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IS SERUM FERRITIN LEVEL DIFFERENT BETWEEN HEALTHY INDIVIDUALS AND NEWLY DIAGNOSED PATIENTS WITH TYPE 2 DIABETES MELLITUS?: A CASE-CONTROL STUDY

Yıl 2021, Cilt: 54 Sayı: 1, 102 - 106, 27.04.2021
https://doi.org/10.20492/aeahtd.826939

Öz

Introduction: This study aims to evaluate whether serum ferritin levels differ between recently diagnosed patients with type 2 diabetes mellitus (DM) and healthy controls, and to assess the relationship between serum ferritin level, insulin resistance and metabolic control in patients with type 2 DM.
Material and methods: This study included 40 patients with recently diagnosed type 2 DM and 40 healthy controls. The Homeostasis Model Assessment of insulin resistance (HOMA-IR) score was used for evaluation of insulin resistance. HOMA-IR scores ≥2.7 were accepted as insulin resistance. The patient and control groups were compared in terms of age, gender, BMI, serum ferritin, insulin, HbA1c, and HOMA-IR scores. If ferritin levels correlated with other parameters was assessed in the patient group. Furthermore, patients with good (HbA1c<7%) and poor glycemic control (HbA1c≥7%) were compared regarding serum ferritin level.
Results: Ninety percent (n=36) of the patient group and 27.5% (n=11) of the controls had HOMA-IR scores ≥2.7. Serum ferritin levels were significantly higher in the patient group (153.57±150.01 vs 62.83±53.18; p=0.003). There were significant positive correlations between serum ferritin and fasting plasma glucose levels (r=0.419 p=0.007), HbA1c (r=0.410, p=0.009) and HOMA-IR score (r=0.320, p=0.044) in the patient group. Mean serum ferritin level of patients with poor metabolic control (201.20±170.67) was significantly higher than ones with good metabolic control (91.92±71.39) among patients with type 2 DM (p=0.047).
Conclusion: Serum ferritin levels were found to be higher in patients with type 2 DM than controls and there was positive correlation between serum ferritin levels and insulin resistance.

