75.204~-0.010)0.050
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陈重阳 1 , 吕小羽 1 , 赵阳婷 1 , 刘露霞 1 , 王亚雯 1 , 李凯 1 , 刘靖芳 1, 2, *
解放军医学杂志 | 临床研究 2024,49(4): 380-386
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解放军医学杂志 | 临床研究 2024, 49(4): 380-386
2型糖尿病患者血清铁蛋白水平与体脂分布的相关性分析
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陈重阳1, 吕小羽1, 赵阳婷1, 刘露霞1, 王亚雯1, 李凯1, 刘靖芳1, 2, *
作者信息
  • 1兰州大学第一临床医学院，甘肃兰州 730000
  • 2兰州大学第一医院内分泌科，甘肃兰州 730000

    • 陈重阳，硕士研究生，主要从事糖尿病及其并发症发病机制研究

通讯作者:

刘靖芳，E-mail：
Association between serum ferritin levels and body fat distribution in patients with type 2 diabetes mellitus
Chong-Yang Chen1, Xiao-Yu Lyu1, Yang-Ting Zhao1, Lu-Xia Liu1, Ya-Wen Wang1, Kai Li1, Jing-Fang Liu1, 2, *
Affiliations
  • 1The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu 730000, China
  • 2Department of Endocrinology, the First Hospital of Lanzhou University, Lanzhou, Gansu 730000, China
出版时间: 2024-04-28 doi: 10.11855/j.issn.0577-7402.2403.2023.1031
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摘要
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目的 探讨2型糖尿病(T2DM)患者血清铁蛋白水平与体脂分布的关系。方法 收集2020年6-11月在兰州大学第一医院内分泌科住院的151例T2DM患者进行回顾性分析。所有患者根据血清铁蛋白水平分为高血清铁蛋白组(n=50)与正常血清铁蛋白组(n=101)。测量两组患者的血糖、血脂，以及内脏脂肪面积(VFA)、皮下脂肪面积(SFA)、肝脂肪、身高、体重和腰围(WC)，计算体重指数(BMI)和内脏肥胖指数(VAI)，并进行组间比较；采用Pearson或Spearman相关性分析及多元线性回归分析血清铁蛋白水平与体脂分布的相关性。结果 高血清铁蛋白组VAI和WC均明显高于正常血清铁蛋白组[分别为3.13(2.16，4.58) vs. 2.66(1.66，3.81)，(96.66±7.78) cm vs. (91.96±9.75) cm，P<0.05]。高血清铁蛋白组中心性肥胖和血脂异常的患病率明显高于正常血清铁蛋白组(分别为88.0% vs. 68.3%，90.0% vs. 75.2%，P<0.05)，且血糖控制差、胰岛素抵抗的构成比也高于正常血清铁蛋白组(分别为96.0% vs. 78.2%、62.0% vs. 40.6%，P<0.05)，而两组间BMI、VFA、SFA水平，以及降糖药物使用情况和糖尿病慢性并发症差异无统计学意义(P>0.05)。T2DM患者血清铁蛋白水平与VAI、WC、三酰甘油(TG)、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血脂异常、血清肌酐(SCr)呈正相关(r=0.171、0.207、0.187、0.243、0.270、0.162、0.162，P<0.05)，与年龄、性别和糖尿病病程呈负相关(r=-0.191、-0.434、-0.352，P<0.05)。多元线性回归显示，在男性T2DM患者中，糖尿病病程和FPG是血清铁蛋白水平增高的危险因素，但WC及VAI对血清铁蛋白的影响不明显；而在女性T2DM患者中，糖尿病病程、TG和VAI是血清铁蛋白水平增高的危险因素(P<0.05)。结论 女性T2DM患者的血脂紊乱和内脏脂肪增加是血清铁蛋白水平增高的危险因素。

糖尿病，2型  /  血清铁蛋白  /  体脂分布  /  内脏肥胖指数  /  胰岛素抵抗

