Publication: Association of Multiple Biomarkers of Iron Metabolism and Type 2 Diabetes: The EPIC-InterAct Study.
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Date
2016-02-09
Authors
Podmore, Clara
Meidtner, Karina
Schulze, Matthias B
Scott, Robert A
Ramond, Anna
Butterworth, Adam S
Di Angelantonio, Emanuele
Danesh, John
Arriola, Larraitz
Barricarte, Aurelio
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Abstract
Observational studies show an association between ferritin and type 2 diabetes (T2D), suggesting a role of high iron stores in T2D development. However, ferritin is influenced by factors other than iron stores, which is less the case for other biomarkers of iron metabolism. We investigated associations of ferritin, transferrin saturation (TSAT), serum iron, and transferrin with T2D incidence to clarify the role of iron in the pathogenesis of T2D. The European Prospective Investigation into Cancer and Nutrition-InterAct study includes 12,403 incident T2D cases and a representative subcohort of 16,154 individuals from a European cohort with 3.99 million person-years of follow-up. We studied the prospective association of ferritin, TSAT, serum iron, and transferrin with incident T2D in 11,052 cases and a random subcohort of 15,182 individuals and assessed whether these associations differed by subgroups of the population. Higher levels of ferritin and transferrin were associated with a higher risk of T2D (hazard ratio [HR] [95% CI] in men and women, respectively: 1.07 [1.01-1.12] and 1.12 [1.05-1.19] per 100 μg/L higher ferritin level; 1.11 [1.00-1.24] and 1.22 [1.12-1.33] per 0.5 g/L higher transferrin level) after adjustment for age, center, BMI, physical activity, smoking status, education, hs-CRP, alanine aminotransferase, and γ-glutamyl transferase. Elevated TSAT (≥45% vs. The pattern of association of TSAT and transferrin with T2D suggests that the underlying relationship between iron stores and T2D is more complex than the simple link suggested by the association of ferritin with T2D.
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MeSH Terms
Adult
Aged
Aged, 80 and over
Alanine Transaminase
Biomarkers
C-Reactive Protein
Case-Control Studies
Diabetes Mellitus, Type 2
Female
Ferritins
Follow-Up Studies
Humans
Incidence
Iron
Male
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Prospective Studies
Risk Factors
Transferrin
Young Adult
gamma-Glutamyltransferase
Aged
Aged, 80 and over
Alanine Transaminase
Biomarkers
C-Reactive Protein
Case-Control Studies
Diabetes Mellitus, Type 2
Female
Ferritins
Follow-Up Studies
Humans
Incidence
Iron
Male
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Prospective Studies
Risk Factors
Transferrin
Young Adult
gamma-Glutamyltransferase