International Journal of Clinical Biochemistry and Research

Print ISSN: 2394-6369

Online ISSN: 2394-6377

CODEN : IJCBK6

International Journal of Clinical Biochemistry and Research (IJCBR) open access, peer-reviewed quarterly journal publishing since 2014 and is published under auspices of the  Innovative Education and Scientific Research Foundation (IESRF), aim to uplift researchers, scholars, academicians, and professionals in all academic and scientific disciplines. IESRF is dedicated to the transfer of technology and research by publishing more...


  • Article highlights
  • Article tables
  • Article images

Article statistics

Viewed: 252

PDF Downloaded: 203


Parmar, Modi, and Gajjar: Study of serum ferritin in type 2 DM patients in north Gujarat


Introduction

Prevalence of Type 2 diabetes mellitus (DM2) has continue to increase in recent decades.1, 2, 3, 4, 5 It is an important health problem worldwide affecting about 8 percent of population.6 Serum ferritin is storage form of Iron. It is globular protein. Ferrous form of Iron enters into cells in condition of oxidative stress and changes into Ferric form which is linked to ferritin and protect the cells from free radicals.7 Oxidative stress is linked with impairment in glucose tolerance and insulin resistance.8, 9, 10 Higher levels of Ferritin and Iron inside cells can produce Insulin resistance and malfunction of Beta cells of Pancreas. Hyperinsulinemia because of Insulin resistance may be responsible for high level of Ferritin. Derangement in metabolism of Iron may produce resistance to insulin, hyperinsulinemia, dyslipidemia and obesity.11, 12

Materials and Methods

The present cross sectional study was carried at Clinical Chemistry Laboratory, Laboratory Services, Department of Biochemistry, GMERS Medical College and Hospital, Vadnagar, Gujarat.

Inclusion criteria

All cases and controls included in study have age more than 40 years.

Study duration

The duration of study was four months.

There were 100 cases having minimum 5 years history of type 2 diabetes mellitus residing at North Gujarat. Patients having acute infections, chronic systemic diseases, cancer, thyroid disorders, history of smoking and alcohol were excluded from study.

Pregnant ladies and lactating mothers were not included.

Patients on Insulin were excluded.

There were 100 healthy controls in this study.

All participants were instructed to continue their usual physical activities and routine diet.

All cases were instructed to take their oral hypoglycemic drugs as per advice of physician.

Criteria for the diagnosis of diabetes mellitus13

Fasting Blood Sugar >126 mg/dL. Fasting is defined as no caloric intake for at least 8h.*

2 hour Post Prandial Blood Sugar > 200 mg/ dL

Laboratory samples

  1. Two ml of venours blood was collected in fluoride vacutainer for estimation of glucose.

  2. Four ml of venours blood was collected in plain vacutainer for estimation of Ferritin.

  3. Four ml of venours blood was collected in EDTA vacutainer for estimation of HbA1c.

  4. Collection of Blood was done in morning in fasting condition.

  5. Samples were analyzed within two hours of collection.

  6. GOD-POD (Glucose Oxidase- Peroxidase) method was used for estimation of glucose.

  7. Nephelometry method was used for estimation of Ferritin and HbA1c.

Statistical analysis

Statistical analysis was done by using SPSS software version for performing student ‘t’ test.

Probability <0.05 considered as significant.

Result

In the present study, 64 patients were males and 36 were females as illustrated in the Table 1. FBS(158.67±20.78), PPBS (176.19±19.84) and ferritin (202.31±17.27 in male and 105.09 ±10.66 in female) levels were significantly increased in type 2 diabetes mellitus patients compared with controls.

Table 1

Age of patients of diabetes mellitus

Age

Male

Female

41-50 yrs

13

8

51-60 yrs

32

19

61-70 yrs

19

9

Total

64

36

Discussion

Chronic disorders like diabetes mellitus and hypertension leads to mortality in present era. Conclusive evidences are available which clearly indicates derangement in trace elements metabolism in diabetes mellitus. Correlation exists between serum ferritin, FBS, HbA1c and Serum Insulin.12 Serum ferritin, a reflector of body iron stores was significantly higher in diabetic patients increased as duration of diabetes increased. This possibly reflects the subclinical hemochromatosis developing in a long standing diabetic patient. 14 Increased body iron stores are possibly associated with occurrence of glucose intolerance, type-2 diabetes and gestational diabetes.15, 16 Poorly controlled patients have hyperferritinemia and there is association between serum ferritin level and diabetic retinopathy.17 We found that high level of serum ferritin (p<0.05) is seen in patients of diabetes mellitus who have poor glycemic control which matches with other studies.17, 18 In diabetic subjects, a positive correlation between increased serum ferritin and poor glycemic control, reflected by higher HbAIc, has been suggested.18 

Table 2

Serum ferritin and HbA1c level in Healthy controls and patients of diabetes mellitus

Name of Parameter

Controls (Mean±SD) (N=100)

Diabetes Mellitus Patients

(Mean±SD) (N=100)

FBS (mg/dl)

89.32 ± 9.21

158.67 ± 20.78*

PPBS (mg/dl)

108.96 ±10.54

176.19 ± 19.84*

Ferritin (ng/ml)

In Male: 141.57 ± 14.65

In Male: 202.31 ± 17.27*

In Female: 79.13 ± 7.42

In Female: 105.09 ± 10.66*

HbA1c (%)

4.89+0.78

7.86 + 2.03*

Conclusion

From the present study it may concluded that high level of serum ferritin is found in patients of type 2 diabetes mellitus who have poor glycemic control which may have role in prognosis and pathogenesis of diabetes mellitus. For better understanding effect of serum ferritin in diabetes mellitus, further clinical studies are needed which should enroll large number of patients and should use higher advanced methods.

