COMPARISON OF IRON STATUS AND INSULIN RESISTANCE BETWEEN NON-DIABETIC OFFSPRING OF TYPE 2 DIABETICS AND NON-DIABETIC OFFSPRING OF NON-DIABETICS
AbstractBackground: Insulin resistance is positively correlated with body iron. It is unclear whether iron is a cause or an outcome of insulin resistance. Insulin resistance precedes type 2 diabetes mellitus. Offspring of type 2 diabetics are insulin resistant as compared to those of the non-diabetics. The present study was designed to compare and correlate insulin resistance with iron parameters (including serum ferritin, transferrin saturation and blood haemoglobin) in non-diabetic offspring of type 2 diabetics and non-diabetic offspring of non-diabetics. Methods: It was a cross-sectional study, conducted on one hundred and twenty male subjects 20–40 years of age. They were divided into two groups, each group having 60 subjects. Group A included non-diabetic offspring of type 2 diabetics, while Group B included non-diabetic offspring of non-diabetics. Fasting blood sample was taken and examined for glucose, haemoglobin, insulin, iron, TIBC and ferritin. Data was analysed by SPSS-17. Results: Insulin resistance and iron parameters were significantly higher (p<0.05) in non-diabetic offspring of type 2 diabetics as compared to those of the non-diabetics. There was significant positive correlation (p=0.027) between insulin resistance and serum iron in non-diabetic offspring of type 2 diabetics. There was also significant positive correlation between insulin resistance and serum iron, transferrin saturation and haemoglobin in non-diabetic offspring of non-diabetics. Conclusion: Non-diabetic offspring of type 2 diabetics have iron load and insulin resistance, that predispose them to the development of type 2 diabetes. Keywords: Insulin resistance, offspring of type 2 diabetics, serum ferritin, transferrin saturation
Fernandez-Real JM, Bermejo AL, Ricart W. Cross-talk between iron metabolism and diabetes. Diabetes 2002;51:2348–54.
Jehn M, Clark JM, Guallar E. Serum ferritin and risk of the metabolic syndrome in U.S. adults. Diabetes Care 2004;27:2422–8.
Bozzini C, Tenuti I, Givelli D, Lotto V, Olvivieri O, Friso S, et al. Prevalence of body iron excess in the metabolic syndrome. Diabetes Care 2005;28:2061–3.
McCarty MF. Hyperinsulinemia may boost both hematocrit and iron absorption by up-regulating activity of hypoxia-inducible factor-1α. Med Hypothesis 2003;61:567–73.
Davis RJ, Corversa S, Czech MP. Insulin stimulates cellular iron uptake and causes the redistribution of intracellular transferrin receptors to the plasma membrane. J Biol Chem 1986;261:8708–11.
Yokomori N, Iwasw Y, Adika K, Inoue M, Tawata M, Onaya T. Transcriptional regulation of ferritin messenger ribonucleic acid levels by insulin in cultured rat glioma cells. Endocrinology 1991;128:1474–80.
Le Guenno G, Chenseaume E, Ruivard M, Morio B, Mazur A. Study of iron metabolism disturbances in an animal model of insulin resistance. Diabetes Res Clin Pract 2007;7:363–70.
Kulaksiz H, Fein E, Redeckor P, Stremmel W, Adler G, Cetin Y. Pancreatic β-cells express hepcidin, an iron-uptake regulatory peptide. J Endocrinol 2008;197:241–9.
Liu Q, Sun L, Tan Y, Wang G, Lin X, Cai L. Role of iron deficiency and overload in the pathogenesis of diabetes and diabetic complications. Curr Med Chem 2009;16:113–29.
Swaminathan S, Alam MG, Fonseca VA, Shah SV. The role of iron in diabetes and its complications. Diabetes Care 2007;30:1926–33.
Syrovatka P, Krami P, Potockova J, Fialova L, Vejrazka M, Crkovska J et al. Relationship between increased body iron stores, oxidative stress and insulin resistance in healthy men. Ann Nutr Metab 2009;54:268–74.
