Correlation between serum ferritin levels and glycemic control in non-anemic type 2 diabetic patients: a comparative hospital-based study

Abstract

Background: Serum ferritin, a marker of iron storage, is increasingly recognized as an independent risk factor for insulin resistance and poor glycemic control in type 2 diabetes mellitus (T2DM). However, its relationship with glycemic indices in non-anemic diabetic patients in the Indian population remains underexplored.

Objective: To evaluate serum ferritin levels in non-anemic T2DM patients and assess their association with glycemic control parameters, including fasting blood glucose (FBG), postprandial blood glucose (PPBG), glycated hemoglobin (HbA1c), fasting insulin, and HOMA-IR.

Methods: This comparative cross-sectional study included 120 participants: 60 non-anemic T2DM patients (Group A) and 60 age- and sex-matched healthy controls (Group B). Individuals with anemia, inflammatory, hepatic, or renal disorders, or those on iron supplementation were excluded. Serum ferritin was measured using electrochemiluminescence immunoassay (ECLIA). Statistical analysis was performed using SPSS version 25.0, applying Pearson correlation and one-way ANOVA.

Results: Mean serum ferritin levels were significantly higher in diabetic patients (186.4 ± 74.2 ng/mL) compared to controls (94.3 ± 38.6 ng/mL) (p<0.001). Significant positive correlations were observed between serum ferritin and HbA1c (r=0.693), HOMA-IR (r=0.641), FBG (r=0.612), PPBG (r=0.587), and fasting insulin (r=0.524). Ferritin levels increased progressively across HbA1c categories, with statistically significant differences (p<0.001).

Conclusion: Elevated serum ferritin is strongly associated with poor glycemic control and increased insulin resistance in non-anemic T2DM patients. It may serve as a useful adjunct biomarker for monitoring metabolic control in type 2 diabetes.