Correlation between serum levels of hepcidin and ferritin in patients with metabolic syndrome in R.Macedonia

Abstract

The metabolic syndrome (MS) is a complex of interrelated risk factors for cardiovascular disease and diabetes. These factors include hyperglycemia, hypertension, high triacylglycerol levels, low HDL-cholesterol (HDL-c) levels, and abdominal obesity. Evidence suggests that iron influences glucose metabolism, even in the absence of significant iron overload. Iron stores, expressed as serum ferritin concentration, have been proposed to be a component of the insulin-resistance syndrome. In 1997, Moirand et al. first reported the presence of histologically proven liver iron overload in overweight subjects with abnormal glucose metabolism and dyslipidemia. The aim of this study was to evaluate the correlation between serum levels of hepcidin and ferritin in patients with metabolic syndrome in R.Macedonia. The study included 240 subjects - 60 males are with MS and 60 males as control group. 60 females are with MS and 60 females as control group. Individuals aged 18 years or older were eligible to participate in the study. In this analysis we included subjects with available complete data allowing their classification according to established criteria for MetS. In detail, the following features were considered: 1) abdominal obesity, defined as the presence of waist circumference ≥102 cm in men or ≥88 cm in women; 2) fasting plasma glucose  ≥ 6.1 mmol/l or drug treatment for elevated blood glucose; 3) serum triglycerides ≥ 1.69 mmol/l or drug treatment for elevated triglycerides; 4) serum HDL cholesterol in men< 1.03 mmol/l and <1.29 mmol/l  in women or drug treatment for low HDL-C; 5) blood pressure ≥130/85 mmHg or drug treatment for elevated blood pressure. Statistical analysis showed that males and females with MS had statistically higher ferritin levels than control group. Statistical analysis showed that males and females with MS had statistically higher hepcidin levels than control group. Serum ferritin levels significantly correlate with hepcidine in all participants with MS excluded females control group.Body mass, BMI, waist circumference, hip circumference, and WHR are statistically significant higher in subjects with MS compared to control groups. Concentrations of lipid parameters for all examinated groups. The concentrations of HDL- cholesterol, triglycerides and apo A are significantly increased in subjects with MS compared to control groups. It has been demonstrated that the prevalence of MS is increasing worldwide, largely the result of greater obesity and sedentary lifestyles. The concentration of serum hepcidin is associated with gender. Males hepcidine levels are higher than females levels. We found a statistically higher hepcidin levels in both groups with MS, compared to control groups, and males hepcidine levels are almost twice higher then females hepcidine levels in bout groups (control group and group with MS).  The authors found a strong positive relationship between increased iron stores measured by the concentration of plasma ferritin and risk of type 2 diabetes, impaired glucose tolerance and metabolic syndrome in middle age and older people. The average concentration of ferritin in men is almost twice higher than in postmenopausal women, and three times higher than in premenopausal women with metabolic syndrome.