Role of Serum Ferritin as an Inflammatory Marker in Non-Infectious
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Background: Serum ferritin is an indicator of iron status, but it can also be elevated in conditions of chronic inflammation, which may contribute to its association with cardiometabolic disorders. Objective: This study aimed to compare ferritin, inflammatory, and iron status indicators in adults with type 2 diabetes mellitus (T2DM), hypertension (HTN), both T2DM and HTN, and healthy controls. Methods: An analytical cross-sectional study was conducted in Karachi, Pakistan, in 2025-2026, comprising 85 adults divided into four groups: controls (n=20), T2DM only (n=22), HTN only (n=21), and T2DM with HTN (n=22). Serum ferritin, has-CRP, serum iron, total iron binding capacity (TIBC), transferrin saturation percentage (TSAT), HbA1c, blood pressure, and body mass index (BMI) were measured. One-way analysis of variance (ANOVA) with Tukey–Kramer multiple comparisons test was used to compare variables between groups and Pearson’s correlation analysis was used to assess the association of serum ferritin with other variables. Results: Serum ferritin and has-CRP varied significantly in the four groups (F=74.635 and F=62.213; p<0.001), with the highest concentrations observed in the dual disease group (242.8±41.5 ng/mL; 4.8±1.2 mg/L). Serum iron, TIBC, and TSAT were comparable between the groups (for TSAT: F=0.592; p=0.622). Serum ferritin correlated with has-CRP (r=0.68; n=220__), HbA1c (n=221__; n=222__), systolic blood pressure (n=223__; n=224__), and BMI (n=225__; n=226__), but not with TSAT (n=227__; n=228__). Conclusion: Serum ferritin appeared to be influenced by inflammatory and cardiometabolic conditions to a greater extent than TSAT and should therefore be interpreted in conjunction with these variables
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1. Kotla NK, Dutta P, Parimi S, Das NK. The role of ferritin in health and disease: recent advances and understandings. Metabolites. 2022;12(7):609.
2. Restrepo-Gallego M, Díaz LE, Rondó PH. Classic and emergent indicators for the assessment of human iron status. Crit Rev Food Sci Nutr. 2021;61(17):2827–40.
3. Sandnes M, Ulvik RJ, Vorland M, Reikvam H. Hyperferritinemia—a clinical overview. J Clin Med. 2021;10(9):2008.
4. Scaramellini N, Fischer D, Agarvas AR, Motta I, Muckenthaler MU, Mertens C. Interpreting iron homeostasis in congenital and acquired disorders. Pharmaceuticals (Basel). 2023;16(3):329.
5. Rosenblum SL. Inflammation, dysregulated iron metabolism, and cardiovascular disease. Front Aging. 2023;4:1124178.
6. Kant R, Kumari SK, Sinha R, Kumar R, Kumar A. Association of inflammatory markers, serum ferritin and high sensitive C-reactive protein, with HbA1c and dyslipidemia in male patients of type 2 diabetes mellitus. Asian J Med Sci. 2024;15(4):78–83.
7. Gauda RM, Acharya M, Yadav MK, Gouda M. Evaluation of serum high-sensitivity C-reactive protein, ferritin level in type 2 diabetic patients and its correlation with glycated hemoglobin in a tertiary care teaching hospital. J Datta Meghe Inst Med Sci Univ. 2021;16(3):448–53.
8. Sciacqua A, Ventura E, Tripepi G, Cassano V, D’Arrigo G, Roumeliotis S, et al. Ferritin modifies the relationship between inflammation and arterial stiffness in hypertensive patients with different glucose tolerance. Cardiovasc Diabetol. 2020;19(1):123.
9. Yu L, Que T, Zhou Y, Liu Z. Dose–response relationship of serum ferritin and dietary iron intake with metabolic syndrome and non-alcoholic fatty liver disease incidence: a systematic review and meta-analysis. Front Nutr. 2024;11:1437681.
10. Barbalho SM, Laurindo LF, Tofano RJ, Flato UAP, Mendes CG, de Alvares Goulart R, et al. Dysmetabolic iron overload syndrome: going beyond the traditional risk factors associated with metabolic syndrome. Endocrines. 2023;4(1):18–37.
11. Fernandez M, Lokan J, Leung C, Grigg A. A critical evaluation of the role of iron overload in fatty liver disease. J Gastroenterol Hepatol. 2022;37(10):1873–83.
12. Vijayakumar TS, Bhaskar M, Sudharsan P, Bupesh G. A mini-review of serum ferritins in diabetes mellitus. Int J Biotechnol Clin Med. 2022;1(3):69–79.
13. Ismaiel A, Al Srouji N. Anemia of chronic disease: epidemiology and pathophysiological mechanisms—literature review. Glob J Med Ther. 2020;2:8–16.
14. Shumi MB, Begum S. Evaluation of iron status in metabolic syndrome. J Bangladesh Soc Physiol. 2021;16(2):82–7.
15. Daniłowicz-Szymanowicz L, Świątczak M, Sikorska K, Starzyński RR, Raczak A, Lipiński P. Pathogenesis, diagnosis, and clinical implications of hereditary hemochromatosis—the cardiological point of view. Diagnostics (Basel). 2021;11(7):1279.