Is Serum Ferritin High in Patients with Diabetic Retinopathy? A Controlled Study

Elis, Avishay; Ferencz, J. R.; Gilady, Gila; Livne, Abraham; Assia, Ehud I.; Lishner, Michael

doi:10.1081/erc-200027354

Cited by 8 publications

(1 citation statement)

References 20 publications

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“…Moreover, the authors reported that there was no apparent correlation between serum iron or serum ferritin and HbA1c concentration between the groups comprised of individuals with T2DM. Thus, the authors concluded that iron does not appear to have a major role in the development of T2DM or diabetic retinopathy (385). Given the overall small sample size (n = 91), which was stratified into groups of 3, it appears that one cannot draw any valid conclusions based upon these data.…”

Section: Iron and T2dmmentioning

confidence: 71%

Effect of total body iron on metabolic dysfunction among U.S. females in the Nhanes 2003-2010, aged 12-49.

Carhart¹

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Experimental and epidemiological studies have reported positive associations between iron parameters and metabolic dysfunction including: Type 2 diabetes mellitus (T2DM) (1-6), metabolic syndrome (7-15), non-alcoholic fatty liver disease (NAFLD) (16-22) and insulin resistance (23,24) with a number of studies showing that reductions in total body iron via dietary modification (e.g., reducing red meat intake) or phlebotomy lead to increases in insulin sensitivity (25), decreases in insulin resistance (26), and reductions in the prevalence of complications associated with T2DM (5, 27), metabolic syndrome (28) and NAFLD (22, 29). Moreover, the risk associated with these outcomes and total body iron differ between males and females and it has been hypothesized that the divergence in risk of disease due to total body iron is related to the female reproductive lifespan (e.g., age at menarche, parity, oral contraceptive use and age at menopause). Regardless of study design, serum ferritin and transferrin saturation have consistently been used in these investigations to estimate total iron stores, which are affected by inflammation and demonstrate diurnal variation. using FeCOOK is recommended in order to replicate these findings among a larger sample comprised of both males and older females.

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Section: Iron and T2dmmentioning

confidence: 71%

Effect of total body iron on metabolic dysfunction among U.S. females in the Nhanes 2003-2010, aged 12-49.

Carhart¹

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Association of iron indices and type 2 diabetes: a meta‐analysis of observational studies

Orban

Schwab

Thorand

et al. 2014

Diabetes Metabolism Res

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The literature on the role of body iron status in the development of type 2 diabetes (T2D) in humans is inconsistent. We aimed to assess the association between iron indices and T2D by a meta-analysis of previously published studies. A systematic literature search was conducted in PubMed and EMBASE. Observational studies on the association of ferritin (when controlled for age and sex), transferrin saturation, soluble transferrin receptor and transferrin with T2D were included. Pooled association estimates were calculated using a random effects model. Forty-six eligible studies were identified. The pooled multivariable adjusted relative risks of T2D in the highest versus lowest quartile of ferritin levels were significantly elevated in both cross-sectional as well as prospective studies and after restriction to inflammation-adjusted studies [overall: 1.67 (95% CI 1.41-1.99)]. The mean difference indicated 43.54 ng/mL (95% CI 28.14-58.94) higher ferritin levels in type 2 diabetic individuals. The relative risk for a transferrin saturation ≥ 50% was 1.59 (95% CI 1.28-1.97), the mean difference was -1.92% [95% CI -2.99-(-0.85)]. Study-specific results of soluble transferrin receptor and transferrin levels were extremely heterogeneous. Ferritin and clinically elevated transferrin saturation were strongly associated with an increased risk of T2D, overall and in prospective studies. Ferritin was also significantly associated after multivariable adjustment including inflammation. Thus, the current evidence hints at a causal effect; however, publication bias and unmeasured confounding cannot be excluded.

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Serum Magnesium, Iron and Ferritin Levels in Patients with Diabetic Retinopathy Attending Makkah Eye Complex, Khartoum, Sudan

Hamdan

Nasser²,

Adam

et al. 2015

Biol Trace Elem Res

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Diabetic retinopathy is the most common complications of diabetes mellitus that, in most occasions, lead to blindness. Multiple evidences linked the serum magnesium, iron and ferritin disturbance with diabetes and its complications. A case-control study was conducted at Makkah Eye Complex, Khartoum, Sudan, to compare the levels of serum magnesium, iron and ferritin in patients with diabetic retinopathy with diabetic patients without diabetic retinopathy (controls). Findings indicate that all patients had type 2 diabetes. The two groups (50 in each arm) were well matched in their basic characteristics. Median (25th-75th interquartile) of serum magnesium in patients with diabetic retinopathy were significantly lower than patients without diabetic retinopathy [1.48 (0.75-1.64) vs. 1.92 (1.4-2.3)mg/dl, P = 0.022]. The median of serum iron and ferritin were lower in cases than control group but did not reach a statistical significance [20.5 (17.2-48.0) vs. 27.0 (16.0-54.0) μg/dl, P = 0.568; 98.0 (45.0-134.75) vs. 101.0 (47.0-161.0) μg/l, P = 0.818]. The duration of diabetes [16.5 (9.3) vs. 11.2 (6.6) years; P = 0.014] and haemoglobin level [13.7 (0.9) vs. 12.5 (2.0) g/dl; P = 0.039] were significantly higher in cases group than control group. A significant inverse correlation was observed between serum magnesium and iron levels. Twenty (40 %) patients had severe non-proliferative diabetic retinopathy with mild macular edema, which is the most prevalent type among the cases group. Hypomagnesaemia among diabetic patients was associated with diabetic retinopathy, while serum iron and ferritin have no significant effect in this setting. Severe non-proliferative diabetic retinopathy with mild macular edema is the prevalent type in this study.

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Is Serum Ferritin High in Patients with Diabetic Retinopathy? A Controlled Study

Cited by 8 publications

References 20 publications

Effect of total body iron on metabolic dysfunction among U.S. females in the Nhanes 2003-2010, aged 12-49.

Effect of total body iron on metabolic dysfunction among U.S. females in the Nhanes 2003-2010, aged 12-49.

Association of iron indices and type 2 diabetes: a meta‐analysis of observational studies

Serum Magnesium, Iron and Ferritin Levels in Patients with Diabetic Retinopathy Attending Makkah Eye Complex, Khartoum, Sudan

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