Serum Ferritin and Soluble Transferrin Receptors in Type II Diabetic Patients: Correlation with TNF-αas a Marker of Inflammation

Document Type : Original Article

Authors

1 Department of Medical Biochemistry , Faculty of Medicine, Cairo University

2 Department of Internal Medicine, Faculty of Medicine, Cairo University

Abstract

Over the past years cumulating evidence has confirmed interlinking pathways
connecting type II diabetes mellitus (DM) with an underlying inflammatory process.
Furthermore, iron overload states have alsobeen directly linkedto the development
of insulin resistance and type II diabetes. Serum ferritin as well as most of the
biochemical markers for iron are affected by the acute phase response rendering the
assessment of iron status in patients with inflammatory conditions somewhat
challenging. So, the present study aimed to determine circulating levels of ferritin and
soluble transferring receptor (sTFR) in type II diabetic patients as well as TNF-αas
an inflammatory marker in order to evaluate whether serum ferritin reflects iron body
stores or inflammation in diabetic patients. Thirty diabetic patients and 15 healthy
control subjects were included in the study. Serum ferritin, sTFR and TNF-αlevels
were measured by enzyme immunoassay.Serum iron and total iron binding capacity
(TIBC) were determined by quantitative colorimetric determination. The results of the
study showed that diabeticpatients have significantly higher serum ferritin levels
than control subjects. However, no differences in sTFR levels were observed between
both groups. A significant negative correlation between ferritin and sTFR levels was
detected in control subjects but not in diabetic patients. Moreover, a significant
positive correlation was found between levels of TNF-αand ferritin but not with sTFR
levels in diabetic patients. Conclusion: Serum ferritin levels are increased in type II
diabetic patients in correlation with the inflammatory marker TNF-αand in the
absence of a reciprocal decrease of sTFR. These findings suggest that the elevated
ferritin levels in type II diabetes are mainly as a result of inflammatory mechanisms
rather than iron overload.

Keywords