title: The interplay among iron metabolism, endothelium and inflammatory cascade in dysmetabolic disorders.
abstract: OBJECTIVE
  Metabolic syndrome (MetS) is considered as a proinflammatory and prothrombotic state with atherogenic risk factors including dyslipidemia, obesity and glucose intolerance. Oxidative stress is a unifying basis of several disorders including diabetes mellitus (DM) and MetS. We therefore designed this cross-sectional study to investigate the potential interaction among iron metabolism, inflammation and endothelial plexus in MetS and DM patients.
  
  
  METHODS
  A total of 62 patients [median age 54 (23-76) years; male/female 16/46] and 18 healthy controls [median age 38 (30-64) years; male/female 6/12] were included in the study. Patient population was classified as MetS (n = 30) and DM (n = 32).
  
  
  RESULTS
  Leukocyte count (p = 0.002) and osteopontin (OPN) levels (p = 0.008) were significantly higher, while C-reactive protein (CRP) (p = 0.056) and IL-6 (p = 0.059) represented a relative increase in the patient group. Leptin, endothelin 1 (ET1), hepcidin, nitric oxide synthase (NOS), erythrocyte sedimentation rate (ESR), iron, transferrin saturation (TS) and ferritin levels were not significantly different between the patient and control groups. Endothelin 1 was found to be higher in the DM group compared to MetS group (p = 0.15, p = 0.049). Leukocyte count, leptin, hepcidin, OPN, NOS, IL-6, ESR, CRP, iron, TS and ferritin levels were not different between DM and MetS groups. A positive correlation was demonstrated between leptin and OPN (p = 0.001, r = 0.360), ferritin and hepcidin (p < 0.01, r = 0.633), IL-6 and CRP (p = 0.023, r = 0.319), leptin and NOS (p = 0.005, r = 0.309) and OPN and NOS (p < 0.001, r = 0.803). There was a negative correlation between hepcidin and NOS (p = 0.009, r = -0.289). When the study cohort was divided into two particular groups based on median ferritin and hepcidin levels, hepcidin (p = 0.002), ALT (p = 0.001) and LDL (p = 0.049) levels were higher in the high-ferritin group. Nitric oxide synthase levels (p = 0.033) were lower, whereas ferritin levels (p = 0.004) were higher in the high-hepcidin group.
  
  
  CONCLUSIONS
  Mechanisms involved in the vicious circle of MetS including inflammation, endothelial vasculature and iron metabolism remain to be elucidated. The role of iron metabolism in this complex interaction should be confirmed with further studies.
authors.affiliation: Department of Hematology, Gazi University Faculty of Medicine, Beşevler, Ankara, Turkey. zeyneparzuyegin@gmail.com.
authors.forename: Z A
authors.initials: ZA
authors.lastname: Yegin
authors.affiliation: Department of Endocrinology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ö T
authors.initials: ÖT
authors.lastname: İyidir
authors.affiliation: Department of Biochemistry, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: C
authors.initials: C
authors.lastname: Demirtaş
authors.affiliation: Department of Hematology, Gazi University Faculty of Medicine, Beşevler, Ankara, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Suyanı
authors.affiliation: Department of Endocrinology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: İ
authors.initials: İ
authors.lastname: Yetkin
authors.affiliation: Department of Biochemistry, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Paşaoğlu
authors.affiliation: Department of Hematology, Gazi University Faculty of Medicine, Beşevler, Ankara, Turkey.
authors.forename: Ç
authors.initials: Ç
authors.lastname: İlhan
authors.affiliation: Department of Hematology, Gazi University Faculty of Medicine, Beşevler, Ankara, Turkey.
authors.forename: G T
authors.initials: GT
authors.lastname: Sucak
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000378:metabolism*; D004730:Endothelium, Vascular / Q000378:metabolism*; D005260:Female; D005293:Ferritins / Q000097:blood; D018149:Glucose Intolerance / Q000097:blood; D064451:Hepcidins / Q000097:blood; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D015850:Interleukin-6 / Q000097:blood; D007501:Iron / Q000378:metabolism*; D020738:Leptin / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000378:metabolism*; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology*; D055815:Young Adult
chemical_list: D064451:Hepcidins; D015850:Interleukin-6; D020738:Leptin; D002097:C-Reactive Protein; D005293:Ferritins; D007501:Iron
keywords: Diabetes mellitus; Ferritin; Hepcidin; Iron overload; Metabolic syndrome; Osteopontin