Objective To explore the relationship between serum ferritin levels and body fat distribution in patients with type 2 diabetes mellitus (T2DM). Methods A retrospective analysis was conducted on 151 patients with T2DM who were hospitalized in the Department of Endocrinology of the First Hospital of Lanzhou University from June to November 2020, and all the patients were divided into high serum ferritin (n=50) and normal serum ferritin (n=101) groups according to their serum ferritin levels. The visceral fat area (VFA), subcutaneous fat area (SFA), liver fat, height, weight and waist circumference (WC) were measured, as well as blood glucose, lipid indexes, body mass index (BMI) and visceral adiposity index (VAI) were also calculated. t-test or nonparametric test was used to compare the differences between the two groups, and the relationship between serum ferritin levels and body fat distribution was analyzed by Pearson or Spearman correlation analysis, multiple linear regression and logistic regression. Results The VAI and WC were significantly higher in high serum ferritin group [3.13(2.16,4.58) and (96.66±7.78) cm] than in normal serum ferritin group [2.66(1.66,3.81) and (91.96±9.75) cm, P<0.05]. The prevalence of central obesity and dyslipidemia was higher in high serum ferritin group (88.0% and 90.0%) than in normal serum ferritin group (68.3% and 75.2%); and the composition ratios of poor glycemic control and insulin resistance (96.0% and 62.0%) were also higher than in normal serum ferritin group (78.2% and 40.6%) (P<0.05), there were no statistically significant differences in BMI, VFA, and SFA levels, as well as antidiabetic drug use and chronic complications of diabetes mellitus between the two groups (P>0.05). Serum ferritin levels in T2DM patients were positively correlated with VAI, WC, triglyceride (TG), fasting blood glucose (FPG), HbA1c, dyslipidemia and serum creatinine (r=0.171, 0.207, 0.187, 0.243, 0.270, 0.162, 0.162; P<0.05), and negatively correlated with age, sex and diabetes course (r=-0.191, -0.434, -0.352; P<0.05). Multivariate linear regression analysis showed that in male T2DM patients, duration of diabetes and FPG were risk factors for increased levels of serum ferritin. However, WC and VAI did not significantly affect serum ferritin levels. In female patients with T2DM, the course of diabetes, TG and VAI were the factors influencing serum ferritin (P<0.05). Conclusion Dyslipidemia and visceral fat accumulation are risk factors for elevated serum ferritin levels in female T2DM patients.

