| Peer-Reviewed

Evaluation of Serum Ferritin in Type 2 Diabetes Mellitus: An Observational Study from North Sulawesi, Indonesia

Received: 22 September 2022    Accepted: 10 October 2022    Published: 18 October 2022
Views:       Downloads:
Abstract

Diabetes mellitus is still an important health problem in Indonesia because the incidence is increasing every year and most patients do not achieve good and proper glycemic control. Analysis of blood ferritin levels in type 2 diabetes mellitus patients is considered limited in many areas. As a marker of iron stores in the body, elevated serum ferritin has been associated with microvascular and macrovascular complications of diabetes mellitus. This study aimed to determine the correlation between serum ferritin levels and fasting blood glucose, glycated hemoglobin (HbA1c), and other biochemical parameters in type 2 diabetes mellitus patients in North Sulawesi, Indonesia. A total of 108 diabetes mellitus patients were included in this cross-sectional study. Subjects were tested for blood pressure, body mass index, fasting blood glucose, hemoglobin, glycated hemoglobin (HbA1c), ferritin, urea, creatinine, uric acid, alanine aminotransferase, aspartate aminotransferase, cholesterol, and triglyceride. The averages of HbA1c% in the good, moderate, and poor groups were 5.70 ± 0.5%, 7.2 ± 0.6, and 10.1 ± 1.6, respectively. Increased fasting blood glucose, ferritin, urea, creatinine, and uric acid levels were observed along with worsening glycemic status. There were significant correlations between serum ferritin and fasting blood glucose, glycated hemoglobin, and alanine aminotransferase (p < 0.05). There were significantly different mean ferritin values in the three groups of glycated hemoglobin, suggesting ferritin can be used as an indicator of control of glycemia and diabetic complications.

Published in International Journal of Diabetes and Endocrinology (Volume 7, Issue 4)
DOI 10.11648/j.ijde.20220704.11
Page(s) 103-108
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Diabetes Mellitus, Ferritin, Glycated Hemoglobin, HbA1c, Blood Glucose

