Influence of ferritin levels and inflammatory markers on HbA1c in the Type 2 Diabetes mellitus patients

Abstract

Objective: Diabetes Mellitus (DM) is a significant public health issue worldwide due to the associated comorbidities. Recent studies have demonstrated a strong relationship between blood glucose levels and serum ferritin levels in patients with type 2 DM. The aim of the study was to investigate the association between Ferritin Levels and Inflammatory Markers on HbA1c in the Type 2 Diabetes Mellitus Patients.
 Methods: This single-center, cross-sectional, controlled study included patients who were admitted to the Endocrine and Metabolic Disorders outpatient clinics of the Private Kütahya Hospital in the province of Kutahya in the Western Turkey. The study included a total of 172 patients, 84 of whom had type 2 DM and 88 without diabetes and constituted the control group. A total of 190 patients with DM were admitted to the Adult Endocrine and Metabolic Diseases Outpatient Clinics of the hospital between July 1, 2018 and September 1, 2018, and among these, the study was conducted on 172 volunteer patients who met the study inclusion criteria and who did not have any missing data. The HbA1c levels, serum ferritin, hemoglobin (Hb), insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), C-Reactive Protein (CRP), lipid profiles, and uric acid levels were compared between the groups.
 Results: The serum ferritin levels of the patients with type 2 DM significantly increased with increasing HbA1c levels (p<0.01). A strong positive correlation was found between serum ferritin levels and HbA1c and fasting blood glucose (FBG) levels (p<0.01).
 Conclusions: Our study results show a significant relationship between HbA1c levels and serum ferritin and CRP levels, suggesting that serum ferritin and CRP levels can be used as a routine screening tool for the early diagnosis of DM. However, further large-scale, prospective studies are needed to confirm these findings.
 doi: https://doi.org/10.12669/pjms.35.4.1003
 How to cite this:Son NE. Influence of ferritin levels and inflammatory markers on HbA1c in the Type 2 Diabetes mellitus patients. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.1003
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Relationship between hs-CRP and HbA1c in Diabetes Mellitus Patients: 2015–2017 Korean National Health and Nutrition Examination Survey

“…Our results support previous studies that suggested the association of CRP with an increased risk of diabetes and metabolic syndrome. 14 Sex, HDL-cholesterol level, income, and smoking status were not significant. The explanatory power increased with additional adjustments from Model 1 (R 2 =0.0364) to Model 2 (R 2 =0.0638) and Model 3 (R 2 =0.0717).…”

“…These results suggest an association between blood sugar levels and inflammation in diabetic patients, similar to previous studies. 14 In a study on the relationship between hs-CRP and insulin resistance in type 2 diabetic patients, it was reported that relatively increased hs-CRP in type 2 diabetic patients was associated with increased insulin resistance, even in the normal range. 15 Currently, the hypothesis explaining the relationship between markers of inflammatory response and insulin resistance is that chronic inflammation can act as an inducer of insulin resistance or stimulate hs-CRP synthesis by an underlying disease, eventually leading to type 2 diabetes.…”

Ferritin levels and COVID-19

“…It has been reported that fatal outcomes by COVID-19 are accompanied by cytokine storm syndrome, thereby it has been suggested that disease severity is dependent of the cytokine storm syndrome 2 . Many individuals with diabetes exhibit elevated serum ferritin levels [3][4][5] , and it is known that they face a higher probability to experience serious complications from COVID-19 6 . On this basis, we briefly review evidence supporting the hypothesis that ferritin levels might be a crucial factor influencing the severity of COVID-19.…”

“…Manipulations decreasing dietary iron should be also considered as they have been shown to modify serum ferritin levels 14,15 . Thus we hypothesized that this might reduce the exacerbation of COVID-19, specially in individuals with morbidities cursing with elevated ferritin levels such as diabetes [3][4][5] .…”

Activities of Serum Ferritin and Treatment Outcomes Among COVID-19 Patients Treated With Vitamin C and Dexamethasone: An Uncontrolled Single-Center Observational Study

“…Ideally, serum ferritin levels might be a crucial factor influencing the severity of COVID-19. Many individuals with diabetes exhibit elevated serum ferritin levels, facing a higher probability of experiencing severe complications from COVID-19 [6]. The median values of serum ferritin levels from a few recent studies exceeded the upper limit of detection in the COVID-19 patients during all the days of hospitalization, suggesting that ferritin levels increased incessantly throughout the hospital stay [7].…”