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Systematic Review Article

Serum Hepcidin, the Hepcidin/Ferritin Ratio and the Risk of Type 2 Diabetes: A Systematic Review and Meta-Analysis

[ Vol. 28 , Issue. 6 ]


Nahid Karamzad, Aziz Eftekhari, Ahad Ashrafi-Asgarabad, Mark J.M. Sullman, Amirhossein Sahebkar and Saeid Safiri*   Pages 1224 - 1233 ( 10 )


Objectives: To perform a meta-analysis on the relationship type 2 diabetes has with serum hepcidin and the hepcidin/ferritin ratio.

Methods: The following databases were searched using all relevant keywords: Web of Science, Medline, Scopus, Embase and Google Scholar. All studies that examined the relationship type 2 diabetes has with serum hepcidin or the hepcidin/ferritin ratio were included in this meta-analysis and systematic review provided, were published in English between 2011 and 2018. A random-effects model was used to pool the standardized mean difference (SMD).

Results: The SMD of serum hepcidin among patients with type 2 diabetes and healthy controls were compared across eight studies (n cases=878; n controls=2306). The pooled SMD of serum hepcidin did not differ significantly between study groups (SMD: 0.04; 95% confidence interval (CI): -0.29 to 0.35). In contrast, the serum hepcidin/ferritin ratio was examined across five studies (n cases=229; n controls=1426) and was found to be negatively associated with the risk of type 2 diabetes (SMD: -0.52; 95% confidence interval (CI): -0.85 to -0.19). There was no publication bias found for the associations serum hepcidin (Egger´s test: P =0.97) or the hepcidin/ferritin ratio (Egger´s test: P =0.75) had with type 2 diabetes.

Conclusion: Although hepcidin has been proposed as a risk marker for type 2 diabetes, our metaanalysis found that the hepcidin/ferritin ratio was superior to hepcidin alone as a risk marker.


Type 2 diabetes mellitus, hepcidins, ferritins, risk marker, meta-analysis, Serum Hepcidin, Hepcidin/ Ferritin Ratio, study groups.


Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Department of Pharmacology and Toxicology, Maragheh University of Medical Sciences, Maragheh, Department of Epidemiology, School of Health, Bam University of Medical Sciences, Bam, School of Humanities and Social Sciences, University of Nicosia, Nicosia, Halal Research Center of IRI, FDA, Tehran, Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran

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