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Ferritin and Soluble Transferrin Receptor Beyond Inflammation: Independent Associations with Fasting Glucose and Metabolic Syndrome in a Central Asian Cohort

Dana KaldarkhanFaculty of Medicine, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkestan 160000, KazakhstanKarlygash SadykovaFaculty of Medicine, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkestan 160000, KazakhstanAinash OshibayevaFaculty of Medicine, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkestan 160000, KazakhstanGulnaz NuskabayevaFaculty of Medicine, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkestan 160000, KazakhstanGulzira BaimakhanovaFaculty of Medicine, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkestan 160000, KazakhstanM. RaimovaDepartment of Neurology and Traditional Medicine, Tashkent State Medical University, Tashkent 100109, UzbekistanNigora AlikulovaDepartment of Neurology and Traditional Medicine, Tashkent State Medical University, Tashkent 100109, UzbekistanNodira KhamidovaDepartment of Neurology and Traditional Medicine, Tashkent State Medical University, Tashkent 100109, UzbekistanShoira IsanovaDepartment of Neurology, Samarkand State Medical University, Samarkand 140103, UzbekistanD. AzizkhojayevaFaculty of Medicine, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkestan 160000, KazakhstanAinur TurmanbayevaFaculty of Medicine, Khoja Akhmet Yassawi International Kazakh-Turkish University, Turkestan 160000, KazakhstanKanatzhan KemelbekovDepartment of Pediatrics-1, South Kazakhstan Medical Academy, Shymkent 160019, Kazakhstan

2026en

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Litsenziya: cc-by

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Background/Objectives: Metabolic syndrome (MetS) is a major global public health concern associated with an increased risk of cardiovascular disease and type 2 diabetes mellitus. Iron metabolism has been implicated, but the storage (ferritin) and functional (soluble transferrin receptor, sTfR) axes are rarely assessed within a single model. We aimed to determine whether both axes are independently associated with glycaemia and MetS and to evaluate their diagnostic value. Materials and Methods: A cross-sectional study was conducted in 297 adults (72.8% women) from Turkestan, Kazakhstan. Hierarchical regression models with sequential adjustment were applied for age, sex, body mass index (BMI), high-sensitivity C-reactive protein (hs-CRP), dietary inflammatory index (DII), HFE H63D genotype, and gamma-glutamyl transferase (GGT). Path analysis and receiver operating characteristic (ROC) analysis were also performed. Results: Ferritin and sTfR were independently associated with fasting glucose (β = 0.27 and 0.73, respectively) and metabolic syndrome (OR = 1.52 and 4.53, respectively). When analyzed separately, neither biomarker reached statistical significance for MetS (ferritin: OR = 1.20, p = 0.140; sTfR: OR = 1.93, p = 0.072). Ferritin demonstrated no discriminatory ability in men (AUC = 0.500, 95% CI 0.370–0.630) and modest discrimination in women (AUC = 0.652, 95% CI 0.571–0.732). GGT accounted for approximately 28% of the ferritin–glucose association in a path-analytic model. Ferritin, GGT, and HbA1c levels increased progressively even among individuals with 0–2 MetS components. Conclusions: Both the storage and functional axes of iron metabolism provide independent information on glycaemic status, but their associations become apparent only when assessed simultaneously. Ferritin alone is not suitable as a diagnostic marker for metabolic syndrome.

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DOI: 10.3390/diagnostics16172773

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