Hepcidin Level Changes in Type 2 Diabetes

Abstract
Background: Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion or insulin action, or both. Diabetes and its complications have become a major public health problem in the world and its prevention has become a public health priority. Hepcidin, a 25-amino-acid antimicrobial peptide, is the central regulator of iron homeostasis. Under normal circumstances, hepcidin expression and subsequent release into plasma prevents further absorption of iron from the duodenal enterocytes by preventing the efflux of iron by ferroportin channels, hence reduced amounts of iron delivery via transferrin to hepatocytes. In response to iron loading, hepcidin expression increased to prevent the further uptake of iron. Conversely, during iron deficiency, hepcidin expression decreased.
Aim of the Study: Was to assess the possible changes of serum hepcidin that may occur in patients with type 2 diabetes.
Objectives: Was to evaluate changes of serum hepcidin level in type 2 diabetes, assess possible relationships of serum hepcidin, iron status, hepcidin: Ferritin ratio and HOMA-IR in type 2 diabetes patients.
Methods: This study consisted of randomized eighty subjects divided into four groups: Group 1: Included 20 patients with impaired glucose tolerance (pre-diabetes), Group 2: Included 20 patients with controlled diabetes, Group 3: 20 patients with uncontrolled diabetes, Group 4: Included 20 healthy volunteers.
Results: Hepcidin: Ferritin ratio was statistically high in impaired glucose tolerance and low in uncontrolled diabetes with (p-value <0.001*) and normal in controlled diabetes and healthy volunteers. Significant negative correlation between hepcidin: ferritin ratio and HOMA-IR in impaired glucose tolerance with (p-value=0.009*) was found.
Conclusion: Serum hepcidin affected by multiple factors so cannot be used for screening of type 2 diabetes. But hepcidin: Ferritin ratio could be a novel marker for early screening of patients with type 2 diabetes.