Destekleyen Kurum

none

Proje Numarası

none

Teşekkür

Dr İsmihan SUNAR for her precious support

Kaynakça

  • 1. Classification and Diagnosis of Diabetes. Diabetes Care 2017; 40: S11-s24.
  • 2. Engelgau MM, Geiss LS, Saaddine JB et al. The evolving diabetes burden in the United States. Ann Intern Med 2004; 140: 945-950.
  • 3. Yang W, Lu J, Weng J et al. Prevalence of diabetes among men and women in China. N Engl J Med 2010; 362: 1090-1101.
  • 4. Mokdad AH, Ford ES, Bowman BA et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. Jama 2003; 289: 76-79.
  • 5. Stumvoll M, Goldstein BJ, van Haeften TW. Type 2 diabetes: principles of pathogenesis and therapy. Lancet 2005; 365: 1333-1346.
  • 6. Carter JS, Pugh JA, Monterrosa A. Non-insulin-dependent diabetes mellitus in minorities in the United States. Ann Intern Med 1996; 125: 221-232.
  • 7. Harris MI, Flegal KM, Cowie CC et al. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. The Third National Health and Nutrition Examination Survey, 1988-1994. Diabetes Care 1998; 21: 518-524.
  • 8. Haffner SM, Miettinen H, Gaskill SP, et al. Decreased insulin secretion and increased insulin resistance are independently related to the 7-year risk of NIDDM in Mexican-Americans. Diabetes 1995; 44: 1386-1391.
  • 9. Shoelson SE, Lee J, Goldfine AB. Inflammation and insulin resistance. J Clin Invest 2006; 116: 1793-1801.
  • 10. Vandanmagsar B, Youm YH, Ravussin A et al. The NLRP3 inflammasome instigates obesity-induced inflammation and insulin resistance. Nat Med 2011; 17: 179-188.
  • 11. Duncan BB, Schmidt MI, Pankow JS et al. Low-grade systemic inflammation and the development of type 2 diabetes: the atherosclerosis risk in communities study. Diabetes 2003; 52: 1799-1805.
  • 12. Pradhan AD, Manson JE, Rifai N et al. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. Jama 2001; 286: 327-334.
  • 13. Vozarova B, Weyer C, Lindsay RS et al. High white blood cell count is associated with a worsening of insulin sensitivity and predicts the development of type 2 diabetes. Diabetes 2002; 51: 455-461.
  • 14. de Rekeneire N, Peila R, Ding J et al. Diabetes, hyperglycemia, and inflammation in older individuals: the health, aging and body composition study. Diabetes Care 2006; 29: 1902-1908.
  • 15. Merkel PA, Simonson DC, Amiel SA et al. Insulin resistance and hyperinsulinemia in patients with thalassemia major treated by hypertransfusion. N Engl J Med 1988; 318: 809-814.
  • 16. Jehn M, Clark JM, Guallar E. Serum ferritin and risk of the metabolic syndrome in U.S. adults. Diabetes Care 2004; 27: 2422-2428.
  • 17. Iwasaki T, Nakajima A, Yoneda M et al. Serum ferritin is associated with visceral fat area and subcutaneous fat area. Diabetes Care 2005; 28: 2486-2491.
  • 18. Emerit J, Beaumont C, Trivin F. Iron metabolism, free radicals, and oxidative injury. Biomed Pharmacother 2001; 55: 333-339.
  • 19. Ford ES, Cogswell ME. Diabetes and serum ferritin concentration among U.S. adults. Diabetes Care 1999; 22: 1978-1983.
  • 20. Chen J, Wildman RP, Hamm LL et al. Association between inflammation and insulin resistance in U.S. nondiabetic adults: results from the Third National Health and Nutrition Examination Survey. Diabetes Care 2004; 27: 2960-2965.
  • 21. Williams R, Smith PM, Spicer EJ et al. Venesection therapy in idiopathic haemochromatosis. An analysis of 40 treated and 18 untreated patients. Q J Med 1969; 38: 1-16.
  • 22. Dymock IW, Cassar J, Pyke DA et al. Observations on the pathogenesis, complications and treatment of diabetes in 115 cases of haemochromatosis. Am J Med 1972; 52: 203-210.
  • 23. Ascaso JF, Pardo S, Real JT et al. Diagnosing insulin resistance by simple quantitative methods in subjects with normal glucose metabolism. Diabetes Care 2003; 26: 3320-3325.
  • 24. Tang Q, Li X, Song P, Xu L. Optimal cut-off values for the homeostasis model assessment of insulin resistance (HOMA-IR) and pre-diabetes screening: Developments in research and prospects for the future. Drug Discov Ther 2015; 9: 380-385.
  • 25. Touitou Y, Proust J, Carayon A et al. Plasma ferritin in old age. Influence of biological and pathological factors in a large elderly population. Clin Chim Acta 1985; 149: 37-45.
  • 26. Woo J, Mak YT, Law LK, et al. Plasma ferritin in an elderly population living in the community. J Med 1989; 20: 123-134.
  • 27. Dinneen SF, O'Mahony MS, O'Brien T et al. Serum ferritin in newly diagnosed and poorly controlled diabetes mellitus. Ir J Med Sci 1992; 161: 636-638.
  • 28. Hernandez C, Lecube A, Carrera A, et al. Soluble transferrin receptors and ferritin in Type 2 diabetic patients. Diabet Med 2005; 22: 97-101.
  • 29. Kim NH, Oh JH, Choi KM et al. Serum ferritin in healthy subjects and type 2 diabetic patients. Yonsei Med J 2000; 41: 387-392.
  • 30. Chen KW, Boyko EJ, Bergstrom RW et al. Earlier appearance of impaired insulin secretion than of visceral adiposity in the pathogenesis of NIDDM. 5-Year follow-up of initially nondiabetic Japanese-American men. Diabetes Care 1995; 18: 747-753.
  • 31. Weyer C, Bogardus C, Mott DM, et al. The natural history of insulin secretory dysfunction and insulin resistance in the pathogenesis of type 2 diabetes mellitus. J Clin Invest 1999; 104: 787-794.
  • 32. Chen L, Li Y, Zhang F et al. Association of serum ferritin levels with metabolic syndrome and insulin resistance in a Chinese population. J Diabetes Complications 2017; 31: 364-368.
  • 33. Fernandez-Real JM, Ricart-Engel W et al. Serum ferritin as a component of the insulin resistance syndrome. Diabetes Care 1998; 21: 62-68.
  • 34. Facchini FS. Effect of phlebotomy on plasma glucose and insulin concentrations. Diabetes Care 1998; 21: 2190.
  • 35. Hua NW, Stoohs RA, Facchini FS. Low iron status and enhanced insulin sensitivity in lacto-ovo vegetarians. Br J Nutr 2001; 86: 515-519.
  • 36. Ascherio A, Rimm EB, Giovannucci E et al. Blood donations and risk of coronary heart disease in men. Circulation 2001; 103: 52-57.