diabetes mellitus, type 2  /  serum ferritin  /  body fat distribution  /  visceral obesity index  /  insulin resistance
陈重阳, 吕小羽, 赵阳婷, 刘露霞, 王亚雯, 李凯, 刘靖芳. 2型糖尿病患者血清铁蛋白水平与体脂分布的相关性分析. 解放军医学杂志, 2024 , 49 (4) : 380 -386 . DOI: 10.11855/j.issn.0577-7402.2403.2023.1031
Chong-Yang Chen, Xiao-Yu Lyu, Yang-Ting Zhao, Lu-Xia Liu, Ya-Wen Wang, Kai Li, Jing-Fang Liu. Association between serum ferritin levels and body fat distribution in patients with type 2 diabetes mellitus[J]. Medical Journal of Chinese People’s Liberation Army, 2024 , 49 (4) : 380 -386 . DOI: 10.11855/j.issn.0577-7402.2403.2023.1031
正文
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糖尿病是严重危害人类健康的慢性疾病之一。据国际糖尿病联合会的数据显示，截至2021年，约有5.36亿人被诊断为糖尿病，到2045年预计将增加至7.83亿[1]。流行病学资料显示，我国糖尿病总体患病率已达11.2%，其中2型糖尿病(type 2 diabetes mellitus，T2DM)占90%以上[2]，已逐渐成为糖尿病患者人数最多的国家[3]。血清铁蛋白是一种进化上保守的蛋白质，可参与铁代谢稳态、氧化应激、炎症反应和胰岛素抵抗等的调节[4-5]。有研究发现，血清铁蛋白水平升高与肥胖、糖尿病和代谢综合征等有关[6-7]，且与T2DM患者肝脏脂肪变性的风险和严重程度呈正相关[8]。目前关于T2DM患者血清铁蛋白水平与体脂分布的关系及其影响因素的研究甚少。本研究探讨T2DM患者血清铁蛋白水平与体脂分布的关系，旨在为糖尿病及其并发症的发病机制研究提供新的思路，并通过控制血清铁蛋白水平和体脂分布状态来延缓糖尿病的进展。
1 资料与方法
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1.1 研究对象
选取2020年6-11月在兰州大学第一医院内分泌科住院治疗的151例T2DM患者进行回顾性分析。其中男98例，女53例，年龄(58.5±9.6)岁。纳入标准：(1)T2DM；(2)年龄>18岁。排除标准：(1)资料缺失；(2)甲状腺功能减退、甲状腺功能亢进等；(3)继发性骨质疏松症，如继发于肾上腺、甲状腺等疾病导致的骨质疏松等；(4)近期服用过激素及影响骨代谢的药物，如性激素、肾上腺皮质激素、钙剂、维生素D等；(5)合并恶性肿瘤、严重的感染性疾病、严重肝肾功能不全、血液或风湿免疫系统等疾病。将纳入的研究对象分为高血清铁蛋白组(n=50)与正常血清铁蛋白组(n=101)。本研究获兰州大学第一医院伦理委员会审批(LDYYLL2021-281)。
1.2 研究方法
1.2.1 基本信息
收集研究对象的基本信息，内容包括性别、年龄、绝经年龄、近期服用药物、糖尿病病史、甲状腺病史等既往其他病史。
1.2.2 体格检查
(1)身高：嘱受试者脱去帽子、鞋袜，赤脚、双足并拢站在身高计的底板上，背部紧靠身高计的立柱，双眼平视，待水平板底面立柱上所显示的读数稳定后，读取并记录数据，单位为cm，精确到0.1 cm。(2)体重：受试者着单衣、脱鞋，直立于体重测量仪上，待测量仪上读数稳定后，读取并记录数据，单位为kg，精确到0.1 kg。(3)腰围(waist circumference，WC)：被检者只穿单衣裤，解开腰带，双手下垂直立，双脚分开30~40 cm，平静呼吸，用皮尺测量髂前上棘和第12肋下缘连线的中点水平线，皮尺应紧贴但不压迫皮肤，精确到0.1 cm。(4)血压：受试者在安静的环境中休息5~10 min，用电子血压计测量右上臂血压，间隔10 min测量3次，取平均值，血压测量单位为mmHg，取整数。
