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
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.