SERUM FERRİTİN DÜZEYİ SAĞLIKLI BİREYLERLE YENİ TANI TİP 2 DİYABET HASTALARINDA FARKLI MIDIR?: VAKA KONTROL ÇALIŞMASI

Yıl 2021, Cilt: 54 Sayı: 1, 102 - 106, 27.04.2021
https://doi.org/10.20492/aeahtd.826939

Öz

Giriş: Bu çalışmanın amacı yeni tanı tip 2 DM hastaları ile sağlıklı bireyler arasında serum ferritin düzeyi açısından fark olup olmadığını değerlendirmek, ayrıca tip 2 DM hastalarında serum ferritin düzeyinin insülin direnci ve metabolik kontrol ile ilişkisini araştırmaktır.
Materyal ve metod: Çalışmaya 40 yeni tanı tip 2 DM hastası ile 40 sağlıklı kişiden oluşan kontrol grubu dahil edildi. İnsülin direncini değerlendirmek için Homeostasis Model Assessment of insülin resistance (HOMA-IR) skoru kullanıldı. HOMA-IR skorunun ≥2,7 olması insulin direnci olarak kabul edildi. Hasta ve kontrol grubunu oluşturan bireyler yaş, cinsiyet dağılımı, VKİ, serum ferritin düzeyi, insülin düzeyi ve HOMA-IR skoru açısından karşılaştırıldı. Hasta grubundaki bireylerin ferritin düzeyi ile diğer parametreler arasındaki ilişki incelendi. Ayrica iyi metabolik kontrollü (HbA1c<%7) ve kötü metabolik kontrollü (HbA1c≥%7) hastaların serum ferritin düzeyleri karşılaştırıldı.
Bulgular: Hasta grubunun %90’ında (n=36), kontrol grubunun %27,5’inde (n=11) HOMA-IR skoru ≥2,7 olarak tespit edildi. Hasta grubunun ferritin düzeyi kontrol grubuna göre anlamlı olarak yüksek saptandı (153,57±150,01’e 62,83±53,18; p=0,003). Hasta grubunda ferritin düzeyi ile açlık kan şekeri (r=0.419 p=0.007), HbA1c (r=0.410, p=0.009) ve HOMA-IR skoru (r=0.320, p=0.044) arasında pozitif bir korelasyon tespit edildi. Tip 2 DM hastalarında kötü metabolik kontrollü hastaların ortalama ferritin düzeyleri (201,20±170,67) iyi metabolik kontrollü hastaların ortalama ferritin düzeylerine (91,92±71,39) göre anlamlı olarak daha yüksek saptandı (p=0,047).
Sonuç: Tip 2 DM hastalarında serum ferritin düzeyi sağlıklı bireylere göre yüksek saptanmış olup serum ferritin düzeyi ile insülin direnci arasında pozitif bir ilişki bulunmuştur.

