Study On The Relationship Between Iron Metabolism And Lower Extremity Arterial Disease In Type 2 Diabetes Mellitus

Objective: To investigate the relationship between iron metabolism and lower extremity arterial disease(LEAD)in type 2 diabetes mellitus(T2DM).Methods: A total of 223 patients with T2 DM who were admitted to the Endocrinology Department of Wuhan Central Hospital from November 2021 to February 2022 were randomly selected as the research subjects,including 154 patients with LEAD and 69 patients without LEAD.50 healthy cases without T2 DM in the same period were selected as the negtive control group(NC).The general clinical data and laboratory indices were compared and analyzed.Results: The level of serum ferritin(SF)in LEAD [315.09(196.76,545.39)ng/ml)] was significantly higher than that in No LEAD [281.41(125.41,433.03)ng/ml].The level of SF in LEAD tended to increase with the improvement of Fontaine stages(P<0.001).Spearman correlation analysis showed a positive correlation between Fontaine stages and SF(r=0.335,P<0.001).In T2 DM subjects,the multivariate logistic regression analysis showed that SF(OR=1.004,95%CI: 1.001-1.006,P<0.001),serum iron(OR=1.808,95%CI: 0.742-0.880,P<0.001),unconjugated iron(OR=1.299,95%CI: 1.208-1.396,P<0.001),transferrin saturation(OR=0.880,95%CI: 0.846-0.916,P<0.001),Hb A1c(OR=0.628,95%CI: 0.543-0.726,P<0.001),age(OR=1.072,95%CI: 1.038-1.108,P<0.001),and diabetes duration(OR=1.070,95%CI: 1.010-1.134,P<0.001)were the independent risk factor of LEAD.ROC curve analysis showed that the area under the curve(AUC)of SF to predict LEAD was 0.712(95%CI: 0.649-0.774,P<0.001).The optimal critical value of SF to predict LEAD was 137.10ng/ml(sensitivity 68.2% and specificity 78.2%).Conclusion: Iron overload is closely related to LEAD.Serum ferritin was significantly increased in patients with LEAD,which was positively correlated with Fontaine stage.It can serve as an effective marker for early prediction of LEAD and its severity.