RELATIONSHIP BETWEEN SERUM FERRITIN AND DIABETES MELLITUS IN PATIENTS WITH CHRONIC HCV DISEASES

Abstract

SUMMARY T he aim of this study was to find out the relationship between serum ferritin and diabetes mellitus in chronic HCV liver disease patients. It is clear that diabetes mellitus can be included to the long list of extra hepatic manifestations of hepatitis C virus infection. Incidence of diabetes mellitus is markedly higher in chronic hepatitis C patients than chronic HBV patients and alcohol related liver disease. The association of HCV infection and DM is present, even before the onset of cirrhosis. Since iron stores expressed as serum ferritin concentration, have been proposed to be a component of the insulin resistance syndrome, type 2 diabetes mellitus frequently associated with elevated levels of serum ferritin although hepatic iron stores have not found to be increased in autopsy liver specimens from diabetic patients. Several reports have shown an increase of ferritin levels in patients with HCV infection and other studies suggested that there is a positive correlation between body iron stores and disease severity in HCV, it could be speculated that iron stores are the link between HCV infection and diabetes mellitus. This study was carried out on 40 patients they were divided into group I: Twinty patients having diabetes mellitus and HCV liver disease, group II: ten patients having diabetes mellitus and negative for HCV and group III: ten healthy individuals as a control group. Serum ferritin were measured by Immunometric assay in all subjects of this study. Serum ferritin levels are related to the presence of diabetes in patients infected by HCV which points to its possible role in the development of diabetes mellitus in chronic HCV liver disease. Iron influences insulin action and interferes with insulin inhibition of glucose production by the liver. Hepatic extraction and metabolism of insulin is reduced with increasing iron stores, leading to peripheral hyperinsulinemia.