SERUM HEPCIDIN PROFILES IN TYPE 2 DIABETES MELLITUS: A COMPARISON OF METFORMIN MONOTHERAPY AND COMBINED ANTIDIABETIC TREATMENT

Abstract

Objective: To assess how serum hepcidin and ferritin concentration is related to the pathogenesis and prognosis of Type 2 Diabetes Mellitus (T2DM) in patients taking metformin as monotherapy or in combination with other antidiabetic drugs.

Duration and place of study: This study was conducted at Sir Ganga Ram Hospital Lahore from September 2024 to September 2025

Methodology: The present observational case-control study involved 150 participants of both genders, each being divided into three equal categories; control group of healthy individuals with no diabetes, a group of patients with T2DM who were administered metformin in monotherapy, and a group of patients with T2DM who were treated with metformin in combination with other antidiabetic medications. Glucose oxidase-peroxidase was used to determine the fasting plasma glucose, and high-performance liquid chromatography was used to measure glycated haemoglobin. Standard enzymatic methods were used to measure parameters of lipid profiles. The serum ferritin, insulin, and hepcidin levels were determined through the enzyme-linked immunosorbent assays. The homeostasis model assessment of insulin resistance was used to calculate insulin resistance. Statistical analysis was done with a version of SPSS 26.

Results: Out of the 150 participants, there were equal representations of male and female members of all categories. Both diabetic groups had significantly high glycaemic parameters such as fasting plasma glucose and glycated haemoglobin compared to controls (p<0.05). The serum ferritin was found to be highly increased in patients with T2DM in comparison to the controls, with a significant difference in hepcidin levels among the treatment groups (p<0.05). There was a relatively lower level of hepcidin and ferritin in patients who were receiving metformin as a monotherapy compared to patients who were receiving combination therapy. Hepcidin had a significant negative relationship with glycated haemoglobin in the metformin-only group (p<0.05).

Conclusion: It seems that hepatocyte growth hormone (Hepcidin) and ferritin are closely associated with glycaemic control and iron metabolism in Type 2 Diabetes Mellitus. Metformin, especially as a monotherapy, can play a role in better regulation of these biomarkers, implying a possible role in addition to glucose lowering in T2DM pathophysiology and prognosis.