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Dietary iron intake, body iron stores, and the risk of type 2 diabetes: a systematic review and meta-analysis.

Abstract

BACKGROUND

Excess iron has been shown to induce diabetes in animal models. However, the results from human epidemiologic studies linking body iron stores and iron intake to the risk of type 2 diabetes mellitus (T2DM) are conflicting. In this study, we aimed to systematically evaluate the available evidence for associations between iron intake, body iron stores, and the risk of T2DM.

METHODS

A systematic search of the PubMed/MEDLINE and EMBASE databases to the end of 22 April 2012 was performed, and reference lists of retrieved articles were screened. Two reviewers independently evaluated the eligibility of inclusion and extracted the data. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random-effects models.

RESULTS

We reviewed 449 potentially relevant articles, and 11 prospective studies were included in the analysis. A meta-analysis of five studies gave a pooled RR for T2DM of 1.33 (95% CI 1.19 to 1.48; P<0.001) in individuals with the highest level of heme iron intake, compared with those with the lowest level. The pooled RR for T2DM for a daily increment of 1 mg of heme iron intake was 1.16 (1.09 to 1.23, P<0.001). Body iron stores, as measured by ferritin, soluble transferrin receptor (sTfR) and the sTfR:ferritin ratio, were significantly associated with the risk of T2DM. The pooled RRs for T2DM in individuals with the highest versus the lowest intake of ferritin levels was 1.70 (1.27-2.27, P<0.001) before adjustment for inflammatory markers and 1.63 (1.03-2.56, P = 0.036) after adjustment. We did not find any significant association of dietary intakes of total iron, non-heme, or supplemental iron intake with T2DM risk.

CONCLUSION

Higher heme iron intake and increased body iron stores were significantly associated with a greater risk of T2DM. Dietary total iron, non-heme iron, or supplemental iron intakes were not significantly associated with T2DM risk.

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  • Authors+Show Affiliations

    ,

    Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, P,R, China.

    , ,

    Source

    BMC medicine 10: 2012 Oct 10 pg 119

    MeSH

    Adult
    Aged
    Animals
    Diabetes Mellitus, Type 2
    Female
    Humans
    Iron
    Iron, Dietary
    Male
    Middle Aged
    Risk Assessment
    Young Adult

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    23046549

    Citation

    Bao, Wei, et al. "Dietary Iron Intake, Body Iron Stores, and the Risk of Type 2 Diabetes: a Systematic Review and Meta-analysis." BMC Medicine, vol. 10, 2012, p. 119.
    Bao W, Rong Y, Rong S, et al. Dietary iron intake, body iron stores, and the risk of type 2 diabetes: a systematic review and meta-analysis. BMC Med. 2012;10:119.
    Bao, W., Rong, Y., Rong, S., & Liu, L. (2012). Dietary iron intake, body iron stores, and the risk of type 2 diabetes: a systematic review and meta-analysis. BMC Medicine, 10, p. 119. doi:10.1186/1741-7015-10-119.
    Bao W, et al. Dietary Iron Intake, Body Iron Stores, and the Risk of Type 2 Diabetes: a Systematic Review and Meta-analysis. BMC Med. 2012 Oct 10;10:119. PubMed PMID: 23046549.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dietary iron intake, body iron stores, and the risk of type 2 diabetes: a systematic review and meta-analysis. AU - Bao,Wei, AU - Rong,Ying, AU - Rong,Shuang, AU - Liu,Liegang, Y1 - 2012/10/10/ PY - 2012/06/10/received PY - 2012/10/10/accepted PY - 2012/10/11/entrez PY - 2012/10/11/pubmed PY - 2013/3/7/medline SP - 119 EP - 119 JF - BMC medicine JO - BMC Med VL - 10 N2 - BACKGROUND: Excess iron has been shown to induce diabetes in animal models. However, the results from human epidemiologic studies linking body iron stores and iron intake to the risk of type 2 diabetes mellitus (T2DM) are conflicting. In this study, we aimed to systematically evaluate the available evidence for associations between iron intake, body iron stores, and the risk of T2DM. METHODS: A systematic search of the PubMed/MEDLINE and EMBASE databases to the end of 22 April 2012 was performed, and reference lists of retrieved articles were screened. Two reviewers independently evaluated the eligibility of inclusion and extracted the data. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random-effects models. RESULTS: We reviewed 449 potentially relevant articles, and 11 prospective studies were included in the analysis. A meta-analysis of five studies gave a pooled RR for T2DM of 1.33 (95% CI 1.19 to 1.48; P<0.001) in individuals with the highest level of heme iron intake, compared with those with the lowest level. The pooled RR for T2DM for a daily increment of 1 mg of heme iron intake was 1.16 (1.09 to 1.23, P<0.001). Body iron stores, as measured by ferritin, soluble transferrin receptor (sTfR) and the sTfR:ferritin ratio, were significantly associated with the risk of T2DM. The pooled RRs for T2DM in individuals with the highest versus the lowest intake of ferritin levels was 1.70 (1.27-2.27, P<0.001) before adjustment for inflammatory markers and 1.63 (1.03-2.56, P = 0.036) after adjustment. We did not find any significant association of dietary intakes of total iron, non-heme, or supplemental iron intake with T2DM risk. CONCLUSION: Higher heme iron intake and increased body iron stores were significantly associated with a greater risk of T2DM. Dietary total iron, non-heme iron, or supplemental iron intakes were not significantly associated with T2DM risk. SN - 1741-7015 UR - https://www.unboundmedicine.com/medline/citation/23046549/Dietary_iron_intake_body_iron_stores_and_the_risk_of_type_2_diabetes:_a_systematic_review_and_meta_analysis_ L2 - https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-10-119 DB - PRIME DP - Unbound Medicine ER -