DIABETOLOGY / RESEARCH PAPER
Serum soluble transferrin receptor levels are
independently associated with homeostasis model
assessment of insulin resistance in adolescent girls
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1 |
Primary Health Care Center, University of Montenegro-Faculty of Medicine, Podgorica, Montenegro |
2 |
Department for Medical Biochemistry, University of Belgrade, Faculty of Pharmacy, Belgrade, Serbia |
CORRESPONDING AUTHOR
Aleksandra Klisic
Primary Health Care Center, University of Montenegro-Faculty of Medicine, Podgorica, Trg Nikole Kovacevica 6, 81000, Podgorica, Montenegro
Submission date: 2020-12-15
Final revision date: 2021-01-12
Acceptance date: 2021-01-24
Online publication date: 2021-05-10
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Markers of iron homeostasis are related to insulin resistance
(IR) in adults. However, studies in children and adolescents are scarce and
show contradictory results. The aim was to evaluate the potential relationship between iron status markers and IR. Additionally, no previous study has
explored the mutual effect of biomarkers of iron homeostasis and inflammation (i.e. high sensitivity C-reactive protein (hsCRP)), and adipokines (i.e.
retinol-binding protein 4 (RBP4)) on IR in the cohort of adolescent girls.
Material and methods:
A total of 60 girls age between 16 and 19 years were
included in the study. Serum levels of ferritin, transferrin, soluble transferrin
receptor (sTfR), hsCRP, and RBP4 were measured by immunonephelometry.
Homeostasis model assessment of insulin resistance (HOMA-IR) and iron
homeostasis indexes were calculated. Univariate and multivariate binary logistic regression analysis were used to investigate the possible independent
associations of the examined biomarkers. Principal component analysis was
used to examine their mutual effect on HOMA-IR in the studied girls.
Results:
Ferritin, sTfR, hsCRP and RBP4 were significant predictors for higher HOMA-IR in univariate analysis (p = 0.020, p = 0.009, p = 0.007, p =
0.003, respectively). Multivariate regression analysis after adjustment for
waist circumference (WC) showed that serum sTfR levels remained positively associated with higher HOMA-IR (p = 0.044). Factorial analysis revealed
that the obesity-inflammation related factor (i.e., WC and hsCRP) and adipokine-acute phase protein related factor (i.e., RBP4 and ferritin) showed
significant differences between HOMA-IR < 2.5 and HOMA-IR ≥ 2.5.
Conclusions:
Serum sTfR levels are independently associated with HOMA-IR,
whereas higher serum ferritin levels together with higher RBP4 are related
to higher HOMA-IR in adolescent girls.