1.2.3 实验室检查
所有研究对象均禁食水8 h后于次日清晨抽取肘静脉血5 ml，常规分离血清，AU5831全自动生化分析仪检测血清铁蛋白、空腹血糖(fasting plasma glucose，FPG)、总胆固醇(total cholesterol，TC)、三酰甘油(triglycerides，TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol，HDL-C)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol，LDL-C)、血尿素氮(serum urea nitrogen，SUN)和血肌酐(serum creatinine，SCr)水平；采用RT-6000酶标分析仪(深圳雷杜生命科学股份有限公司)检测25-羟基维生素D3(25-hydroxyvitamin D3，25-OH-D3)水平；采用高效液相分析法(伯乐-D10)测定糖化血红蛋白(glycosylated hemoglobin，HbA1c)。所有患者均口服100 g馒头或75 g无水葡萄糖，行口服葡萄糖耐量试验+胰岛素释放试验，采用AU5831全自动生化分析仪检测餐后2 h血糖(post-challenge 2 hour plasma glucose，2hPG)；采用化学发光法(Centaur-XP全自动化学发光免疫分析仪)测定空腹胰岛素(fast insulin，FINS)。采用Osteosys EXA-3000双能X线仪测定内脏脂肪面积(visceral fat area，VFA)和皮下脂肪面积(subcutaneous fat area，SFA)，单位以cm2表示。肝脏超声检查如符合以下情况则提示存在肝脏脂肪沉积[9]：肝脏近场回声增强，远场回声减弱；肝脏实质回声致密，强于肾脏；肝内血管和胆管结构显示不清。
1.2.4 各指标分层标准及内脏脂肪指数的计算
(1)T2DM[3]：糖尿病典型症状加随机血糖≥11.1 mmol/L或FPG≥7.0 mmol/L或2hPG≥11.1 mmol/L。(2)高血清铁蛋白[10]：男性>400 μg/L，女性>150 μg/L。(3)体重指数[body mass index，BMI，单位为体重/身高2(kg/m2)][11]：体重过低(BMI<18.5)，体重正常(18.5≤BMI≤23.9)，超重(24.0≤BMI≤27.9)，肥胖(BMI≥28.0)；中心性肥胖：男性WC≥90 cm，女性WC≥85 cm。(4)内脏脂肪指数(visceral adiposity index，VAI)[12]：男性=[WC/(39.68+1.88×BMI)]×(TG/1.03)×(1.31/HDL)，女性=[WC/(36.58+1.89×BMI)]×(TG/0.81)×(1.52/HDL)。(5)高血压[13]：收缩压(systolic blood pressure，SBP)≥140 mmHg，舒张压(diastolic blood pressure，DBP)≥90 mmHg，或正在使用降压药物。(6)血脂异常[14]：TC≥5.2 mmol/L或TG≥1.7 mmol/L或LDL-C≥3.4 mmol/L或HDL-C<1.0 mmol/L。(7)胰岛素抵抗指数的稳态评估模型(homeostasis model assessment of insulin resistance，HOMA-IR)[15]：采用稳态模型评估法计算[HOMA-IR=FPG(mmol/L)×FINS(μU/ml)/22.5]。胰岛素抵抗：HOMA-IR≥2.69，无胰岛素抵抗：HOMA-IR<2.69。(8)血糖控制情况[16]：HbA1c<7%表示血糖控制良好，HbA1c≥7%表示血糖控制不佳。
1.3 指标分析
比较两组患者的基本资料、糖尿病病病程、糖尿病并发症、降糖方案、血糖、肝肾功能、血脂、VFA、SFA、肝脏脂肪、WC、BMI和VAI等的差异，分析血清铁蛋白水平与各指标的相关性，以及血清铁蛋白水平与体脂分布之间的关系。
1.4 统计学处理
采用SPSS 27.0软件进行统计分析。计量资料均进行正态性检验，符合正态分布以$\bar{x}±s$表示，两组间比较采用ｔ检验；非正态分布以M(Q1，Q3)表示，组间比较采用非参数检验。计数资料以例(%)表示，组间比较采用χ2检验。连续变量与血清铁蛋白水平的相关性采用Pearson相关性分析，分类变量与血清铁蛋白水平的相关性采用Spearman相关性分析。采用多元线性回归分析T2DM患者血清铁蛋白与其他因素的相关性。P<0.05为差异有统计学意义。
2 结果
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2.1 两组临床资料比较
与正常血清铁蛋白组比较，高血清铁蛋白组年龄较小，糖尿病病程较长，VAI、WC、TC、TG、LDL、FPG、HbA1c和SCr水平明显升高(P<0.05)；但两组间SBP、DBP、BMI、HDL、VFA、SFA、2hPG、HOMA-IR、BUN和25-OH-D3P>0.05，表1)。
