Muhammet Ateş, Tayyibe Saler
İstanbul Medical Journal - 2026;27(2):136-142
Introduction: The present investigation sought to examine the relationship of circulating ferritin concentrations with type 2 diabetes mellitus (T2DM) and with diabetes-related complications. Additionally, we aimed to determine whether serum ferritin could serve as a biomarker of metabolic and inflammatory status in individuals with diabetes. Methods: This retrospective observational study included 422 subjects: 195 with T2DM, 82 with insulin resistance (IR), and 145 metabolically healthy controls. Demographic characteristics and biochemical variables were evaluated. Intergroup differences were analyzed using analysis of variance. Correlation analyses and receiver operating characteristic (ROC) curve assessments were performed to determine diagnostic accuracy. Furthermore, multivariable logistic regression was conducted to identify independent factors associated with diabetic complications. Results: Participants with T2DM had significantly greater mean age and body mass index than control subjects (p<0.001). Serum ferritin concentrations were significantly increased in both the T2DM and IR groups relative to controls (p<0.001). Ferritin levels were positively associated with HbA1c (r: 0.179, p=0.012) and age (r: 0.133, p=0.006). In contrast, inverse relationships were observed between ferritin and both diabetes duration (r: -0.192, p=0.007) and initiation of insulin treatment (r: -0.243, p=0.007). The ROC curve analysis indicated that ferritin demonstrated fair discriminatory performance in identifying T2DM (area under the curve: 0.725, p<0.001). Elevated ferritin concentrations were observed in patients with diabetic neuropathy, retinopathy, and nephropathy compared with controls (p<0.001); however, no statistically significant differences were detected among the specific complication subtypes (p=0.111). In multivariate analysis, diabetes duration emerged as the sole independent determinant of diabetic complications (p=0.046). Conclusion: Serum ferritin is significantly elevated in T2DM and correlates with poor glycemic control. Although ferritin reflects metabolic and inflammatory activity, diabetes duration remains the strongest predictor of diabetic complications.
