Email this article Association of serum ferritin and glycated haemoglobin in patients of type 2 diabetes mellitus and its correlation with components of metabolic syndrome
Abstract
Background: Ferritin is a universal intracellular protein that stores iron and releases it in a controlled fashion, and reflects iron stores of the body. Recent studies indicate that increased body iron stores are associated with development of type 2 diabetes mellitus (DM) hence affecting the level of glycated haemoglobin. The aim and objectives of this study were to determine the relationship between serum ferritin and glycated haemoglobin in type 2 diabetes patients and to find out correlation between serum ferritin level and components of metabolic syndrome.
Methods: This study included 100 cases of type 2 DM compared with age and sex-matched 100 non-diabetic controls. Serum ferritin, fasting blood sugar, lipid parameters and waist circumference were estimated, and glycated haemoglobin was calculated by HPLC method.
Results: The mean serum ferritin in cases was 178.59±84.17 µg/l and in controls was 107.17±13.83 µg/l (p=0.0001). The mean age was 53.32±10.14 years in cases and 51.8±10.54 years in controls. Mean HbA1C level in cases was higher (8.40±1.22) as compared to controls (5.4±0.34) and it was statistically significant (p<0.0001). There was a positive linear correlation between HbA1C level and serum ferritin irrespective to gender in case group (r=0.342) and it was statistically significant (p<0.0001). Serum ferritin was significantly higher in hypertensive type 2 DM patients than hypertensive non-diabetic patients (p<0.0239).
Conclusions: The findings of this study suggest that increased level of serum ferritin is positively related to glycaemic control.
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Ghazanfari Z, Haghdoost SA, and Mohammad A. Comparison of HbA1c and Fasting Blood Sugar Tests in General Population. Int J Prev Med. 2010;1(3):187-94.
Adeghate E, Schattner P, and Dunn E: An update on the etiology and epidemiology of diabetes mellitus. Ann NY Acad Sci. 2006;1084:1-29.
IDF Diabetes Atlas. Chapter-2.1, 6th edn. 2013;34.
Pankaj B, Puja B, Akshay R, and Kansal HM. Is serum ferritin associated with type II diabetes mellitus: A clinical study in a representative Indian population. J Med Sci Res. 2011;2:20‑4.
Jiang R, Manson JE, Meigs JB, Ma J, Rifai N, and Hu FB: Body iron stores in relation to risk of type 2 diabetes in apparently healthy women. JAMA. 2004;291:711-7.
Cooksey RC, Jouihan HA, Ajioka RS. Oxidative stress, beta-cell apoptosis, and The Relationship between Serum Ferritin and Glycosylated Hemoglobin 408 decreased insulin secretory capacity in mouse models of hemochromatosis. Endocrinology. 2004;145:5305-12.
Zafon C, Lecube A, and Sim´o R. Iron in obesity. An ancient micronutrient for a modern disease. Obesity Reviews. 2010;11(4):322-8.
Dekker LH, Nicolaou M, and Van Der ADL. Sex differences in the association between serum ferritin and fasting glucose in type 2 diabetes among South Asian, Surinamese African, Surinamese and ethnic Dutch: the population-based SUNSET study. Diabetes Care. 2013;36(4):965-71.
Sun L, Zong G, Pan A. Elevated serum ferritin is associated with increased incidence of type 2 diabetes in middle aged and elderly Chinese adults. J Nutr. 2013;143(9):1459-65.
Feldt-Rasmussen. Is there a need to optimize glycemic control in hemodialyzed diabetic patients? Kidney Int. 2006;70:1392-4.
Stolar M. Glycemic control and complications in type 2 diabetes mellitus. Am J Med. 2010;123(3):S3-11.
Padmaja P, Shabana S and Shariq Mas. Serum ferritin and HbA1c in type 2 diabetes mellitus. Int J Clin and Biomed Res. 2015;1(3):30-7.
Radoi V, Lixandru D, Mohara M, Virgolici B. Advanced glyca- tion end products in diabetes mellitus: Mechanism of action and focused treatment. Proc Rom Acad Series B. 2012;1:9-19.
Halliwell B, Gutteridge JMC. Role of free radicals and catalytic metal ions in human disease: an overview. Meth Enzymol. 1990;186:1-85.
Herbert V. Everyone should be tested for iron disorders. J Am Diet Assoc. 1992;92:1509-76.
Jouihan HACP, Cooksey RC, Hoagland EA, Boudina S, Abel ED, Winge DR et al Iron- mediated inhibition of mitochondrial manganese uptake mediates mitochondrial dysfunction in a mouse model of hemochromatosis. Mol Med. 2008;14:98-108.
Jomova K, Valko M. Advances in metal-induced oxidative stress and human disease. Toxicology. 2011;283:65-87.
Kaneto H, Katakami N, Matsuhisa M, Matsuoka TA. Role of reactive oxygen species in the progression of type 2 diabetes and atherosclerosis. Mediators inflammation. 2010;2010:453892.
Balla J, Jacob HS, Balla G, Nath K, Vercellotti GM. Endothelial cell hemeoxygenase and ferritin induction by heme proteins: a possible mechanism limiting shock damage. Trans Assoc Am Phys. 1993;105.
Balla G, Jacob HS, Balla J, Rosenberg M, Apple F, Eaton JW et al. Ferritin: a cytoprotective antioxidant stratagem of endothelium. J Biol Chem. 1992;267:18148-53.
Swaminathan S, Fonseca VA, Alam MG, Shah SV. The role of iron in diabetes and its complications. Diabetes Care. 2007;30(7):1926-33.
Qian M, Liu M, Eaton JW. Transition metals bind to glycated proteins forming redox active “glycochelates”: implications for the pathogenesis of certain diabetic complications. Biochem Biophys Res Comm. 1998;250:385-9.
Fernandez-Real JM, Richard- Engel W, Arroyo E, Balanca R, Casamitjana-Abella R. Serum ferritin as a component of the in- sulin resistance syndrome. Diabetes Care. 1998;21(1):62-8.
Ford ES, Cogswell ME. Diabetes and serum ferritin concentra- tion among U.S. adults. Diabetes Care. 1999;22:1978-83.
Tuomainen TP, Nyyssonen K, Salonen R, Tervahuta A, Korpela H, Lakka T et al. Body iron stores are associated with serum insulin and blood glucose concentration: Population study in 1,013 eastern Finnish Men. Diabetes Care. 1997;20(3):426-8.
Thanna RC, Nigosker S. Level of serum ferritin and glycated haemoglobin in type 2 diabetes mellitus. Int J Med and Health Sci. 2016;2(2):49-51.
Thilip Kumar G, Saravanan A, Ramachandran C and John Nitin Ashok. Mean blood glucose level and glycated haemoglobin level in patients of non-insulin dependent diabetes mellitus and its correlation with serum ferritin level. Int J Med Sci. 2011;4(1 and 2):13-7.
Ryoo JH, Kim SY Oh CM. The incidental relationship between serum ferritin levels and hypertension. Int J Cardiol. 2015;183:258-62.
Raj S, Rajan GV. Correlation between elevated serum ferritin and HbA1c in type 2 diabetes mellitus. Int J Res Med Sci. 2013;1(1):12-5.
Samotra S, Kudyar RP. Relationship between serum ferritin and type 2 diabetes mellitus. J Knowledge Sci. 2008;10:170-4.
