Milton Fabian Suárez-Ortegón1, Stela McLachlan2, Anna H Price2, Mercé Fernández-Balsells3, Josep Franch-Nadal4, Manel Mata-Cases5, Joan Barrot-de la Puente6, Xavier Mundet-Tudurí6, Didac Mauricio7, Wifredo Ricart3, Sarah H Wild2, Mark W J Strachan8, Jackie F Price2, José-Manuel Fernández-Real9. 1. Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK; Nutrition Group, Universidad Del Valle, Cali, Colombia. Electronic address: Milton.Suarez@ed.ac.uk. 2. Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK. 3. Department of Diabetes, Endocrinology and Nutrition, Institut D'Investigació Biomèdica de Girona (IdIBGi), CIBEROBN (CB06/03/010) and Instituto de Salud Carlos III (ISCIII), Girona, Spain. 4. DAP-Catgroup, Unitat de Suport a La Recerca Barcelona Ciutat, Institut Universitari D'Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain; Primary Health Care Center Raval Sud, Gerència D'Àmbit D'Atenció Primària Barcelona Ciutat, Institut Català de La Salut, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Spain. 5. DAP-Catgroup, Unitat de Suport a La Recerca Barcelona Ciutat, Institut Universitari D'Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Spain; Primary Health Care La Mina (Sant Adrià de Besò), Gerència D'Àmbit D'Atenció Primària Barcelona Ciutat, Institut Català de La Salut, Barcelona, Spain. 6. DAP-Catgroup, Unitat de Suport a La Recerca Barcelona Ciutat, Institut Universitari D'Investigació en AtencióPrimària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain. 7. Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Spain. 8. Metabolic Unit, Western General Hospital, Edinburgh, Scotland, UK. 9. Department of Diabetes, Endocrinology and Nutrition, Institut D'Investigació Biomèdica de Girona (IdIBGi), CIBEROBN (CB06/03/010) and Instituto de Salud Carlos III (ISCIII), Girona, Spain. Electronic address: jmfreal@idibgi.org.
Abstract
BACKGROUND AND AIMS: The possible contribution of iron to cardiovascular complications of type 2 diabetes (T2D) has been scarcely investigated. We aimed to study whether serum ferritin is linked to prevalent/incident cardiovascular disease (CVD) in T2D. METHODS: The prevalence of coronary heart disease (CHD), cerebrovascular disease (CEVD) and CVD was evaluated in the SIDIAP study (n = 38,617) and prevalence and 7-year incidence were analysed in the Edinburgh Type 2 Diabetes Study (ET2DS) (n = 821). Logistic and Cox regressions were used to describe associations between serum ferritin and CVD adjusting for confounding variables. RESULTS: Increase of 1 SD unit in log-ferritin was associated with lower CVD prevalence in fully-adjusted models (ET2DS odds ratio (OR) 95% confidence interval (CI): 0.81 (0.68-0.96), p = 0.018; SIDIAP study: 0.91 (0.88-0.94), p < 0.001). In ET2DS, ferritin in the highest (vs. the lowest) quintile was associated with lower incidence of CVD (fully adjusted HR 95% CI: 0.46 (0.26-0.83), p = 0.010). This association persisted after removing subjects with CVD at baseline (n = 536) (HR 95% CI: 0.34 (0.14-0.81), p = 0.016). CONCLUSIONS: Low iron status was associated with CVD risk in T2D. This pattern was consistent in populations at different cardiovascular risk. Low iron status seems to be harmful for cardiovascular health in T2D and it may be a target for intervention.
BACKGROUND AND AIMS: The possible contribution of iron to cardiovascular complications of type 2 diabetes (T2D) has been scarcely investigated. We aimed to study whether serum ferritin is linked to prevalent/incident cardiovascular disease (CVD) in T2D. METHODS: The prevalence of coronary heart disease (CHD), cerebrovascular disease (CEVD) and CVD was evaluated in the SIDIAP study (n = 38,617) and prevalence and 7-year incidence were analysed in the Edinburgh Type 2 Diabetes Study (ET2DS) (n = 821). Logistic and Cox regressions were used to describe associations between serum ferritin and CVD adjusting for confounding variables. RESULTS: Increase of 1 SD unit in log-ferritin was associated with lower CVD prevalence in fully-adjusted models (ET2DS odds ratio (OR) 95% confidence interval (CI): 0.81 (0.68-0.96), p = 0.018; SIDIAP study: 0.91 (0.88-0.94), p < 0.001). In ET2DS, ferritin in the highest (vs. the lowest) quintile was associated with lower incidence of CVD (fully adjusted HR 95% CI: 0.46 (0.26-0.83), p = 0.010). This association persisted after removing subjects with CVD at baseline (n = 536) (HR 95% CI: 0.34 (0.14-0.81), p = 0.016). CONCLUSIONS: Low iron status was associated with CVD risk in T2D. This pattern was consistent in populations at different cardiovascular risk. Low iron status seems to be harmful for cardiovascular health in T2D and it may be a target for intervention.
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