Endocrine Abstracts

JOINT2811

Introduction: Iron, as an essential micronutrient, crucially modulates insulin sensitivity, impacting various processes in glucose homeostasis. The mechanisms involved in this interaction are crucial for developing targeted therapeutic interventions to address metabolic disorders. The aim of the present study was to investigate the correlation of iron homeostasis factors with hematological and biochemical markers in patients with T2DM taking into consideration the treatment schema.

Methodology: 400 subjects were included, 200 with T2DM: 100 in metformin treatment (PMET), 100 in GLP1 analogs treatment (PGLP), 100 control with prediabetes (PDC), and 100 healthy controls (C). Also, iron homeostasis markers were assessed: Iron (Fe), ferritin (Ferr), hepcidin (Eps), transferrin, transferrin saturation (TSAT), Total Iron Binding Capacity (TIBC), hematological and biochemical indices and HbA1C%. Statistical Analysis was performed by SPSS. Informed consent were acquired from all the participants

Results: Higher levels of BMI, WBC, transferrin, total and LDL cholesterol, and CRP were observed in PMET and PGLP compared to the C and PDC (P < 0. 001). Also, diabetic patients showed a significant decrease in iron, hepcidin, and TSAT compared to C and PDC (P < 0. 001). Regarding the differences between the therapeutic schemes, PGLP1 showed significantly increased BMI, fasting glucose, urinary microalbumin, and direct bilirubin, and had significantly lower platelet and alkaline phosphatase (ALP) levels, compared to PMET. PMET showed increased mean platelet volume and decreased HDL levels, compared to C only (P = 0. 026), while their hepcidin was decreased compared to both C and PDC (p ≤0. 0001). PGLP1 showed significantly reduced hepcidin and increased considerably uric acid, compared to the PDC (P = 0. 005 and P = 0. 046, respectively) and reduced considerably HDL, ALP, and direct bilirubin compared to both the C and PDC (p≤0. 0001). At the same time, the PDC and both diabetic groups had higher levels of BMI, fasting sugar, HbA1c %, red blood cell distribution range, hematocrit, triglycerides, urea, uric acid, creatinine, and pyruvate transaminase, compared to the control group (p≤0. 045). Statistical analysis in all patients with diabetes according to fasting glucose levels showed that subjects with >100 to 130mg/dL had higher total iron-binding capacity (P = 0. 026), transferrin (P = 0. 021), transferrin/ferritin ratio (P = 0. 05), platelets (P = 0. 026) as compared to normal fasting glucose levels ≤100mg/Dl

Conclusion: Diabetic patients show disturbed iron homeostasis and a mild inflammatory state. These are associated with an increase and hyperfunction of PLTs, and hyperlipidemia reflecting cardiovascular risk, mainly in patients with uncontrolled diabetes.