References
[1] Young EE, Okafor CN, Okwara CC. Diabetes mellitus, associated co-morbidities and complications - A review. Int Res J Med Med Sci 2016; 07 (03): 47-55.
[2] World Health Organization. Global report on diabetes. Working Papers 2016; id: 10553, eSocial Sciences.
[3] Pamungkas RA, Chamroonsawasdi K. Family Functional-based Coaching Program on Healthy Behavior for Glycemic Control among Indonesian Communities: A Quasi-experimental Study. Oman Med J 2020; 35 (5): e173–e173.
[4] Pamungkas RA, Chamroonsawasdi K. Self-management based coaching program to improve diabetes mellitus self-management practice and metabolic markers among uncontrolled type 2 diabetes mellitus in Indonesia: A quasi-experimental study. Diabetes Metab Syndr Clin Res Rev 2020; 14 (1): 53–61.
[5] Badan Penelitian dan Pengembangan Kesehatan. Hasil Utama RISKESDAS 2018. Kementerian Kesehatan RI; 2018.
[6] Arora P. Correlation between Serum Ferritin and glycated Hb level in patients of type 2 DM. Int J Cur Res Rev 2017; 9 (6), 30-3.
[7] Rawat N, Mathur N, Harikrishnan R, Choudary J, Rawat K, Mathur M. A study of correlation of serum ferritin with glycated hemoglobin in diabetes mellitus type 2 patients: a case control study. Asian Pac J Health Sci 2016; 3 (4), 83–8.
[8] Son NE. Influence of ferritin levels and inflammatory markers on HbA1c in the Type 2 Diabetes mellitus patients. Pak J Med Sci 2019; 35 (4): 1030-5.
[9] Rajpathak S, Ma J, Manson J, Willett WC, Hu FB. Iron Intake and the Risk of Type 2 Diabetes in Women: A prospective cohort study. Diabetes Care 2006; 29 (6): 1370–6.
[10] Kaleru T, Vankeshwaram VK, Maheshwary A, Mohite D, Khan S. Diabetes Mellitus in the Middle-Aged and Elderly Population (>45 Years) and Its Association With Pancreatic Cancer: An Updated Review. Cureus 2020; 12 (6): e8884-e8884.
[11] Kirkman MS, Briscoe VJ, Clark N, Florez H, Haas LB, Halter JB, et al. Diabetes in Older Adults. Diabetes Care 2012; 35 (12): 2650–64.
[12] LeRoith D, Biessels GJ, Braithwaite SS, Casanueva FF, Draznin B, Halter JB, et al. Treatment of Diabetes in Older Adults: An Endocrine Society* Clinical Practice Guideline. J Clin Endocrinol Metab 2019; 104 (5): 1520–74.
[13] Purwanto DS, Laloan RJ, Raranta HPT, Kepel BJ. Electrolyte Levels Analysis on Diabetes Mellitus Patients in Noongan Regional General Hospital, North Sulawesi, Indonesia. Int J Diabetes Metab 2020: 5 (4), 54-60.
[14] Sobers-Grannum N, Murphy MM, Nielsen A, Guell C, Samuels TA, Bishop L, et al. Female Gender Is a Social Determinant of Diabetes in the Caribbean: A Systematic Review and Meta-Analysis. Wu Q, editor. PLOS ONE 2015; 10 (5): e0126799.
[15] Borah M, Goswami R. Evaluation of serum ferritin in in type II diabetes mellitus: a hospital based observational study from Dibrugarh, Assam, India. Int J Res Med Sci 2016; 4 (11): 4916–21.
[16] Sharifi F, Sazandeh S. Serum ferritin in type 2 diabetes mellitus and its relationship with HbA1c. Acta Med Iran 2004; 42 (2): 142-5.
[17] Canturk Z, Çetinarslan B, Tarkun İ, Zafer Canturk N. Serum Ferritin Levels in Poorly- and Well-Controlled Diabetes Mellitus. Endocr Res 2003; 29 (3): 299–306.
[18] Altamura S, Müdder K, Schlotterer A, Fleming T, Heidenreich E, Qiu R, et al. Iron aggravates hepatic insulin resistance in the absence of inflammation in a novel db/db mouse model with iron overload. Mol Metab 2021; 51: 101235.
[19] Thomas MC, MacIsaac RJ, Tsalamandris C, Jerums G. Elevated iron indices in patients with diabetes: Short report. Diabet Med 2004; 21 (7): 798–802.
[20] Tangvarasittichai S. Oxidative stress, insulin resistance, dyslipidemia and type 2 diabetes mellitus. World J Diabetes 2015; 6 (3): 456-80.
[21] Ito F, Sono Y, Ito T. Measurement and Clinical Significance of Lipid Peroxidation as a Biomarker of Oxidative Stress: Oxidative Stress in Diabetes, Atherosclerosis, and Chronic Inflammation. Antioxidants 2019; 8 (3): 72.
[22] Avelar TMT, Storch AS, Castro LA, Azevedo GVMM, Ferraz L, Lopes PF. Oxidative stress in the pathophysiology of metabolic syndrome: which mechanisms are involved? J Bras Patol E Med Lab 2015; 51 (4): 231–9.
[23] Jiang R. Body Iron Stores in Relation to Risk of Type 2 Diabetes in Apparently Healthy Women. JAMA 2004; 291 (6): 711.
[24] Zhao Z, Li S, Liu G, Yan F, Ma X, Huang Z, et al. Body Iron Stores and Heme-Iron Intake in Relation to Risk of Type 2 Diabetes: A Systematic Review and Meta-Analysis. Ye J, editor. PLoS ONE 2012; 7 (7): e41641.
[25] Utzschneider KM, Largajolli A, Bertoldo A, Marcovina S, Nelson JE, Yeh MM, et al. Serum ferritin is associated with non-alcoholic fatty liver disease and decreased Β-cell function in non-diabetic men and women. J Diabetes Complications 2014; 28 (2): 177–84.
[26] Ketema EB, Kibret KT. Correlation of fasting and postprandial plasma glucose with HbA1c in assessing glycemic control; systematic review and meta-analysis. Arch Public Health 2015; 73 (1): 43.
[27] Khondker F, Roy MN, Saha PR, Huq R, Ahmed R, Biswas S. Relationship Between Serum Ferritin Level and HbA1c in Bangladeshi Type 2 Diabetic Patients. Anwer Khan Mod Med Coll J 2018; 9 (1): 29–33.
[28] Moirangthem MM, Rajkumari VD. Study of Serum Ferritin and HbA1c Levels in Type 2 Diabetes Mellitus. J Evid Based Med Healthc 2020; 7 (27): 1282–5.
[29] Raj S, Rajan G. Correlation between elevated serum ferritin and HbA1c in type 2 diabetes mellitus. Int J Res Med Sci 2013; 1 (1): 12.
[30] Amartey NAA, Nsiah K, Mensah FO. Plasma Levels of Uric Acid, Urea and Creatinine in Diabetics Who Visit the Clinical Analysis Laboratory (CAn-Lab) at Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. J Clin Diagn Res. 2015; 9 (2): BC05-09.
[31] Adler AI, Stevens RJ, Manley SE, Bilous RW, Cull CA, Holman RR, et al. Development and progression of nephropathy in type 2 diabetes: The United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int 2003; 63 (1): 225–32.
[32] Bamanikar S, Bamanikar A, Arora A. Study of Serum urea and Creatinine in Diabetic and non- diabetic patients in in a tertiary teaching hospital. J Med Res 2016; 2 (1): 12- 5.
[33] Cugy D. Relationship of morningness-eveningness questionnaire score to ferritin, gamma glutamyl-transpeptidase and alanine amino-transferase concentrations in a large cohort. Sleep Med Disord Int J 2018; 2 (3): 60-5.
[34] Choi KM, Lee KW, Kim HY, Seo JA, Kim SG, Kim NH, et al. Association among serum ferritin, alanine aminotransferase levels, and metabolic syndrome in Korean postmenopausal women. Metabolism 2005; 54 (11): 1510–4.
Cite This Article
  • APA Style

