Higher ferritin levels, but not serum iron or transferrin saturation, are associated with Type 2 diabetes mellitus in adult men and women free of genetic haemochromatosis

Yeap, B. and Divitini, M. and Gunton, J. and Olynyk, J. and Beilby, J. and McQuillan, B. and Hung, J. et al. 2015. Higher ferritin levels, but not serum iron or transferrin saturation, are associated with Type 2 diabetes mellitus in adult men and women free of genetic haemochromatosis. Clinical Endocrinology. 82 (4): pp. 525-532.

Source Title

Clinical Endocrinology

DOI

10.1111/cen.12529

ISSN

0300-0664

School

School of Biomedical Sciences

Funding and Sponsorship

http://purl.org/au-research/grants/nhmrc/1021326

Remarks

This is the peer reviewed version of the following article: Yeap, B. and Divitini, M. and Gunton, J. and Olynyk, J. and Beilby, J. and McQuillan, B. and Hung, J. et al. 2015. Clinical Endocrinology. 82 (4): pp. 525-532, which has been published in final form at http://doi.org/10.1111/cen.12529. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving at http://olabout.wiley.com/WileyCDA/Section/id-820227.html#terms

URI

http://hdl.handle.net/20.500.11937/4510

Collection

Curtin Research Publications

Abstract

Context - Iron overload predisposes to diabetes and higher ferritin levels have been associated with diabetes. However, it is unclear whether ferritin reflects differences in iron-related parameters between diabetic and nondiabetic persons. We examined associations of serum ferritin, iron and transferrin saturation with Type 2 diabetes in adults without genetic predisposition to iron overload. Design, participants and measurements - Cross-sectional analysis of community-dwelling men and women aged 17–97 years from the Busselton Health Survey, Western Australia. Men and women carrying genotypes associated with haemochromatosis (C282Y/C282Y or C282Y/H63D) were excluded. Serum ferritin, iron and transferrin saturation were assayed. Results - There were 1834 men (122 with diabetes, 6·6%) and 2351 women (141 with diabetes, 6%). In men, higher serum ferritin was associated with diabetes after adjusting for age, smoking, alcohol, cardiovascular history, body mass index (BMI), waist, blood pressure, lipids, C-reactive protein (CRP), adiponectin, alanine transaminase (ALT) and gamma-glutamyl transpeptidase (GGT) [odds ratio (OR): 1·29 per 1 unit increase log ferritin, 95% confidence interval (CI) = 1·01–1·65, P = 0·043]. In women, higher serum ferritin was associated with diabetes [fully adjusted OR: 1·31 per 1 unit increase log ferritin, 95% CI = 1·04–1·63, P = 0·020; 1·84 for tertile (T) 3 vs T1, 95% CI = 1·09–3·11]. Neither iron levels nor transferrin saturation were associated with diabetes risk in men or women. Higher ferritin was not associated with insulin resistance in nondiabetic adults. Conclusions - In adults, higher ferritin levels are independently associated with prevalent diabetes while iron and transferrin saturation are not. Ferritin is a robust biomarker for diabetes risk, but further investigation is needed to clarify whether this relationship is mediated via iron metabolism.