Relation of iron stores to oxidative stress in type 2 diabetes

Background: Recent studies revealed elevated serum ferritin levels predict new-onset type 2 diabetes. Further studies proved ferritin to be an important and independent predictor of the development of diabetes. The link between hyperglycemia, enhanced free radical activity (oxidative stress) and serum iron and its stores (serum ferritin levels) levels is not clear. Objectives: The present study is an attempt to understand the relationship between serum ferritin levels and oxidative stress (measured by malondialdehyde). Materials and Methods: The study comprised of 30 apparently healthy controls and 30 type 2 diabetic patients who attended the outpatient and inpatient departments of Medical College, Kolkata. Levels of fasting blood glucose, postprandial blood glucose, serum iron, serum ferritin, glycosylated hemoglobin (HbA1c) and malondialdehyde (MDA), serum urea and creatinine were estimated. The statistical software SPSS 11.0 and Systat 8.0 were used for the analysis of the data and Microsoft Word and Excel have been used to generate tables and graphs. Results: Serum iron (82.16 13.24 g/dl), serum ferritin (224.53 96.06 g/L), HbA1c (8.62 1.79), MDA (2.66 0.76 nmol/ml) levels were significantly higher in type 2 diabetics compared with apparently healthy controls. Elevations in serum iron, ferritin and HbA1c are accompanied by a parallel increase in blood glucose. Based on groups of glycemic control, i.e. HbA1c levels > 8, serum ferritin levels were highest, 258.63 22.67 g/dl. There is an inverse correlation of serum ferritin levels to MDA levels in the diabetic cases of longer duration of more than 10 years. Conclusion: Serum ferritin level in the present study is found to be higher in the newly diagnosed cases and lower in those patients suffering from diabetes for more than 10 years. This study probably suggests that serum ferritin can represent either as a pro-oxidant or as an antioxidant in a time-dependent manner.