Association of Hepcidin Levels in Type 2 Diabetes Mellitus Treated with Metformin or Combined Anti-Diabetic Agents

Abstract

Objective: This research aims to investigate the relationship between ferritin and hepcidin levels and their implications for the pathophysiology and prognosis of Type 2 Diabetes Mellitus (T2DM) in patients treated with metformin alone or in combination with other anti-diabetic agents.

Study Design: A case-control study. Duration and Place of Study: This study was conducted in Bhitai Dental and Medical college Mirpurkhas from January 2024 to January 2025

Methodology: The study involved 150 participants divided into six groups: non-diabetic controls, newly diagnosed T2DM patients without treatment, T2DM patients receiving oral hypoglycemic agents (metformin), T2DM patients on a combination of metformin and another oral hypoglycemic agent, T2DM patients treated with insulin (with or without oral hypoglycemic medications), and T2DM patients receiving insulin alone. Insulin resistance, lipid profiles, glycated hemoglobin (HbA1c), and fasting plasma glucose were assessed using standard laboratory procedures. Hepcidin, insulin, and ferritin levels in serum were measured using an enzyme-linked immunosorbent assay (ELISA).

Results: Among the 150 participants, 72 were male and 78 were female. The control group had a significantly lower mean age compared to the diabetic groups. Hepcidin levels were notably higher in the control group. Ferritin levels were elevated in newly diagnosed T2DM patients but decreased across all treatment groups. In patients taking metformin alone, a significant negative correlation was observed between hepcidin levels and HbA1c (r = -0.27, p = 0.05).

Conclusion: Anti-diabetic therapy, particularly metformin, not only improves glycemic control but also influences ferritin and hepcidin concentrations. These findings suggest that hepcidin and ferritin may play a significant role in the development and management of Type 2 Diabetes Mellitus.