Abstract

Background and Aim: The main aim of the present work was to establish the relationship between ferritin level (FERR) and glucose status in diabetic Saudi females and to validate serum FERR as a marker of insulin resistance (IR). Methods: This case- control study was done on 180 subjects including 100 female patients with type 2 diabetes and 80 healthy female (control) of the same age were enrolled. Fasting blood samples were procured to measure concentrations of FERR by an electrochemiluminescence immunoassay using the Cobas e 411 immunoassay analyzer. Fasting serum glucose, glycated hemoglobin, lipid profile, kidney function tests and minerals were automatically measured by Siemens Dimension X P and auto analyzer. The association of FERR with parameters of adiposity, glucose tolerance, and lipid profile was examined. Results: In the present study, unpaired student's t test detected significant increase in the FERR levels in diabetic female patients compared to the control (p< 0.05). A noteworthy positive correlation of FERR with IR (r≤0.632) and fasting insulin levels (r≤0.497) was observed in female patients. Furthermore, the Atherogenic Index of Plasma (AIP≤Log TG/HDL) conjectured cardiovascular risk showing that 65% of these patients with diabetes had increased risk while only 20% had intermediary risk. The AIP predicts that the cardiovascular risk showed statistically significant correlation with FERR levels and hyperglycemia. Conclusions: High serum FERR level was associated with impaired glucose metabolism and increased cardiovascular risk in type 2 diabetes female patients.

Keywords: Cardiovascular Risk · Metabolic Syndrome · Type 2 Diabetes Mellitus · Serum Ferritin

