BACKGROUND & AIMS: Iron overload is known to cause diabetes. However, the underlying mechanism is poorly understood. We therefore studied the association of different markers of iron metabolism, namely ferritin, erythrocyte protoporphyrin and transferrin saturation (TSAT, as defined by a percentage of transferrin that is saturated with iron) with pre-diabetes (preDM) in US adults without chronic kidney disease, anemia, and iron deficiency. METHODS: Data on 2575 participants of the National Health and Nutrition Examination Survey (NHANES) 1999-2002 who were free of diabetes, chronic kidney disease, iron deficiency, and anemia were analyzed. Data on 3876 participants of the NHANES III (1988-1994) were used as replication. Homeostasis model assessment of insulin resistance (HOMA-IR), blood glycosylated hemoglobin level (HbA1C), fasting glucose, insulin, and preDM (defined as a fasting plasma glucose 100-125 mg/dl or an HBA1C value 5.7-6.4%) were measured as the outcomes. RESULTS: Logistic regression analyses indicated independent associations of high ferritin (Ptrend = 0.028) and low TSAT (P(trend) = 0.029) with preDM after adjusting for sociodemographics, physical activity (active/sedementary), metabolic and inflammatory markers (triglycerides, total cholesterol, HDL cholesterol, mean arterial pressure, CRP, white cell count, and albumin), and liver enzymes (GGT, Alk phos, AST, and ALT). The NHANES III data showed similar associations. Combining the results showed a more significant association for high ferritin (P(meta) = 0.016) and low TSAT (P(meta) = 0.002). Moreover, TSAT was associated with HbA1C, fasting glucose, insulin, and HOMA-IR (P(meta) ≤ 0.001). CONCLUSIONS: Higher ferritin and lower TSAT are associated with higher risk of preDM in a general population without confounding diseases. Further research is needed to examine the underlying mechanism of these two indices, especially TSAT, in the pathophysiology of preDM.
BACKGROUND & AIMS:Iron overload is known to cause diabetes. However, the underlying mechanism is poorly understood. We therefore studied the association of different markers of iron metabolism, namely ferritin, erythrocyte protoporphyrin and transferrin saturation (TSAT, as defined by a percentage of transferrin that is saturated with iron) with pre-diabetes (preDM) in US adults without chronic kidney disease, anemia, and iron deficiency. METHODS: Data on 2575 participants of the National Health and Nutrition Examination Survey (NHANES) 1999-2002 who were free of diabetes, chronic kidney disease, iron deficiency, and anemia were analyzed. Data on 3876 participants of the NHANES III (1988-1994) were used as replication. Homeostasis model assessment of insulin resistance (HOMA-IR), blood glycosylated hemoglobin level (HbA1C), fasting glucose, insulin, and preDM (defined as a fasting plasma glucose 100-125 mg/dl or an HBA1C value 5.7-6.4%) were measured as the outcomes. RESULTS: Logistic regression analyses indicated independent associations of high ferritin (Ptrend = 0.028) and low TSAT (P(trend) = 0.029) with preDM after adjusting for sociodemographics, physical activity (active/sedementary), metabolic and inflammatory markers (triglycerides, total cholesterol, HDL cholesterol, mean arterial pressure, CRP, white cell count, and albumin), and liver enzymes (GGT, Alk phos, AST, and ALT). The NHANES III data showed similar associations. Combining the results showed a more significant association for high ferritin (P(meta) = 0.016) and low TSAT (P(meta) = 0.002). Moreover, TSAT was associated with HbA1C, fasting glucose, insulin, and HOMA-IR (P(meta) ≤ 0.001). CONCLUSIONS: Higher ferritin and lower TSAT are associated with higher risk of preDM in a general population without confounding diseases. Further research is needed to examine the underlying mechanism of these two indices, especially TSAT, in the pathophysiology of preDM.
Authors: Mayra L Estrella; Cynthia M Pérez; Erick Suárez; Wilmarie Fuentes-Payán; Bharat Thyagarajan; Jonathan C Goldsmith; Martha L Daviglus; M Larissa Avilés-Santa Journal: Endocr Pract Date: 2021-12-08 Impact factor: 3.443
Authors: Clara Podmore; Karina Meidtner; Matthias B Schulze; Robert A Scott; Anna Ramond; Adam S Butterworth; Emanuele Di Angelantonio; John Danesh; Larraitz Arriola; Aurelio Barricarte; Heiner Boeing; Françoise Clavel-Chapelon; Amanda J Cross; Christina C Dahm; Guy Fagherazzi; Paul W Franks; Diana Gavrila; Sara Grioni; Marc J Gunter; Gaelle Gusto; Paula Jakszyn; Verena Katzke; Timothy J Key; Tilman Kühn; Amalia Mattiello; Peter M Nilsson; Anja Olsen; Kim Overvad; Domenico Palli; J Ramón Quirós; Olov Rolandsson; Carlotta Sacerdote; Emilio Sánchez-Cantalejo; Nadia Slimani; Ivonne Sluijs; Annemieke M W Spijkerman; Anne Tjonneland; Rosario Tumino; Daphne L van der A; Yvonne T van der Schouw; Edith J M Feskens; Nita G Forouhi; Stephen J Sharp; Elio Riboli; Claudia Langenberg; Nicholas J Wareham Journal: Diabetes Care Date: 2016-02-09 Impact factor: 19.112