M M Fadil, N K Zaidan
Iron metabolism has emerged as a potential regulator of metabolic and endocrine pathways, particularly in female health disorders. However, its role as a biological mediator linking insulin resistance, thyroid function, and vitamin D status remains insufficiently explored. The study aimed to analyze the role of iron status as a biological mediator in the pathogenesis of metabolic and hormonal disturbances, with a focus on insulin resistance, thyroid stimulating hormone (TSH), and vitamin D3. A cross-sectional study was conducted on 88 young, non-pregnant, fasting women aged 18-30 years with untreated iron deficiency. Iron status parameters (ferritin, serum iron, total iron-binding capacity (TIBC), and transferrin saturation) were evaluated alongside metabolic markers (insulin, glucose, HOMA-IR, QUICKI), as well as TSH, and vitamin D3 levels. Statistical analyses included multiple linear regression, binary logistic regression, and partial correlation controlling for age using SPSS version 28. The multiple linear regression model demonstrated a strong fit (R2 = 0.864, p < 0.001), with ferritin identified as an important independent Insulin Resistance Index (HOMA-IR) (β = -0.224, p < 0.001). Furthermore, ferritin showed a strong positive correlation with QUICKI (r = +0.76), indicating improved insulin sensitivity. Partial correlation analysis confirmed a strong independent association between ferritin and HOMA-IR (r = -0.803, p < 0.001), in addition to vitamin D3 (r = 0.781, p < 0.001). No significant relationship was observed between iron profile and TSH (p > 0.05). Logistic regression achieved perfect classification but was unstable due to complete separation. Iron status, particularly ferritin, plays a central role in metabolic dysregulation and may act as a biological mediator in insulin resistance and vitamin D metabolism. These findings highlight the importance of iron homeostasis in female health disorders and suggest potential pathways for targeted intervention.