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Tipping the balance:Haemoglobinopathies and the risk ofdiabetes

World Journal of Diabetes 2016年第1期7卷 8-13页

作者： Henry J Baldwin aislinn e.gre.n Kayleigh M Spellar Philip J Arthur Hannah G Phillips Jeetesh V Patel University of nottingham Medical School Nottingham NG7 2UHUnited Kingdom University of Birmingham Centre for Cardiovascular Sciences Sandwell and West Birmingham Hospitals NHS TrustWest Midlands B18 7QHUnited Kingdom Sandwell Medical Research Unit LyndonSandwell General HospitalWest Midlands B71 4HJUnited Kingdom

AIM: To establish a link between the risk of diabetes with haemoglobinopathies by examining available evidence of the effects of iron and blood glucose homeostasis from molecular to epidemiological ***: A systematic literature search was performed using electronic literature databases using various search terms. The International Diabetes Federation World Atlas was used to generate a list of populations with high rates of diabetes. Pub Med, Scopus and Google Scholar were used to identify which of these populations also had a reported prevalence of haemoglobin ***: Abnormalities in iron homeostasis leads to increases in reactive oxygen species in the blood. This promotes oxidative stress which contributes to peripheral resistance to insulin in two ways:(1) reduced insulin/insulin receptor interaction; and(2) β-cell dysfunction. Hepcidin is crucial in terms of maintaining appropriate amounts of iron in the body and is in turn affected by haemoglobinopathies. Hepcidin also has other metabolic effects in places such as the liver but so far the extent of these is not well understood. It does however directly control the levels of serum ferritin. High serum ferritin is found in obese patients and those with diabetes and a meta-analysis of the various studies shows that high serum ferritin does indeed increase diabetes ***: From an epidemiological standpoint, it is plausible that the well-documented protective effects of haemoglobinopathies with regard to malaria may have also offered other evolutionary advantages. By contributing to peripheral insulin resistance, haemoglobinopathies may have helped to sculpt the so-called "thrifty genotype", which hypothetically is advantageous in times of famine. The prevalence data however is not extensive enough to provide concrete associations between diabetes and haemoglobinopathies- more precise studies are required.

关键词： Diabetes Ferritin Haemoglobinopathy Ironmetabolism Malaria

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