Elevated levels of ferritin and hs-CRP in type 2 diabetes

Objectives: To measure the levels of high-sensitivity C-reactive protein and ferritin in blood and to assess their association with inflammation in people with Type 2 diabetes.

Method: The case-control study was conducted between November 2012 to November 2013 at the Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi, and comprised randomly selected patients and healthy controls. Fasting blood samples were analysed for blood glucose, insulin, high-sensitivity C-reactive protein and iron status. SPSS 19 was used for statistical analysis.

Results: Of the 210 subjects initially selected, 99(47%) were excluded owing to anaemia. The study population, as such, comprised 111(53%) with an overall mean age of 38.6±1.56 years and mean fasting blood sugar of 110.78±3.795mg/dl. Group 1 had 44(39.6%) healthy controls while Group 2 had 67(60.3%) diabetic patients. Elevated levels of mean serum ferritin (233.11±43.84ng/ml), insulin (29.94±2.19), homeostasis model of insulin resistance (10.23±0.89) and high-sensitivity C-reactive protein (5.29±0.80 mg/L) with low serum iron levels (1.07± 0.115 ?g/dl) were found in Group 2. There was positive correlation of homeostasis model of insulin resistance with fasting blood sugar (r=0.596; p<0.001), serum ferritin (r=0.306; p<0.008), insulin (r=0.866; p<0.001), and total ironbinding capacity (r=0.302; p<0.009). There was negative correlation with serum iron (r=-0.280; p<0.016) and transferrin saturation (r=-0.316; p<0.006).

Conclusion: Elevated ferritin levels without evident iron overload may affect glucose homeostasis, leading to insulin resistance in conjunction with inflammatory changes as seen by elevated C-reactive protein levels.