2.2 两组T2DM患者不同指标构成比比较
与正常血清铁蛋白组比较，高血清铁蛋白组男性的构成比及血糖控制差、胰岛素抵抗的构成比较高(P<0.05)，中心性肥胖、血脂异常的患病率也较高(P<0.05)。而两组间超重/肥胖、脂肪肝、高血压的患病率差异无统计学意义(P>0.05)。此外，不同降糖药物使用情况以及糖尿病并发症下的高铁蛋白和正常铁蛋白患病率之间差异无统计学意义(P>0.05)(表2)。
2.3 T2DM患者铁蛋白水平与各指标的相关性分析
进一步探讨T2DM患者的血清铁蛋白水平与有统计学差异的指标之间的关系，其中，分类变量赋值为：性别(1=男性，2=女性)，中心性肥胖(0=无，1=有)，胰岛素抵抗分组(0=无，1=有)，血脂异常(0=无，1=有)。相关分析结果显示，VAI、WC、TG、FPG、HbA1c、血脂异常、SCr与血清铁蛋白呈明显正相关(P<0.05)，而年龄、性别和糖尿病病程与血清铁蛋白呈负相关(P<0.05，表3)。
2.4 T2DM患者血清铁蛋白水平影响因素的相互作用分析
以血清铁蛋白为因变量，年龄为协变量，进行单变量协方差分析，结果显示，年龄对血清铁蛋白水平无明显影响(β=-2.720，95%CI -5.909~0.470，P=0.094)；修正年龄后，不同性别间血清铁蛋白水平差异有统计学意义(β=115.634，95%CI 51.445~179.822，P<0.05)。由于性别对血清铁蛋白水平有影响，因此，进一步将研究对象按性别分层，以血清铁蛋白水平为因变量，将年龄、糖尿病病程、WC、TC、TG、LDL、FPG、HbA1c(P<0.05)，而年龄、WC、TC、TG、LDL、FPG、HbA1c、SCr和VAI对男性T2DM患者血清铁蛋白水平无影响(P>0.05)；调整年龄、TC、TG、LDL、HbA1c和SCr等变量(模型2)后，糖尿病病程和FPG是血清铁蛋白水平升高的危险因素(P<0.05)，VAI和WC对男性T2DM患者血清铁蛋白水平无影响。在女性T2DM患者中，在未调整变量(模型1)时，糖尿病病程和TG是血清铁蛋白水平升高的危险因素，而年龄、WC、TC、LDL、FPG、HbA1c、SCr和VAI与男性T2DM患者的血清铁蛋白水平无关(P>0.05)；调整年龄、WC、TC、LDL、FPG、HbA1c和SCr等变量(模型2)后，糖尿病病程、TG和VAI是女性T2DM患者血清铁蛋白水平升高的危险因素(表4)。
3 讨论
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近年来，随着我国糖尿病患病率逐年上升，探索与糖尿病发病和进展相关的因素对于预防和延缓糖尿病及其并发症的发生发展尤为重要。研究表明，血清铁蛋白水平升高与肥胖、糖尿病和代谢综合征等有关[6]，且与T2DM患者肝脏脂肪变性的风险和严重程度呈正相关[8]。此外，内脏脂肪增多会增加T2DM及其并发症的发生风险[17]，提示T2DM患者体脂分布异常可能与血清铁蛋白水平有关。
既往研究发现，全身性肥胖、中心性肥胖和肝脏脂肪异位沉积均为糖尿病的危险因素[18]，且以肝脏脂肪异位沉积更为明显[19]。本研究用BMI代表全身性肥胖，WC代表中心性肥胖，VAI、VFA和SFA及脂肪肝代表脂肪异位沉积，并纳入糖脂代谢的相关指标，分析了T2DM患者的血清铁蛋白水平与体脂分布的关系，结果显示，高血清铁蛋白组VAI和WC较正常血清铁蛋白组高，且中心性肥胖、血脂异常、胰岛素抵抗的患病率增高，T2DM患者血清铁蛋白水平与VAI、WC、TG、FPG、HbA1c、血脂异常、SCr呈正相关，与年龄、性别和糖尿病病程呈负相关。进一步研究发现，在男性T2DM患者中，糖尿病病程和FPG是血清铁蛋白水平的危险因素，但WC和VAI对血清铁蛋白影响不明显；而在女性T2DM患者中，糖尿病病程、TG和VAI是血清铁蛋白的危险因素。目前关于血清铁蛋白水平与体脂分布之间关系的研究较少。Iwasaki等[20]发现，血清铁蛋白水平与肝脏脂肪含量(r=-0.280，P<0.05)、VFA(r=0.254，P<0.05)及SFA(r=0.231，P<0.05)等均明显相关；Sun等[21]发现，循环中的血清铁蛋白浓度升高与中老年人T2DM和代谢综合征的风险较高有关，但与肥胖、炎症、脂肪因子和其他危险因素无关。而本研究表明，T2DM患者的血脂紊乱、中心性肥胖以及胰岛素抵抗等均与血清铁蛋白水平升高有关，血清铁蛋白水平与VAI、WC、TG、FPG、HbA1c和SCr呈正相关；且线性回归分析表明，在女性T2DM患者中，糖尿病病程、TG和VAI是血清铁蛋白水平升高的危险因素，提示女性T2DM患者的血脂紊乱、内脏脂肪增加及糖尿病病程是血清铁蛋白水平升高的危险因素，与前述结果基本一致。
