Effect of Empagliflozin on Serum Ferritin and Its Relationship With Inflammatory Markers in Prediabetic and Diabetic Patients

<b>Background:</b> This research is aimed at evaluating the effects of the SGLT2 inhibitor empagliflozin on inflammatory markers, some iron metabolism markers, and their interrelationships before and after using empagliflozin. <b>Methods:</b> A quasiexperimental study was conducted on 44 prediabetic and Type 2 diabetic patients aged 18-65 years. The participants were among those treated at the clinic affiliated with Kerman Medical Sciences University between 2022 and 2023. The study included diabetic patients with HbA1c levels of 0.5%-1% higher than the therapeutic target who were not using blood sugar control medication. Each patient received a daily dose of 10 mg of empagliflozin for 3 months. Changes in serum levels of iron, total iron-binding capacity (TIBC), ferritin, transferrin saturation, inflammatory markers IL-6, C-reactive protein (CRP), and uric acid were measured before and 3 months after commencing empagliflozin. <b>Results:</b> Three months after starting empagliflozin, the mean FPG and Hb A1c levels showed a drop (<i>p</i> < 0.05). The serum ferritin level decreased, and TIBC increased significantly (<i>p</i> < 0.05) following empagliflozin treatment. Additionally, the serum levels of CRP (<i>p</i> < 0.05), IL-6 (<i>p</i> < 0.001), and uric acid (<i>p</i> < 0.001) declined. Analysis of the correlation between serum ferritin level and IL-6 and uric acid before and after empagliflozin use revealed a positive correlation between serum ferritin and IL-6 (<i>p</i> = 0.04) and uric acid (<i>p</i> = 0.03). However, no significant correlation was observed between the change in ferritin and CRP levels (<i>p</i> = 0.22). <b>Conclusion:</b> Following empagliflozin treatment, serum levels of ferritin and inflammatory markers interleukin-6, CRP, and uric acid declined, indicating a significant relationship between SGLT2 inhibition, inflammation, and iron metabolism. Furthermore, the correlation between ferritin and inflammatory markers suggests that reduced ferritin levels may result from reduced inflammation. <b>Trial Registration:</b> ClinicalTrials.gov identifier: IRCT20090317001774N10.