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Iron Stores May Predict Diabetes Risk: Presented at ADA

By Charlene Laino

NEW ORLEANS, LA -- June 18, 2003 -- Women with high body iron stores may be at increased risk for type 2 diabetes, according to a new analysis from the Nurses Health Study.

Rui Jiang, PhD, a postdoctoral fellow at the Harvard School of Public Health, in Boston, Massachusetts, United States, presented the findings here on June 17^th at the 63^rd Scientific Sessions of the American Diabetes Association.

While type 2 diabetes is a common manifestation of hemochromatosis, previous studies looking at whether high iron stores predict the risk of the disease among healthy persons have shown conflicting results, she said.

The current prospective, nested, case-control study addressed the question in a large cohort of initially healthy women, looking at 2 biomarkers of iron stores -- serum ferritin and ratio of soluble transferrin receptor to serum ferritin (TfR/ferritin) -- in relation to the development of the disease. The cohort consisted of 32,826 women in the Nurses Health Study without signs of heart disease, cancer, or diabetes when they provided blood samples in 1989–90.

By 2000, 735 women had developed type 2 diabetes. The 787 controls were matched for age, fasting status, race and -- if they were obese -- body mass index (BMI).

Mean ferritin level was 109 ng/mL among cases and 71.7 ng/mL among controls (P<0.001). Mean TfR/ferritin ratio was 103 among cases and 141 among controls (P=0.01).

A conditional logistic regression model that controlled for BMI, family history of diabetes, physical activity, smoking, alcohol use, and menopausal status was used to estimate the relative risk of diabetes by quintiles of ferritin and TfR/ferritin.

Women in the highest quintile of ferritin concentration were 2.66 times more likely to have diabetes, compared with those in the lowest quintile, the study showed. And women in the lowest quintile for TfR/ferritin ratio were 2.42 times more likely to develop the disease, compared with those in the highest quintile, Dr. Jiang said.

Further adjustment for levels of C-reactive protein and interleukin-6, and for dietary variables did not significantly change the results, she said.

If the findings from the current observational trial are confirmed in future studies, "a simple blood test could be used to identify women at high risk for diabetes," Dr. Jiang said.


[Study title: Body Iron Stores in Relation to Risk of Type 2 Diabetes in Women. Abstract 306-OR]

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