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Association of iron indices and type 2 diabetes: a meta-analysis of observational studies.
Diabetes Metab Res Rev 2014; 30(5):372-94DM

Abstract

The literature on the role of body iron status in the development of type 2 diabetes (T2D) in humans is inconsistent. We aimed to assess the association between iron indices and T2D by a meta-analysis of previously published studies. A systematic literature search was conducted in PubMed and EMBASE. Observational studies on the association of ferritin (when controlled for age and sex), transferrin saturation, soluble transferrin receptor and transferrin with T2D were included. Pooled association estimates were calculated using a random effects model. Forty-six eligible studies were identified. The pooled multivariable adjusted relative risks of T2D in the highest versus lowest quartile of ferritin levels were significantly elevated in both cross-sectional as well as prospective studies and after restriction to inflammation-adjusted studies [overall: 1.67 (95% CI 1.41-1.99)]. The mean difference indicated 43.54 ng/mL (95% CI 28.14-58.94) higher ferritin levels in type 2 diabetic individuals. The relative risk for a transferrin saturation ≥ 50% was 1.59 (95% CI 1.28-1.97), the mean difference was -1.92% [95% CI -2.99-(-0.85)]. Study-specific results of soluble transferrin receptor and transferrin levels were extremely heterogeneous. Ferritin and clinically elevated transferrin saturation were strongly associated with an increased risk of T2D, overall and in prospective studies. Ferritin was also significantly associated after multivariable adjustment including inflammation. Thus, the current evidence hints at a causal effect; however, publication bias and unmeasured confounding cannot be excluded.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

24327370

Citation

Orban, Ester, et al. "Association of Iron Indices and Type 2 Diabetes: a Meta-analysis of Observational Studies." Diabetes/metabolism Research and Reviews, vol. 30, no. 5, 2014, pp. 372-94.
Orban E, Schwab S, Thorand B, et al. Association of iron indices and type 2 diabetes: a meta-analysis of observational studies. Diabetes Metab Res Rev. 2014;30(5):372-94.
Orban, E., Schwab, S., Thorand, B., & Huth, C. (2014). Association of iron indices and type 2 diabetes: a meta-analysis of observational studies. Diabetes/metabolism Research and Reviews, 30(5), pp. 372-94. doi:10.1002/dmrr.2506.
Orban E, et al. Association of Iron Indices and Type 2 Diabetes: a Meta-analysis of Observational Studies. Diabetes Metab Res Rev. 2014;30(5):372-94. PubMed PMID: 24327370.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of iron indices and type 2 diabetes: a meta-analysis of observational studies. AU - Orban,Ester, AU - Schwab,Sigrid, AU - Thorand,Barbara, AU - Huth,Cornelia, PY - 2012/11/08/received PY - 2013/10/29/revised PY - 2013/10/31/accepted PY - 2013/12/12/entrez PY - 2013/12/12/pubmed PY - 2015/2/20/medline KW - ferritin KW - iron KW - soluble transferrin receptor KW - transferrin KW - type 2 diabetes SP - 372 EP - 94 JF - Diabetes/metabolism research and reviews JO - Diabetes Metab. Res. Rev. VL - 30 IS - 5 N2 - The literature on the role of body iron status in the development of type 2 diabetes (T2D) in humans is inconsistent. We aimed to assess the association between iron indices and T2D by a meta-analysis of previously published studies. A systematic literature search was conducted in PubMed and EMBASE. Observational studies on the association of ferritin (when controlled for age and sex), transferrin saturation, soluble transferrin receptor and transferrin with T2D were included. Pooled association estimates were calculated using a random effects model. Forty-six eligible studies were identified. The pooled multivariable adjusted relative risks of T2D in the highest versus lowest quartile of ferritin levels were significantly elevated in both cross-sectional as well as prospective studies and after restriction to inflammation-adjusted studies [overall: 1.67 (95% CI 1.41-1.99)]. The mean difference indicated 43.54 ng/mL (95% CI 28.14-58.94) higher ferritin levels in type 2 diabetic individuals. The relative risk for a transferrin saturation ≥ 50% was 1.59 (95% CI 1.28-1.97), the mean difference was -1.92% [95% CI -2.99-(-0.85)]. Study-specific results of soluble transferrin receptor and transferrin levels were extremely heterogeneous. Ferritin and clinically elevated transferrin saturation were strongly associated with an increased risk of T2D, overall and in prospective studies. Ferritin was also significantly associated after multivariable adjustment including inflammation. Thus, the current evidence hints at a causal effect; however, publication bias and unmeasured confounding cannot be excluded. SN - 1520-7560 UR - https://www.unboundmedicine.com/medline/citation/24327370/Association_of_iron_indices_and_type_2_diabetes:_a_meta_analysis_of_observational_studies_ L2 - https://doi.org/10.1002/dmrr.2506 DB - PRIME DP - Unbound Medicine ER -