Proje Numarası

none

Kaynakça

  • 1. Classification and Diagnosis of Diabetes. Diabetes Care 2017; 40: S11-s24.
  • 2. Engelgau MM, Geiss LS, Saaddine JB et al. The evolving diabetes burden in the United States. Ann Intern Med 2004; 140: 945-950.
  • 3. Yang W, Lu J, Weng J et al. Prevalence of diabetes among men and women in China. N Engl J Med 2010; 362: 1090-1101.
  • 4. Mokdad AH, Ford ES, Bowman BA et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. Jama 2003; 289: 76-79.
  • 5. Stumvoll M, Goldstein BJ, van Haeften TW. Type 2 diabetes: principles of pathogenesis and therapy. Lancet 2005; 365: 1333-1346.
  • 6. Carter JS, Pugh JA, Monterrosa A. Non-insulin-dependent diabetes mellitus in minorities in the United States. Ann Intern Med 1996; 125: 221-232.
  • 7. Harris MI, Flegal KM, Cowie CC et al. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U.S. adults. The Third National Health and Nutrition Examination Survey, 1988-1994. Diabetes Care 1998; 21: 518-524.
  • 8. Haffner SM, Miettinen H, Gaskill SP, et al. Decreased insulin secretion and increased insulin resistance are independently related to the 7-year risk of NIDDM in Mexican-Americans. Diabetes 1995; 44: 1386-1391.
  • 9. Shoelson SE, Lee J, Goldfine AB. Inflammation and insulin resistance. J Clin Invest 2006; 116: 1793-1801.
  • 10. Vandanmagsar B, Youm YH, Ravussin A et al. The NLRP3 inflammasome instigates obesity-induced inflammation and insulin resistance. Nat Med 2011; 17: 179-188.
  • 11. Duncan BB, Schmidt MI, Pankow JS et al. Low-grade systemic inflammation and the development of type 2 diabetes: the atherosclerosis risk in communities study. Diabetes 2003; 52: 1799-1805.
  • 12. Pradhan AD, Manson JE, Rifai N et al. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. Jama 2001; 286: 327-334.
  • 13. Vozarova B, Weyer C, Lindsay RS et al. High white blood cell count is associated with a worsening of insulin sensitivity and predicts the development of type 2 diabetes. Diabetes 2002; 51: 455-461.
  • 14. de Rekeneire N, Peila R, Ding J et al. Diabetes, hyperglycemia, and inflammation in older individuals: the health, aging and body composition study. Diabetes Care 2006; 29: 1902-1908.
  • 15. Merkel PA, Simonson DC, Amiel SA et al. Insulin resistance and hyperinsulinemia in patients with thalassemia major treated by hypertransfusion. N Engl J Med 1988; 318: 809-814.
  • 16. Jehn M, Clark JM, Guallar E. Serum ferritin and risk of the metabolic syndrome in U.S. adults. Diabetes Care 2004; 27: 2422-2428.
  • 17. Iwasaki T, Nakajima A, Yoneda M et al. Serum ferritin is associated with visceral fat area and subcutaneous fat area. Diabetes Care 2005; 28: 2486-2491.
  • 18. Emerit J, Beaumont C, Trivin F. Iron metabolism, free radicals, and oxidative injury. Biomed Pharmacother 2001; 55: 333-339.
  • 19. Ford ES, Cogswell ME. Diabetes and serum ferritin concentration among U.S. adults. Diabetes Care 1999; 22: 1978-1983.
  • 20. Chen J, Wildman RP, Hamm LL et al. Association between inflammation and insulin resistance in U.S. nondiabetic adults: results from the Third National Health and Nutrition Examination Survey. Diabetes Care 2004; 27: 2960-2965.