    Diana Shintawati Purwanto, Yanti Meilen Mewo, Stefana Helena Margaretha Kaligis, Edmond Leonard Jim. (2022). Evaluation of Serum Ferritin in Type 2 Diabetes Mellitus: An Observational Study from North Sulawesi, Indonesia. International Journal of Diabetes and Endocrinology, 7(4), 103-108. https://doi.org/10.11648/j.ijde.20220704.11

    Copy | Download

    ACS Style

    Diana Shintawati Purwanto; Yanti Meilen Mewo; Stefana Helena Margaretha Kaligis; Edmond Leonard Jim. Evaluation of Serum Ferritin in Type 2 Diabetes Mellitus: An Observational Study from North Sulawesi, Indonesia. Int. J. Diabetes Endocrinol. 2022, 7(4), 103-108. doi: 10.11648/j.ijde.20220704.11

    Copy | Download

    AMA Style

    Diana Shintawati Purwanto, Yanti Meilen Mewo, Stefana Helena Margaretha Kaligis, Edmond Leonard Jim. Evaluation of Serum Ferritin in Type 2 Diabetes Mellitus: An Observational Study from North Sulawesi, Indonesia. Int J Diabetes Endocrinol. 2022;7(4):103-108. doi: 10.11648/j.ijde.20220704.11

