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A study on relation between serum ferritin and glycated hemoglobin in type 2 diabetes mellitus

Author: 
Dr. L. S. Patil, Dr. Timmanna Giraddi, Dr. Deepak Chinagi, Dr. Prasad Ugaragol and Dr. Banashankari Kolluru
Subject Area: 
Health Sciences
Abstract: 

Background: Diabetes Mellitus is a metabolic disorder of multiple etiologies characterized by chronic hyperglycemia with disturbances of carbohydrate, fat and protein metabolism. DM is associated with several complications. Ferritin is the major iron storage protein and plays a key role in iron metabolism. Ferritin in the circulation is a secretory form of the protein which is glycosylated and has been hypothesized for its role in the pathogenesis of diabetes and its complications. Increased accumulation of iron affects insulin synthesis and secretion from the pancreas, and interferes with the insulin extracting capacity of the liver. Iron deposition in muscle decreases glucose uptake because of muscle damage. Iron deposition in the liver may also cause insulin resistance by interfering with the ability of insulin to suppress hepatic glucose production. Aim: This cross-sectional study was performed to find a link between serum ferritin and type 2 diabetes mellitus and also glycated hemoglobin as a blood glucose control marker in diabetic patients. Material and Methods: This study was conducted in the Department of Medicine, BLDE University’s Shri B M Patil Medical College and Research Centre, Vijayapura from January 2014 to June 2015 on newly detected and known patients of type 2 diabetes mellitus who attended outpatient and inpatient department. A total of 131 patients of type 2 diabetes mellitus were included in the study. The mean age of study population was 53.46 ± 10.74 years. Out of 131 patients 70 patients (53.43%) were males and 61 patients (46.56%) were females, accounting for a ratio of male to female as 1.15:1. The mean duration of diabetes was 7.04 ± 3.25 years. 105 patients (80.16% of the cases) were on Oral Hypoglycemic Agents for the treatment of diabetes. The mean BMI was 23.95 ± 3.15. 42 patients (32.08% of the cases) had BMI ranging from 25 to 29.99. We observed 90 patients (69%) had fasting blood glucose above 126mg/dl and 72 patients (55%) had post prandial blood glucose above 200mg/dl, showing the existence of poor glycemic control. The mean HbAlc level was 8.34± 0.84. Total cholesterol more than 200 mg/dl in 52 patients (40%) and 67 patients (51%) had LDL Cholesterol more than 100 mg/dl. 62 patients (47%) HDL Cholesterol was less than 40 mg/dl. Triglyceride levels were more than 150 mg/dL in 39 patients (29.77%). 74.7% of cases had serum ferritin ranging from 101 – 200 ng/ml. We found that in 90 patients whose FBS was more than 126mg/dl, the mean serum ferritin was 164.56ng/ml. We found 72 patients whose PPBS was more than 200mg/dl, the mean serum ferritin was 173.49ng/ml. We found 76 patients whose HbAlc was more than 8%, the mean serum ferritin was 176.06ng/ml. The p-value of ≤ 0.001 when we correlated serum ferritin levels with FBS and PPBS and HbA1C. This p value was statistically significant. Conclusion: There was positive association between serum ferritin and body mass index measurements, fasting blood glucose levels, postprandial blood glucose levels, glycosylated hemoglobin as a measure of glycemic control. We also observed there was direct association between serum ferritin levels and triglyceride and LDL Cholesterol, but inverse association with HDL Cholesterol. When correlated with other variables like age, gender, duration of diabetes, total cholesterol, we found no significant correlation (p-value being statistically insignificant).

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