Συσχέτιση επιπέδων φερριτίνης, σιδήρου ορού και κορεσμού τρανσφερρίνης σε άτομα με σακχαρώδη διαβήτη τύπου 2 (Master thesis)

Τριανταφύλλου, Μαρία


Type II diabetes mellitus is a disease that is characterized by chronic inflammation and it has been established that ferritin is elevated during inflammation. The question that needs to be answered is if the elevated iron levels, which the best biomarker is ferritin, cause diabetes, or if diabetes causes elevated ferritin levels. Aim: The aim of this study is to correlate ferritin levels, iron levels and transferrin saturation in patients suffering from type metabolism II diabetes, so that the role of ferritin can be clarified (as an acute phase protein or in relation with iron) and as a possible therapeutic target. Materialandmethods: The sample of this particular study consists of fifty (50) patients with DM type II that were being followed up at the hematology unit at the 1st propaedeutic department of Internal Medicine, AHEPA hospital, during 2014-2017. Patients with neoplastic or inflammatory diseases, hemoglobinopathies and the ones receiving frequent transfusions were excluded since their ferritin levels were already high. In patients with ferritin levels >380 ng/dL were screened with molecular tests for hereditary hemochromatosis. All of the data was collected from the patients’ records and their lab results (Hb, Ht, Fe, CRP, TSAT, TIBC, GFR, ferritin, creatinine, hepcidin, etc) that were carried out in the Microbiology Lab of the AHEPA hospital during 2014-2017. A descriptive and an exploratory analysis were carried out for this particular study. The descriptive analysis was essential so that the main variables were described and the exploratory analysis was carried out to clarify the relation between the main relations. For the analysis of the data the statistic packet SPSS was utilized. The significance level was set at 0.05. The Spearman coefficient was applied which is a non-parametric measure of statistical dependence between two variables. Results: The median value of HbA1c in the population of the study was 6.5% (IQR 6.2%-6.8%). The average of ferritin was 64.7 ng/mL (SD: 45) and the average of iron was 47.4μg/dL (SD 15.4). The average of CRP was 1.3mg/dL (SD: 0.8). In this particular population there was an average correlation between CRP and ferritin (Spearman’s rho 0.43, p=0.002), however Tsat and ferritin were strongly correlated   (Spearman’s rho 0.6, p<0.001). Furthermore, there was an average correlation between iron and ferritin (Spearman’s rho 0.45, p=0.001). Conclusions: It has been shown that the levels and the metabolism of iron and ferritin are affected by the subclinical inflammation that is set in type II DM, but ferritin is still considered to be a reliable biomarker for the iron reserve.
Institution and School/Department of submitter: Σχολή Επαγγελμάτων Υγείας και Πρόνοιας/ Τμήμα Νοσηλευτικής
Subject classification: Φερριτίνη
Τρανσφερίνη
Διαβήτης
Ferritin
Transferrin
Diabetes
Σίδηρος
Iron
Keywords: Σακχαρώδης Διαβήτης;φερριτίνη;τρανσφερρίνη;φλεγμονή;Diabetes mellitus;ferritin;transferrin;inflammation
Description: Σκοπός της παρούσης εργασίας, είναι η ανεύρεση συσχετίσεων μεταξύ των επιπέδων φερριτίνης, σιδήρου ορού και κορεσμού τρανσφερρίνης σε διαβητικούς τύπου 2, ώστε να αποσαφηνισθεί ο ρόλος της φερριτίνης στο συγκεκριμένο πληθυσμό(ως πρωτεΐνης οξείας φάσης ή συσχετιζόμενης με το μεταβολισμό του σιδήρου) και να αποτελέσει πιθανό θεραπευτικό στόχο.
URI: http://195.251.240.227/jspui/handle/123456789/12063
Table of contents: ΚΑΤΑΛΟΓΟΣ ΠΙΝΑΚΩΝ………………………………………………………….iii ΚΑΤΑΛΟΓΟΣ ΣΧΗΜΑΤΩΝ ΚΑΙ ΕΙΚΟΝΩΝ…………………………………….iv ΚΑΤΑΛΟΓΟΣ ΣΥΝΤΟΜΟΓΡΑΦΙΩΝ ΚΑΙ ΣΥΜΒΟΛΩΝ………………………..v ΠΕΡΙΛΗΨΗ………………………………………………………………………….1 ABSTRACT………………………………………………………………………….3 ΠΡΟΛΟΓΟΣ………………………………………………………………………….5 Α. ΓΕΝΙΚΟ ΜΕΡΟΣ………………………………………………………………….6 ΕΙΣΑΓΩΓΗ/ ΚΕΦΑΛΑΙΟ 1. ΟΡΙΣΜΟΣ ΣΑΚΧΑΡΩΔΗ ΔΙΑΒΗΤΗ……………….7 ΚΕΦΑΛΑΙΟ 2. ΕΠΙΠΟΛΑΣΜΟΣ ΣΑΚΧΑΡΩΔΗ ΔΙΑΒΗΤΗ………………………9 ΚΕΦΑΛΑΙΟ 3.ΚΡΙΤΗΡΙΑ ΔΙΑΓΝΩΣΗΣ…………………………………………...12 ΚΕΦΑΛΑΙΟ 4.ΟΜΟΙΟΣΤΑΣΗ ΓΛΥΚΟΖΗΣ-ΠΑΘΟΓΕΝΕΙΑ ΣΑΚΧΑΡΩΔΗ ΔΙΑΒΗΤΗ……………………………………………………………………………16 ΚΕΦΑΛΑΙΟ 5.ΤΑΞΙΝΟΜΗΣΗ ΣΑΚΧΑΡΩΔΗ ΔΙΑΒΗΤΗ……………………….19 ΚΕΦΑΛΑΙΟ.6 ΔΙΑΒΗΤΗΣ ΚΑΙ ΚΑΡΔΙΑΓΓΕΙΑΚΗ ΝΟΣΟΣ……………………26 ΚΕΦΑΛΑΙΟ. 7 ΑΝΑΙΜΙΑ ΚΑΙ ΣΑΚΧΑΡΩΔΗΣ ΔΙΑΒΗΤΗΣ……………………28 7.1 Μεταβολισμός σιδήρου…………………………………………………………28 7.2 Αναιμία χρονίας νόσου:παθοφυσιολογία και αντιμετώπιση…………………….29 7.2.1Παθοφυσιολογια……………………………………………………………….29 7.2.2Διάγνωση ΑΝΧ ……………………………………………………………………………...35 7.2.3Αντιμετώπιση ΑΧΝ……………………………………………………………37 7.3 Η αναιμία της διαβητικής νεφροπάθειας…………………………………………44 ΕΙΔΙΚΟ ΜΕΡΟ………………………………………………………………………48 ΚΕΦΑΛΑΙΟ 1.ΣΚΟΠΟΣ……………………………………………………………49 ΚΕΦΑΛΑΙΟ 2.ΥΛΙΚΟ ΚΑΙ ΜΕΘΟΔΟΣ…………………………………………..50 ΚΕΦΑΛΑΙΟ 3. ΑΠΟΤΕΛΕΣΜΑΤΑ…………………………………………………………………53 ΚΕΦΑΛΑΙΟ 4.ΣΥΖΗΤΗΣΗ…………………………………………………………75 ΚΕΦΑΛΑΙΟ 5.ΣΥΜΠΕΡΑΣΜΑΤΑ…………………………………………………79 ΒΙΒΛΙΟΓΡΑΦΙΑ……………………………………………………………………..80
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