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High ferritin and low transferrin saturation are associated with pre-diabetes among a national representative sample of U.S. adults.
Clin Nutr 2013; 32(6):1055-60CN

Abstract

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+Show Affiliations

Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23312547

Citation

Cheung, Ching-Lung, et al. "High Ferritin and Low Transferrin Saturation Are Associated With Pre-diabetes Among a National Representative Sample of U.S. Adults." Clinical Nutrition (Edinburgh, Scotland), vol. 32, no. 6, 2013, pp. 1055-60.
Cheung CL, Cheung TT, Lam KS, et al. High ferritin and low transferrin saturation are associated with pre-diabetes among a national representative sample of U.S. adults. Clin Nutr. 2013;32(6):1055-60.
Cheung, C. L., Cheung, T. T., Lam, K. S., & Cheung, B. M. (2013). High ferritin and low transferrin saturation are associated with pre-diabetes among a national representative sample of U.S. adults. Clinical Nutrition (Edinburgh, Scotland), 32(6), pp. 1055-60. doi:10.1016/j.clnu.2012.11.024.
Cheung CL, et al. High Ferritin and Low Transferrin Saturation Are Associated With Pre-diabetes Among a National Representative Sample of U.S. Adults. Clin Nutr. 2013;32(6):1055-60. PubMed PMID: 23312547.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High ferritin and low transferrin saturation are associated with pre-diabetes among a national representative sample of U.S. adults. AU - Cheung,Ching-Lung, AU - Cheung,Tommy T, AU - Lam,Karen S L, AU - Cheung,Bernard M Y, Y1 - 2012/12/28/ PY - 2012/07/18/received PY - 2012/11/19/revised PY - 2012/11/26/accepted PY - 2013/1/15/entrez PY - 2013/1/15/pubmed PY - 2014/8/19/medline KW - ALT KW - AST KW - Alk phos KW - C-reactive protein KW - CRP KW - Ferritin KW - GFR KW - GGT KW - HOMA-IR KW - HbA1C KW - IFG KW - Inflammation KW - Iron KW - MAP KW - NHANES KW - National Health and Nutrition Examination Survey KW - Pre-diabetes KW - TSAT KW - Transferrin saturation KW - alanine transaminase KW - alkaline phosphatase KW - aspartate aminotransferase KW - gamma-glutamyl transpeptidase KW - glomerular filtration rate KW - glycosylated hemoglobin KW - homeostasis model assessment of insulin resistance KW - impaired fasting glucose KW - mean arterial pressure KW - transferrin saturation SP - 1055 EP - 60 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 32 IS - 6 N2 - 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. SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/23312547/High_ferritin_and_low_transferrin_saturation_are_associated_with_pre_diabetes_among_a_national_representative_sample_of_U_S__adults_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(12)00281-6 DB - PRIME DP - Unbound Medicine ER -