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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


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.

Type Journal
Authors Yeap, B. B.; Divitini, M. L.; Gunton, J. E.; Olynyk, J. K.; Beilby, J. P.; McQuillan, B.; Hung, J.; Knuiman, M. W.;
Published Date 2015-04-01
Published Volume 82
Published Issue 4
Published Pages 525-32
Status Published in-print
URL link to publisher's version