Implication of soluble transferrin receptor and ferritin ratio in gestational diabetes

Ferritin provides a good estimate of body iron stores, but loses its significance during systemic inflammation, a defining feature of insulin resistance (IR). On the other hand, serum transferrin receptor protein (sTfR) represents true iron load of body. This study attempts to identify the utility of sTfR/ferritin index in gestational diabetes mellitus (GDM). Eighty-eight pregnant females were recruited and divided into group A (norm-glycemic pregnant) and group B (GDM) according to the IADPSG criteria. Insulin, hemoglobin, serum iron, ferritin, sTfR, and CRP levels were determined. However, HbA1c and sTfR/ferritin ratio were calculated by formulas. Mann Whitney U and Spearman’s rank correlation were used, where p < 0.05 was considered significant. Results showed no difference between the groups in terms of age, weight, and BMI. IR was significantly high in GDM as compared to non-GDM subjects (p < 0.001), however, the insulin levels were found to be low in GDM group. Hemoglobin was comparatively lower in GDM females (p = 0.212). Serum levels of sTfR, ferritin, and hs-CRP were found to be higher in GDM as compared to non-GDM (p = 0.774, p = 0.201, and p = 0.267, respectively). The sTfR/ferritin ratio was lower in the GDM as compared to the healthy controls (p = 0.326). Furthermore, the correlation between sTfR/ferritin ratio and insulin resistance was slightly negative (r = −0.301, p = 0.347). These results suggest that sTfR may be used for the estimation of accurate iron status in the body during gestational diabetes. However, longitudinal studies are required to propose the utility and a cutoff value for this biomarker..