    Copy | Download

  • @article{10.11648/j.ijde.20220704.11,
      author = {Diana Shintawati Purwanto and Yanti Meilen Mewo and Stefana Helena Margaretha Kaligis and Edmond Leonard Jim},
      title = {Evaluation of Serum Ferritin in Type 2 Diabetes Mellitus: An Observational Study from North Sulawesi, Indonesia},
      journal = {International Journal of Diabetes and Endocrinology},
      volume = {7},
      number = {4},
      pages = {103-108},
      doi = {10.11648/j.ijde.20220704.11},
      url = {https://doi.org/10.11648/j.ijde.20220704.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20220704.11},
      abstract = {Diabetes mellitus is still an important health problem in Indonesia because the incidence is increasing every year and most patients do not achieve good and proper glycemic control. Analysis of blood ferritin levels in type 2 diabetes mellitus patients is considered limited in many areas. As a marker of iron stores in the body, elevated serum ferritin has been associated with microvascular and macrovascular complications of diabetes mellitus. This study aimed to determine the correlation between serum ferritin levels and fasting blood glucose, glycated hemoglobin (HbA1c), and other biochemical parameters in type 2 diabetes mellitus patients in North Sulawesi, Indonesia. A total of 108 diabetes mellitus patients were included in this cross-sectional study. Subjects were tested for blood pressure, body mass index, fasting blood glucose, hemoglobin, glycated hemoglobin (HbA1c), ferritin, urea, creatinine, uric acid, alanine aminotransferase, aspartate aminotransferase, cholesterol, and triglyceride. The averages of HbA1c% in the good, moderate, and poor groups were 5.70 ± 0.5%, 7.2 ± 0.6, and 10.1 ± 1.6, respectively. Increased fasting blood glucose, ferritin, urea, creatinine, and uric acid levels were observed along with worsening glycemic status. There were significant correlations between serum ferritin and fasting blood glucose, glycated hemoglobin, and alanine aminotransferase (p < 0.05). There were significantly different mean ferritin values in the three groups of glycated hemoglobin, suggesting ferritin can be used as an indicator of control of glycemia and diabetic complications.},
     year = {2022}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Evaluation of Serum Ferritin in Type 2 Diabetes Mellitus: An Observational Study from North Sulawesi, Indonesia
    AU  - Diana Shintawati Purwanto
    AU  - Yanti Meilen Mewo
    AU  - Stefana Helena Margaretha Kaligis
    AU  - Edmond Leonard Jim
    Y1  - 2022/10/18
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ijde.20220704.11
    DO  - 10.11648/j.ijde.20220704.11
    T2  - International Journal of Diabetes and Endocrinology
    JF  - International Journal of Diabetes and Endocrinology
    JO  - International Journal of Diabetes and Endocrinology
    SP  - 103
    EP  - 108
    PB  - Science Publishing Group
    SN  - 2640-1371
    UR  - https://doi.org/10.11648/j.ijde.20220704.11
    AB  - Diabetes mellitus is still an important health problem in Indonesia because the incidence is increasing every year and most patients do not achieve good and proper glycemic control. Analysis of blood ferritin levels in type 2 diabetes mellitus patients is considered limited in many areas. As a marker of iron stores in the body, elevated serum ferritin has been associated with microvascular and macrovascular complications of diabetes mellitus. This study aimed to determine the correlation between serum ferritin levels and fasting blood glucose, glycated hemoglobin (HbA1c), and other biochemical parameters in type 2 diabetes mellitus patients in North Sulawesi, Indonesia. A total of 108 diabetes mellitus patients were included in this cross-sectional study. Subjects were tested for blood pressure, body mass index, fasting blood glucose, hemoglobin, glycated hemoglobin (HbA1c), ferritin, urea, creatinine, uric acid, alanine aminotransferase, aspartate aminotransferase, cholesterol, and triglyceride. The averages of HbA1c% in the good, moderate, and poor groups were 5.70 ± 0.5%, 7.2 ± 0.6, and 10.1 ± 1.6, respectively. Increased fasting blood glucose, ferritin, urea, creatinine, and uric acid levels were observed along with worsening glycemic status. There were significant correlations between serum ferritin and fasting blood glucose, glycated hemoglobin, and alanine aminotransferase (p < 0.05). There were significantly different mean ferritin values in the three groups of glycated hemoglobin, suggesting ferritin can be used as an indicator of control of glycemia and diabetic complications.
    VL  - 7
    IS  - 4
    ER  - 

    Copy | Download

Author Information
  • Department of Biochemistry, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia

  • Department of Biochemistry, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia

  • Department of Biochemistry, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia

  • Department of Cardiovascular Medicine, Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia

  • Sections