T2DM是一种由多种遗传和环境因素引起的代谢性疾病，主要表现为肝脏、肌肉、脂肪等外周组织对胰岛素的敏感性下降，利用葡萄糖的能力降低，最终导致糖代谢紊乱[22-23]。此外，T2DM的脂质代谢紊乱会导致脂质长期积累，进而引起内质网应激、氧化应激、组织炎症反应，甚至组织纤维化等改变[24]。血清铁蛋白能够调节铁代谢稳态、氧化应激、炎症反应和胰岛素抵抗等[4]。已有研究表明，血清铁蛋白与T2DM的多种并发症有联系。血清铁蛋白水平升高与T2DM的肝脏脂肪变性、脂肪变性级别和晚期纤维化风险增加相关[25]，且能够促进炎症反应、脂质过氧化及氧化应激反应的发生，最终导致糖尿病肾脏疾病的进展[26]，还通过调节过氧化和非酶促糖基化，导致糖尿病患者出现血管功能障碍[27]。还有研究发现，内脏脂肪肥胖可能通过炎症、氧化应激、血管内皮功能障碍、血管平滑肌功能障碍、异位脂肪对器官的作用等机制参与T2DM及其大血管、微血管疾病的发生发展[18]。人体内脏脂肪的堆积引起的内脏型肥胖是一种慢性低度炎症状态[28]，在内脏脂肪积累的过程中，脂肪组织经历了细胞和结构的重塑，可导致促炎脂肪因子表达上调[29]。脂肪因子和细胞因子的释放，以及脂肪及其代谢产物的过量堆积，可使机体呈胰岛素抵抗状态，这与肥胖、糖尿病、代谢功能障碍相关性脂肪肝、心血管疾病、多囊卵巢综合征等相关[30]。高血清铁蛋白可能是脂肪组织功能障碍的一个指标[31]：一方面，血清铁蛋白水平升高可能归因于中心性肥胖相关的炎症状态[32]；另一方面，血清铁蛋白可能通过调节脂肪因子水平，从而导致脂肪组织功能障碍和脂肪代谢紊乱[33]。进一步研究发现，铁超负荷可促进血清和糖皮质激素诱导激酶同系物-1(serum-and glucocorticoid-inducible kinase homolog，SGK-1)的表达，促进铁蛋白和脂肪的堆积[34]。结合本研究结果，T2DM患者的血清铁蛋白水平升高和体脂分布异常可能通过糖脂代谢紊乱、炎症反应或氧化应激等相互联系、相互促进，并共同促进T2DM的进展。但关于T2DM患者中血清铁蛋白水平与体脂分布之间联系的具体机制，仍需进一步研究。
本研究发现，男性T2DM患者的血清铁蛋白水平更高，考虑可能与样本量小、雄激素水平降低有关。既往研究发现，男性T2DM患者的游离睾酮浓度低于正常水平[35]；男性人群的腹部肥胖与血浆雄激素浓度呈反比，而女性则相反[36]，雌激素能够驱动脂肪堆积在臀部肌肉中[37]，这种脂肪储存模式与较低的T2DM风险有关[38]。此外，男性睾酮与血清铁蛋白水平呈负相关[39]，睾酮替代物能够抑制T2DM男性的促炎细胞因子的表达[40]。因此，男性T2DM患者的血清铁蛋白水平升高可能与其雄激素水平下降以及腹部肥胖和炎症反应状态有关。
综上所述，T2DM患者全身及中心性肥胖、糖脂代谢紊乱与高血清铁蛋白密切相关，且女性T2DM患者的血脂紊乱、内脏脂肪增加及糖尿病病程是血清铁蛋白水平升高的危险因素，血清铁蛋白和体脂分布异常可能促进T2DM及其并发症的进展。因此，在T2DM患者的临床管理中需对血清铁蛋白水平和体脂分布情况加以重视。本研究仍存在一定的局限性：首先为回顾性研究，不能分析血清铁蛋白水平升高与体脂分布异常的因果关系，且未对两者之间的内在联系进行深入分析，未来可通过大样本前瞻性队列研究和试验性研究进行探讨；其次是未测量研究对象的铁调素和铁含量以及铁代谢相关的指标，未将体脂分布相关的指标进一步细化，因此对于脂肪分布与铁代谢的具体联系仍需进一步研究。
基金
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  • 国家自然科学基金(81960155)
  • 甘肃省自然科学基金(20JR10RA690)
  • 兰州大学第一医院院内基金(ldyyyn2020-01)
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doi: 10.11855/j.issn.0577-7402.2403.2023.1031
  • 接收时间：2022-11-15
  • 首发时间：2025-11-23
  • 出版时间：2024-04-28
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  • 收稿日期：2022-11-15
  • 录用日期：2023-01-02
基金
National Natural Science Foundation of China(81960155)
国家自然科学基金(81960155)
Natural Science Foundation of Gansu Province(20JR10RA690)
甘肃省自然科学基金(20JR10RA690)
Internal Hospital Foundation of the First Hospital of Lanzhou University(ldyyyn2020-01)
兰州大学第一医院院内基金(ldyyyn2020-01)
作者信息
    1兰州大学第一临床医学院，甘肃兰州 730000
    2兰州大学第一医院内分泌科，甘肃兰州 730000

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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