Conflict of Interest

None.

Source of funding

Self-funding was done for the study.

References

1 

J McKinlay L Marceau US public health and the 21st century: diabetes mellitusLancet200035692317576110.1016/s0140-6736(00)02641-6

2 

S Wild G Roglic A Green R Sicree H King Global Prevalence of Diabetes: Estimates for the year 2000 and projections for 2030Diabetes Care200427510475310.2337/diacare.27.5.1047

3 

VM Freid K Prager AP Mackay H Xia Hyattsville, Maryland: National Center for Health StatisticsChartbook on Trends in the Health of AmericansHealth, United States2003

4 

W Yang J Lu J Weng W Jia L Ji J Xiao Prevalence of diabetes among men and women in ChinaN Engl J Med2010362109010110.1056/NEJMoa0908292

5 

CS Fox MJ Pencina JB Meigs RS Vasan YS Levitzky RB Agostino Sr Trends in the incidence of type 2 diabetes mellitus from the 1970s to the 1990s: The Framingham Heart StudyCirculation200611329148

6 

E Hughes M Mccracken H Roberts AH Mokdad B Valluru R Goodson Surveillance for certain health behaviors among states and selected local areas--behavioral risk factor surveillance systemMMWR Surveill Summ20065571124

7 

EC Theil Ferritin: Structure, Gene Regulation, and Cellular Function in Animals, Plants, and MicroorganismsAnn Rev Biochem198756128931510.1146/annurev.bi.56.070187.001445

8 

K Park M Gross DH Lee P Holvoet JH Himes JM Shikany Oxidative Stress and Insulin Resistance: The Coronary Artery Risk Development in Young Adults studyDiabetes Care20093271302710.2337/dc09-0259

9 

R Brudevold T Hole J Hammerstrøm Hyperferritinemia Is Associated with Insulin Resistance and Fatty Liver in Patients without Iron OverloadPLoS ONE2008310e354710.1371/journal.pone.0003547

10 

HN Kim SW Song Concentrations of chromium, selenium, and copper in the hair of viscerally obese adults are associated with insulin resistanceBiol Trace Elem Res201415821527

11 

M Jehn JM Clark E Guallar Serum Ferritin and Risk of the Metabolic Syndrome in U.S. AdultsDiabetes Care2004272422810.2337/diacare.27.10.2422

12 

M Ashourpour M Djalali A Djazayery MR Eshraghian M Taghdir A Saedisomeolia Relationship between serum ferritin and inflammatory biomarkers with insulin resistance in a Persian population with type 2 diabetes and healthy peopleInt J Food Sci Nutr20106133162310.3109/09637480903555150

13 

Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2019Am Diabetes Assoc Diabetes Care2019421S13S28

14 

DK Moczulski W Grzeszczak B Gawlik Role of Hemochromatosis C282Y and H63D Mutations in HFE Gene in Development of Type 2 Diabetes and Diabetic NephropathyDiabetes Care200124711879110.2337/diacare.24.7.1187

15 

JM Fernandez-Real G Penarroja A Castro F Garcia-Bragado A Lopez-Bermejo W Ricart Blood Letting in High-Ferritin Type 2 Diabetes: Effects on vascular reactivityDiabetes Care2002251222495510.2337/diacare.25.12.2249

16 

ES Ford ME Cogswell Diabetes and serum ferritin concentration among U.S. adultsDiabetes Care1999221219788310.2337/diacare.22.12.1978

17 

Z Canturk B Çetinarslan İ Tarkun NZ Canturk Serum Ferritin Levels in Poorly‐ and Well‐Controlled Diabetes MellitusEndocr Res200329329930610.1081/erc-120025037

18 

E Eschwege R Saddi H Wacjman R Levy N Thibult A Duchateau Haemoglobin AIc in patients on venesection therapy for haemochromatosisDiabete Metab1982813740



jats-html.xsl

© This is an open access article distributed under the terms of the Creative Commons Attribution License - Attribution 4.0 International (CC BY 4.0). which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Article type

Original Article


Article page

9-11


Authors Details

Jigar A Parmar, Gaurav D Modi, Margit G Gajjar


Article History

Received : 12-03-2021

Accepted : 22-03-2021

Available online : 30-04-2021


Article Metrics


View Article As

 


Downlaod Files