Iron: a Strong Element in the Pathogenesis of Chronic Hyperglycaemia After Acute Pancreatitis
- 78 Downloads
Evidence shows an association between markers of iron metabolism and glucose metabolism in type 2 diabetes mellitus. Acute pancreatitis is the largest contributor to diabetes of the exocrine pancreas. However, the pathogenesis of new-onset pre-diabetes or diabetes after pancreatitis remains unclear. This study aimed to investigate associations between markers of iron metabolism and glucose metabolism following acute pancreatitis. Fasting blood samples were collected to analyse markers of glucose metabolism (haemoglobin A1c) and iron metabolism (hepcidin, ferritin, and soluble transferrin receptor). Participants were categorised into two groups: normoglycaemia after acute pancreatitis and chronic hyperglycaemia after acute pancreatitis. Binary logistic and linear regression analyses were conducted, and potential confounders were adjusted for in multivariable analyses. A total of 83 individuals following an episode of acute pancreatitis were included, of whom 19 developed chronic hyperglycaemia. Hepcidin was significantly increased in individuals with chronic hyperglycaemia after acute pancreatitis in two adjusted models (p = 0.045 and p = 0.048). Ferritin was significantly decreased in individuals with chronic hyperglycaemia after acute pancreatitis in three adjusted models (p = 0.016, p = 0.009, and p = 0.011). Soluble transferrin receptor was not significantly associated with chronic hyperglycaemia after acute pancreatitis. These findings suggest that iron metabolism is significantly altered in individuals with chronic hyperglycaemia after acute pancreatitis and may provide better insights into the pathogenesis of new-onset diabetes after pancreatitis.
KeywordsDiabetes Ferritin Glucose metabolism Hepcidin Pancreas
This study was part of the Clinical and Epidemiological Investigations in Metabolism, Nutrition, and Pancreatic Diseases (COSMOS) program. COSMOS is supported in part by the Health Research Council of New Zealand (grant 15/035 to Dr. Petrov), which played no role in the study design; collection, analysis, or interpretation of data; or writing of the manuscript.
- 4.Bonfils L, Ellervik C, Friedrich N, Linneberg A, Sandholt C, Jorgensen ME et al (2015) Fasting serum levels of ferritin are associated with impaired pancreatic beta cell function and decreased insulin sensitivity: a population-based study. Diabetologia 58:523–533. https://doi.org/10.1007/s00125-014-3469-4 CrossRefPubMedGoogle Scholar
- 14.Pendharkar SA, Asrani VM, Xiao AY, Yoon HD, Murphy R, Windsor JA et al (2016) Relationship between pancreatic hormones and glucose metabolism: a cross-sectional study in patients after acute pancreatitis. Am J Physiol Gastrointest Liver Physiol 311:G50–G58. https://doi.org/10.1152/ajpgi.00074.2016 CrossRefPubMedGoogle Scholar
- 16.Xiao AY, Tan MLY, Wu LM, Asrani VM, Windsor JA, Yadav D et al (2016) Global incidence and mortality of pancreatic diseases: a systematic review, meta-analysis, and meta-regression of population-based cohort studies. Lancet Gastroenterol Hepatol 1:45–55. https://doi.org/10.1016/S2468-1253(16)30004-8 CrossRefPubMedGoogle Scholar
- 21.Gillies NA, Pendharkar SA, Singh RG, Asrani VM, Petrov MS (2017) Lipid metabolism in patients with chronic hyperglycaemia after an episode of acute pancreatitis. Diab Met Syndr: Clin Res Rev. https://doi.org/10.1016/j.dsx.2016.12.037
- 26.Fabbrini E, Magkos F, Conte C, Mittendorfer B, Patterson BW, Okunade AL et al (2012) Validation of a novel index to assess insulin resistance of adipose tissue lipolytic activity in obese subjects. J Lipid Res 53(2):321–324. https://doi.org/10.1194/jlr.D020321 CrossRefPubMedPubMedCentralGoogle Scholar
- 27.Hill NR, Levy JC, Matthews DR (2013) Expansion of the homeostasis model assessment of β-cell function and insulin resistance to enable clinical trial outcome modelling through the interactive adjustment of physiology and treatment effects: iHOMA2. Diabetes Care 36(8):2324–2330. https://doi.org/10.2337/dc12-0607 CrossRefPubMedPubMedCentralGoogle Scholar
- 39.Forouhi NG, Harding AH, Allison M, Sandhu MS, Welch A, Luben R, et al (2007) Elevated serum ferritin levels predict new-onset type 2 diabetes: results from the EPIC-Norfolk Prospective Study 50(5):949–956Google Scholar