[Anemia and iron metabolism in patients with type-2 diabetes mellitus].
BACKGROUND
Nowadays the iron status in chronic illnesses can be judged by non-invasive methods, too. The soluble transferrin receptor, that is also measurable in most laboratories, means a leap forward among the new markers.


OBJECTIVE
The authors examined the prevalence of anemia and the iron status of type-2 diabetic patients with markers of the iron metabolism. They studied the clinical applicability of these laboratory procedures.


METHODS
Concentration of iron, transferrin, ferritin and soluble transferrin receptor levels of healthy and diabetic patients were compared with a Mann-Whitney U-test. They examined the incidence and the type of anemia, the cause of the elevation in soluble transferrin receptor levels, and the effect of inflammation and nephropathy on the iron status. Relationship of the transferrin saturation, the concentration of ferritin and soluble transferrin receptor levels were depicted by graphic representations.


RESULTS
The authors have found difference between the transferrin levels of women and men in contrast to the literature (z = 3.56; p < 0.05). The reference intervals of the ferritin levels of the control and patient groups also showed a significant difference between women and men (z = 7.59; z = 5.69; p < 0.05). 7% of the patients have suffered from anemia. 23% of the patient group had nephropathy, 10% of this subgroup was anemic, and further 8% of this subgroup had iron distribution disorder. 6% of the patients had elevated soluble transferrin receptor levels. Anemia or iron metabolism alteration was found only in 14% of the cases with elevated C-reactive protein levels.


CONCLUSIONS
According to these findings ferritin reference levels of healthy people can not be used in diabetes mellitus similarly to other chronic illnesses. It seems that anemia is not frequent in diabetes mellitus. There is no connection between nephropathy and anemia, and not all of the inflammatory conditions are accompanied with iron metabolism disturbance. The soluble transferrin receptor can be interpreted only together with the other markers. In the opinion of the authors, the iron status of an individual can be judged with the collective use of all markers in chronic diseases, too.
Megyei Jogú Város Kórháza, Központi Laboratórium, Nagykanizsa. drkovacs@nkkorhaz.hu
Ferenc
F
Kovács
Imre
I
Szakál
Katalin
K
Révész
Agnes
A
Lévai
András
A
Dobos
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D048909:Diabetes Complications / Q000097:blood / Q000175:diagnosis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D007501:Iron / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011990:Receptors, Transferrin / Q000097:blood; D014168:Transferrin / Q000378:metabolism
D015415:Biomarkers; D011990:Receptors, Transferrin; D014168:Transferrin; D005293:Ferritins; D007501:Iron