Ferritin Concentrations, Metabolic Syndrome, and Type 2 Diabetes in Middle-Aged and Elderly Chinese

Graduate School, Chinese Academy of Sciences, Peping, Beijing, China
Journal of Clinical Endocrinology &amp Metabolism (Impact Factor: 6.31). 10/2008; 93(12):4690-6. DOI: 10.1210/jc.2008-1159
Source: PubMed

ABSTRACT Elevated ferritin concentrations frequently cluster with well-established risk factors of diabetes including obesity, metabolic syndrome, chronic inflammation, and altered circulating adipokines. Few studies, however, have systematically evaluated the effect of these risk factors on ferritin-diabetes association, particularly in Chinese populations.
We aimed to investigate, in a middle-aged and elderly Chinese population, whether elevated ferritin concentrations are associated with higher risk of metabolic syndrome and type 2 diabetes and to what extent the associations were influenced by obesity, inflammation, and adipokines.
We conducted a population-based, cross-sectional survey of 3,289 participants aged 50-70 yr in Beijing and Shanghai in 2005. Fasting plasma ferritin, glucose, insulin, lipid profile, glycohemoglobin, inflammatory markers, adipokines, and dietary profile were measured.
Median ferritin concentrations were 155.7 ng/ml for men and 111.9 ng/ml for women. After multiple adjustment, the odds ratios (ORs) were substantially higher for type 2 diabetes (OR 3.26, 95% confidence interval 2.36-4.51) and metabolic syndrome [OR 2.80 (95% confidence interval 2.24-3.49)] in the highest ferritin quartile compared with those in the lowest quartile. These associations remained significant after further adjustment for dietary factors, body mass index, inflammatory markers, and adipokines.
Elevated circulating ferritin concentrations were associated with higher risk of type 2 diabetes and metabolic syndrome in middle-aged and elderly Chinese independent of obesity, inflammation, adipokines, and other risk factors. Our data support the crucial role of iron overload for metabolic diseases, even in a country with relatively high prevalence of iron deficiency.

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Available from: Oscar H Franco, Aug 24, 2015
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    • "Copper (Cu) and zinc (Zn) play critical roles in oxidant/antioxidant mechanisms. Imbalances in these processes lead to high susceptibility to oxidative damage of tissues and eventually to the development of diabetes and diabetic complications [7] [8] [9] [10] [11] [12]. Cu is a prooxidant, participating in metal-catalyzed formation of free radicals. "
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    • "The health effects caused by iron overload have received increasing attention [1]. There is accumulating evidence to suggest that elevated concentrations of circulating ferritin, a marker of iron stores, are associated with the prevalence and risk of metabolic syndrome [2] [3] [4] [5] and type 2 diabetes [6]. Metabolic syndrome and type 2 diabetes are multifactorial disorders in which insulin resistance (IR) is closely involved. "
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    ABSTRACT: OBJECTIVE: Several epidemiological studies have reported that high concentrations of circulating ferritin, a marker of iron stores, are related to insulin resistance (IR); however, questions remain regarding inconsistent data between Asian men and women and the inadequate consideration of potential confounding effects on the relationship between ferritin and IR. Our aim was to examine the relationship between serum ferritin concentrations and IR markers in the Japanese population. MATERIALS/METHODS: We analyzed data (n=493) from a cross-sectional survey conducted in 2009 among a Japanese working population aged 20-68years. Fasting serum ferritin and insulin levels and fasting plasma glucose levels were determined, and the homeostatic model assessment of IR (HOMA-IR) was calculated. Multiple regression analysis was performed with adjustments for demographic and lifestyle factors, body mass index and serum C-reactive protein. RESULTS: Fasting insulin and HOMA-IR significantly increased with increasing levels of serum ferritin after adjustment for covariates in men (P for trend=.005 and .001, respectively). Compared with men in the lowest tertile of serum ferritin, those in the highest tertile had a 24% higher HOMA-IR score. Additional data suggested a positive association between iron intake and HOMA-IR (P for trend=.07) in men. Neither serum ferritin nor iron intake was related to IR markers in women, even in postmenopausal women. CONCLUSIONS: Serum ferritin concentrations were positively associated with fasting insulin and HOMA-IR in men but not in women, suggesting an important role of iron storage in the pathogenesis of IR in Japanese men.
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    • "Ferritin is a widely used marker of iron status in epidemiological studies and accurately reflects body iron stores in healthy individuals [5]. Several cross-sectional and retrospective case–control studies have linked elevated ferritin levels with DM [6]. Furthermore, a few prospective studies have also reported that relatively high levels of ferritin are associated with an increased of risk of developing DM in apparently healthy individuals [7] [8]. "
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