Bozzini C, Girelli D, Olivieri O, Martinelli N, Bassi A, De Matteis G, et al. Prevalence of body iron excess in the metabolic syndrome. Diabetes Care 2005;28:2061–3.
Jehn ML, Guallar E, Clark JM, Couper D, Duncan BB, Ballantyne CM, et al. A prospective study of plasma ferritin level and incident diabetes. Am J Epidemiol 2007;165:1047–54.
Buchanan TA. Perspectives in diabetes. How can we prevent type 2 diabetes? Diabetes 2007;56:1502–7.
Kumar A, Tewari P, Sahoo SS. Prevalence of insulin resistance in first degree relatives of type-2 diabetes mellitus patients: A prospective study in North Indian population. Indian J Clinical Biochem 2005;20:10–7.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment. Insulin resistance and beta cell function from fasting plasma glucose and insulin concentration in man. Diabetologia 1985;28:419–21
Shahid A, Lone KP, Saeed S, Arslan M. Male offspring of both diabetic parents have higher insulin resistance and serum leptin levels compared to those with one diabetic parent. Hormones 2008;7:313–9
Valdez R. Detecting undiagnosed type 2 diabetes: Family history as a risk factor and screening tool. J Diabetes Sci Technol 2009;3(4):722–6
Psyrogiannis A, Kyriazopoulou V, Symeonidis A, Leotsinidis M, Vagenakis AG. Relative iron overload in offspring of patients with type2 diabetes mellitus: A new component in the conundrum of insulin resistance syndrome. Hormones 2003;2:161–8.
Salem Z, Vazirinejad R, Sheikholeslami NZ, Hshemi Z, Tashakiry M. The comparison of serum ferritin concentration between healthy people with and without history of family diabetes. Pak J Med Sci 2008;24:296–9
Zelber-sagi S, Nitzan-Kaluski D, Helpern Z, Oren R. NAFLD and hyperinsulinemia are major determinants of serum ferritin levels. J Hepatol 2007;46:700–7.
Brudevold R, Hole T, Hammerston J. Hyperferritenemia is associated with insulin resistance and fatty liver in patients without iron overload. Plos One 2008;3:e3547
Aigner E, Hinz C, Steiner K, Rossman B, Pfleger J, Hohla F et al. Iron stores, liver transaminase levels and metabolic risk in healthy teenagers. J Clin Invest 2010;40:155–63.
Hashimoto N, Suzuki Y, Haruki AT, Sakuma Y, Iwai R, Takahashi H. The association between the ferritin concentration, and the serum insulin resistance markers, and follow up analysis for three years in non diabetic Japanese men. Diabetes Care 2008;31:55–60
Kim CH, Kim HK, Bae SJ, Park JY, Lee KU. Association of elevated serum ferritin concentration with insulin resistance and impaired glucose metabolism in Korean men and women. Metabolism 2011;60(3):414–20.
Luque-Ramírez M, Alvarez-Blasco F, Botella-Carretero JI, Sanchón R, San Millán JL, Escobar-Morreale HF. Increased body iron stores of obese women with polycystic ovary syndrome are a consequence of insulin resistance and hyperinsulinism and are not a result of reduced menstrual losses. Diabetes Care 2007;30:2309–13.
Windness JA, Susa JB, Gracia JF, Singer DB, Sehgal W, Oh W, et al. Increased erythropoiesis and elevated erythropoietin in infants born to diabetic mothers and in hyperinsulinemic rhesus fetuses. J Clin Invest 1981;67:637–42.
Sun L, Franco OH, Hu FB, Cai L, Yu Z, Li H et al. Ferritin concentrations, metabolic syndrome, and type 2 diabetes in middle-aged and elderly Chinese. J Clin Endocrinol Metab 2008;93:4690–6.
Ashourpour M, Dajlali M, Diazayery A, Eshragihan M.R, Taqhdir M, Saedisomeolia A. Relationship between serum ferritin and inflammatory biomarkers with insulin resistance in a Persian population with type 2 diabetes and healthy people. Int J Food Sci Nutr 2010;61:316–23.