References

  1. 1.Elhadd AT. The rising menace of diabetes in the Middle East: Time for action. Saudi J Health Sci 2012;1: 44-45.
  2. 2.Abdulfatai O, Lateef. Type 2 Diabetes Mellitus: A Review of Current Trends. Oman Med J. 2012; 27: 269–273.
  3. 3.World Health Organization. https:// www.who.int/news-room/fact-sheets/ detail/diabetes. Diabetes in Saudi World Health Organization (diabetes) Online Resources (updated 2019). Available from: https://www.who.int/countries/sau/en/. [4]AmericanDiabetesAssociation.https:// www.diabetes.org/. Online Resources (updated 2019). Available from: https://www. diabetes.org/diabetes/type-2.
  4. 4.Aastha, Rajeev, Shalini. Microvasular and Macrovascular complications in diabetesmellitus:Distinctorcontinuum.Indian J Endocrinol Metab 2016; 20: 546–551.
  5. 5.Anjana, Joseraj, Geetha. Evaluation of serum ferritin in type 2 diabetes mellitus. Journal of evaluation of research in medical biochemistry 2016; 1: 4-6.
  6. 6.Shim, Kang, Oh, Baek, Yang, et al.Association of serum ferritin with insulin resistance, abdominal obesity, and metabolic syndrome in Korean adolescent and adults, Medicine 2017; 96:8.
  7. 7.Bao W, Chavarro JE, Tobias DK, Bowers K, Li S, et al. Long term risk of type 2 diabetes in relation to habitual iron intake in women with a history of gestational diabetes: a prospective cohort study. Am J Clin Nutr 2016;103:375-81.
  8. 8.Wrede E, Buettner R, Bollheimer C, Scholmerich J, Palitzsch D, Hellerbrand C. Association between serum ferritin and the 90 Majmaah Journal of Health Sciences ,Vol. 8, Issue 3, September - 2020 , Muharam - 1442 Evaluation of Ferritin Levels in Saudi Female Patients with Type 2 Diabetes insulin resistance syndrome in a representative population. Eur J Endocrinol 2006; 154:333-40.
  9. 9.Faiza, Fasiha, Shehryar, Najeeha, Syeda. Elevated levels of Ferritin and hs- CRPin type 2 diabetes, Journal of Pakistan medical Association 2014; 64:89-91.
  10. 10.Sun L, Franco H, Hu B, Cai L, Yu Z, Li H. Ferritin concentrations, metabolic syndrome and type 2 diabetes in middle-aged and elderly Chinese. J Clin Endocrinol Metab 2008; 93:90-6.
  11. 11.Bo-wei, Xu-min, Jun-ru, Fang-ning, Fu-Zai. The Relationship between Serum Ferritin and Insulin Resistance in Different Glucose Metabolism in Non-obese an Adults. International Journal of Endocrinology 2015; 1: 34-36.
  12. 12.Barton, Barton,Acton. Insulin Resistance and Metabolic Syndrome: Clinical and Laboratory Associations in African Americans Without Diabetes in the Hemochromatosis and Iron Overload Screening Study. Metab Syndr Relat Disord 2018;16:267-273.
  13. 13.Suárez , Arbeláez, Mosquera, Méndez, Aguilar. C-reactive protein, waist circumference, and family history of heart attack are independent predictors of body iron stores in apparently healthy premenopausal women. Biol Trace Elem Res 2012;148:135-8.
  14. 14.Tang, Liu, Tang , Tan, Lu Z, et al. High serum ferritin level is an independent risk factor for metabolic syndrome in a Chinese male cohort population. Diabetol Metab Syndr 2015; 7:11.
  15. 15.Cantur KZ, Cetinarslay B, Tarkun I, Canturk NZ. Serum ferritin levels in poorlyand well-controlled diabetes mellitus. Endocr Res 2003; 29:299-306.
  16. 16.Carrera, Simó, Lecube, Hernández. Soluble transferrin receptors and ferritin in Type 2 patients with diabetes . Diabetic Medicine 2004; 1:97–101. [18]DoyardM,FatihN,MonnierA,Island ML,Aubry M. Iron excess limits HHIPL-2 gene expression and decreases osteoblastic activity in human MG-63 cells Osteoporos Int2012;23:2435–2445.
  17. 17.Kim CH, Kim HK, Bae SL, Park JY, Lee KU. Association of elevated serum ferritin concentration with insulin resistance and impaired glucose metabolism in Korean men and women. Metabolism 2011; 60:214-20. Majmaah Journal of Health Sciences ,Vol. 8, Issue 3, September - 2020 , Muharam - 1442 91 Evaluation of Ferritin Levels in Saudi Female Patients with Type 2 Diabetes
  18. 18.Hernandez A, Lecube A, Carrera RS. Soluble transferrin receptors and ferritin in type 2 patients with diabetes . Diabetic Med 2005; 22:97.
  19. 19.Aclan Ozder. Lipid profile abnormalities seen in T2DM patients in primary healthcare in Turkey: a cross-sectional study. Lipids Health Dis 2014; 13:183.
  20. 20.Xifra G, Moreno, Ricart W, Fernández. Obesity status influences the relationship among serum osteocalcin, iron stores and insulin sensitivity. Clin Nutr 2018;37:2091-2096.
  21. 21.Colagiuri S, Craig J. Assessment of kidney function in type 2 diabetes. Nephrology 2010; 15:146–16.
  22. 22.Olga G, Evgenya U, Yulia D, Ekaterina B, Ekaterina S, Olga B. Insulin resistance and inflammation markers in myocardial infarction. J Inflamm Res 2013; 6:83-90.
  23. 23.Pravenec M, Kajiya T, Zídek V, Landa V, Mlejnek P, Simáková M. Effects of human C-reactive protein on pathogenesis of features of the metabolic syndrome. Hypertension 2011; 57:731-7.
  24. 24.Rajpathak S, Ma J, Manson J, Willett WC,HuFB.Ironintakeandtheriskoftype 2 diabetes in women: a prospective cohort study. Diabetes Care 2006; 29:1370-6.
  25. 25.Buse JB, Ginsberg HN, Bakris GL. Primary prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association. Diabetes Care 2018; 30:162–172. https://www.diabetes.org/.
  26. 26.American Diabetes Association. Cardiovascular disease and risk management. In Standards of Medical Care in Diabetes. Diabetes Care 2015; 38:49–57. https:// www.diabetes.org/.

Peer review

Peer reviewed by 4 reviewers, who chose to remain anonymous.

Majmaah Journal of Health Sciences · eISSN 1658-8223 · Majmaah University · open access