Objective: To investigate the association of iron with stress hormones and insulin resistance in patients with gestational diabetes mellitus (GDM). Methods: Seventy-five pregnant women diagnosed as GDM during 24-28 weeks were collected from January to November 2015 in Yantai Yuhuangding Hospital, and 75 normal pregnant women were used as control group. Blood glucose, insulin, stress hormones and iron metabolism related indexes were detected. Homeostasis model assessment for insulin resistance (HOMA-IR) was used to evaluate insulin resistance, and the correlation of iron metabolism with stress hormones and insulin resistance was analyzed. Results: Compared with control group, norepinephrine (NE) and epinephrine (E) levels were higher in GDM group (both P<0.05), but there was no significant difference in cortisol level between two groups (P>0.05). Serum ferritin (SF), serum iron, and transferrin saturation levels were higher in GDM group than those in control group(all P<0.01). Multivariate logistic analysis showed that cortisol, E, and NE levels were positively correlated with SF level in GDM group (all P<0.05). Cortisol and E levels were positively correlated with transferrin saturation (both P<0.05). SF and transferrin saturation were positively correlated with HOMA-IR in two groups (P<0.05 or P<0.01). Conclusion Iron overload may involve in dysfunction of stress adaptation and insulin resistance in patients with GDM. (Chin J Endocrinol Metab, 2018, 34: 563-566)

Objective:To analyze the relationship between iron metabolism and insulin resistance in patients with polycystic ovary syndrome (PCOS) complicated with gestational diabetes mellitus (GDM) .Methods:The pregnant women who were routinely tested in Yantai Yuhuangding Hospital from Jan. 2017 to Feb. 2018 were selected for screening. 60 pregnant women with GDM were diagnosed as gestational diabetes group (GDM) , 60 cases of GDM pregnant women previously diagnosed as polycystic ovary syndrome (PCOS) as polycystic ovarian diabetes group (PGDM) , and 60 normal pregnant women were as the normal control group (NC) . The levels of blood glucose, insulin, hemoglobin and iron indexes (serum iron, ferritin and transferrin saturation) were measured in three groups, and the changes of oxidative stress injury and inflammation level were evaluated. The relationship between iron and inflammation with insulin resistance was analyzed by multiple linear regression.Results:Compared with NC, the hemoglobin decreased, the saturation of ferritin and transferrin increased in PGDM group[ F=3.55, 8.24, 5.10, all P<0.05], Malondialdehyde increased and superoxide dismutase decreased[ F=11.11,7.24,all P<0.01], the level of tumor necrosis factor-alpha and interleukin-6 increased [ F=4.02,19.06, all P<0.05]. Compared with GDM group, Hb was decreased, SF, TS were increased and HOMA-IR, MDA, TNF-α, IL-6 were increased in PGDM group (all P<0.05) . MDA, TNF-alpha and interleukin -6 were positively correlated with ferritin ( r=0.42, 0.43, 0.56, P<0.05) , and were positively correlated with the saturation of ferritin ( r=0.61, 0.42. 0.52, all P<0.01) , and the superoxide dismutase was negatively correlated with the saturation of ferritin and transferrin ( r=-0.61, -0.42, P<0.05) , and the saturation of ferritin and transferrin was positively correlated with the insulin resistance index ( r=0.39, 0.41, P<0.01) . Conclusions:Iron deposition in patients with PGDM leads to increased oxidative stress injury and inflammatory response, which aggravates insulin resistance. The disorder of iron metabolism may be related to the mechanism of hyperglycemia in patients with PGDM.

The clinical data of 9 patients with exogenous lipid pneumonia confirmed by pathology were retrospectively analyzed. There were 4 males and 5 females, aged 57-79 years, with a history of intestinal obstruction and oral administration of liquid paraffin. The main clinical symptoms were cough, expectoration and fever (8 cases), and combined with wheezing (5 case); and crackles and rhonchi were revealed on chest auscultation in all patients. The right lung lower lobe was involved in all 9 cases, the left lower lobe, right middle and lower lobe were also involved in 6 case. The CT scan showed that infiltration (7 case) and consolidation (6 case) were the most common imaging features, followed by the septal thickening (5 case) and pleural effusion (4 case); the low density fat-like changes within the consolidative opacities was a specific feature of lipid pneumonia (3 case). The lung biopsy was performed in the target site through bronchoscope, and pathology showed the interstitial fibrous tissue hyperplasia with chronic inflammatory cell infiltration and adipocyte-like cells. Six patients were treated with glucocorticoid and repeated bronchoalveolar lavage with good response, one cases died and two cases discharged automatically. The clinical manifestation and imaging features of exogenous lipid pneumonia are lack of specificity; transbronchial lung biopsy is an effective method for the diagnosis. The repeated bronchoalveolar lavage with saline combined with medication of glucocorticoids are effective for the treatment of exogenous lipid pneumonia.