Elevated serum ferritin levels predict new-onset type 2 diabetes: results from the EPIC-Norfolk prospective study.

TitleElevated serum ferritin levels predict new-onset type 2 diabetes: results from the EPIC-Norfolk prospective study.
Publication TypeJournal Article
Year of Publication2007
AuthorsForouhi, NG, Harding, AH, Allison, M, Sandhu, MS, Welch, A, Luben, R, Bingham, S, Khaw, KT, Wareham, NJ
JournalDiabetologia
Volume50
Issue5
Pagination949-56
Date Published2007 May
ISSN0012-186X
KeywordsC-Reactive Protein, Cohort Studies, Diabetes Mellitus, Type 2, Energy Intake, Female, Ferritins, Humans, Incidence, Male, Middle Aged, Reference Values, United Kingdom
Abstract

AIMS/HYPOTHESIS: The aim of this study was to examine the association between baseline body iron stores and new-onset diabetes.SUBJECTS AND METHODS: We studied the association between baseline serum ferritin concentration and type 2 diabetes in 360 clinically incident diabetes cases and 758 controls nested within the EPIC (European Prospective Investigation of Cancer)-Norfolk Cohort Study. Serum ferritin levels were categorised into five groups: sex-specific quartiles of the normal range of ferritin and a group with clinically raised ferritin below levels indicative of haemochromatosis.RESULTS: Baseline serum ferritin was higher among cases than control participants (geometric mean: men 96.6 vs 67.8 ng/ml, respectively, p < 0.001; women 45.9 vs 34.8 ng/ml, respectively, p = 0.005). In analyses adjusted for known risk factors (age, BMI, sex, family history, physical activity, smoking habit) and dietary factors measured by 7-day food diary, the risk of diabetes was markedly elevated in participants with clinically raised ferritin compared with the lowest quartile (odds ratio [OR] 7.4, 95% CI 3.5-15.4). Further adjustment for potential confounding by inflammation (C-reactive protein, IL-6 and fibrinogen) had no material impact on the observed association, while adjustment for hepatic enzymes (alanine aminotransferase and gamma glutamyl transferase) and adiponectin attenuated the magnitude of association, but it remained statistically significant (OR 3.2 [1.3-7.6]).CONCLUSIONS/INTERPRETATION: Serum ferritin is an important and independent predictor of the development of diabetes. This finding may have important implications for understanding the aetiology of diabetes.

DOI10.1007/s00125-007-0604-5
Alternate JournalDiabetologia
Citation Key10.1007/s00125-007-0604-5
PubMed ID17333112
Grant ListG0401527 / / Medical Research Council / United Kingdom
MC_U106179471 / / Medical Research Council / United Kingdom