  • 21. Williams R, Smith PM, Spicer EJ et al. Venesection therapy in idiopathic haemochromatosis. An analysis of 40 treated and 18 untreated patients. Q J Med 1969; 38: 1-16.
  • 22. Dymock IW, Cassar J, Pyke DA et al. Observations on the pathogenesis, complications and treatment of diabetes in 115 cases of haemochromatosis. Am J Med 1972; 52: 203-210.
  • 23. Ascaso JF, Pardo S, Real JT et al. Diagnosing insulin resistance by simple quantitative methods in subjects with normal glucose metabolism. Diabetes Care 2003; 26: 3320-3325.
  • 24. Tang Q, Li X, Song P, Xu L. Optimal cut-off values for the homeostasis model assessment of insulin resistance (HOMA-IR) and pre-diabetes screening: Developments in research and prospects for the future. Drug Discov Ther 2015; 9: 380-385.
  • 25. Touitou Y, Proust J, Carayon A et al. Plasma ferritin in old age. Influence of biological and pathological factors in a large elderly population. Clin Chim Acta 1985; 149: 37-45.
  • 26. Woo J, Mak YT, Law LK, et al. Plasma ferritin in an elderly population living in the community. J Med 1989; 20: 123-134.
  • 27. Dinneen SF, O'Mahony MS, O'Brien T et al. Serum ferritin in newly diagnosed and poorly controlled diabetes mellitus. Ir J Med Sci 1992; 161: 636-638.
  • 28. Hernandez C, Lecube A, Carrera A, et al. Soluble transferrin receptors and ferritin in Type 2 diabetic patients. Diabet Med 2005; 22: 97-101.
  • 29. Kim NH, Oh JH, Choi KM et al. Serum ferritin in healthy subjects and type 2 diabetic patients. Yonsei Med J 2000; 41: 387-392.
  • 30. Chen KW, Boyko EJ, Bergstrom RW et al. Earlier appearance of impaired insulin secretion than of visceral adiposity in the pathogenesis of NIDDM. 5-Year follow-up of initially nondiabetic Japanese-American men. Diabetes Care 1995; 18: 747-753.
  • 31. Weyer C, Bogardus C, Mott DM, et al. The natural history of insulin secretory dysfunction and insulin resistance in the pathogenesis of type 2 diabetes mellitus. J Clin Invest 1999; 104: 787-794.
  • 32. Chen L, Li Y, Zhang F et al. Association of serum ferritin levels with metabolic syndrome and insulin resistance in a Chinese population. J Diabetes Complications 2017; 31: 364-368.
  • 33. Fernandez-Real JM, Ricart-Engel W et al. Serum ferritin as a component of the insulin resistance syndrome. Diabetes Care 1998; 21: 62-68.
  • 34. Facchini FS. Effect of phlebotomy on plasma glucose and insulin concentrations. Diabetes Care 1998; 21: 2190.
  • 35. Hua NW, Stoohs RA, Facchini FS. Low iron status and enhanced insulin sensitivity in lacto-ovo vegetarians. Br J Nutr 2001; 86: 515-519.
  • 36. Ascherio A, Rimm EB, Giovannucci E et al. Blood donations and risk of coronary heart disease in men. Circulation 2001; 103: 52-57.
Toplam 36 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Veli Sunar 0000-0003-4672-4621

Proje Numarası none
Yayımlanma Tarihi 27 Nisan 2021
Gönderilme Tarihi 16 Kasım 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 54 Sayı: 1

Kaynak Göster

AMA Sunar V. IS SERUM FERRITIN LEVEL DIFFERENT BETWEEN HEALTHY INDIVIDUALS AND NEWLY DIAGNOSED PATIENTS WITH TYPE 2 DIABETES MELLITUS?: A CASE-CONTROL STUDY. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. Nisan 2021;54(1):102-106. doi:10.20492/aeahtd.826939