Skip to main content
Erschienen in: Acta Diabetologica 6/2014

01.12.2014 | Original Article

Serum ferritin, diabetes, diabetes control, and insulin resistance

verfasst von: Yiqiang Zhan, Zheng Tang, Jinming Yu

Erschienen in: Acta Diabetologica | Ausgabe 6/2014

Einloggen, um Zugang zu erhalten

Abstract

Aims

The present study aims to investigate the association between serum ferritin and diabetes, diabetes control, and insulin resistance (IR) and examine whether gender is a modifier for these associations in a community-based sample.

Methods

A cross-sectional survey of 8,235 participants was conducted in 2009. Serum ferritin, glucose, hemoglobin A1c (HbA1c), insulin, inflammatory markers, and lipid markers were measured. IR was estimated with a Homeostasis Model Assessment (HOMA-IR) equation. Multiple logistic and linear regression models were applied to evaluate these associations.

Results

The numbers of diabetic patients and non-diabetic participants in the present study were 644 (7.8 %) and 7,591 (92.2 %). After adjusting for multiple confounders, the odds ratios (ORs) and 95 % confidence intervals (CIs) for diabetes were 1.48 (1.31–1.69) in men and 1.43 (1.24–1.65) in women for one-unit increase in log-transformed serum ferritin levels. Likewise, ORs (95 % CIs) for poor diabetes control (HbA1c ≥7.5 %) were 1.58 (1.21–2.05) and 1.37 (1.07–1.77) in men and women, respectively. As for HOMA-IR, the respective betas (P value) for one-unit increase in log-transformed serum ferritin were 0.07 (P < 0.0001) and 0.06 (P < 0.0001) in men and women.

Conclusions

In conclusion, elevated serum ferritin levels were associated with higher risks of diabetes, higher levels of HbA1c, and HOMA-IR independent of several confounders.
Literatur
1.
Zurück zum Zitat Wang Y, Mi J, Shan XY, Wang QJ, Ge KY (2007) Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China. Int J Obes (Lond) 31:177–188CrossRef Wang Y, Mi J, Shan XY, Wang QJ, Ge KY (2007) Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China. Int J Obes (Lond) 31:177–188CrossRef
2.
Zurück zum Zitat Xu Y, Wang L, He J, Bi Y, Li M et al (2013) Prevalence and control of diabetes in Chinese adults. JAMA 310:948–959PubMedCrossRef Xu Y, Wang L, He J, Bi Y, Li M et al (2013) Prevalence and control of diabetes in Chinese adults. JAMA 310:948–959PubMedCrossRef
3.
Zurück zum Zitat Yang W, Lu J, Weng J, Jia W, Ji L et al (2010) Prevalence of diabetes among men and women in China. N Engl J Med 362:1090–1101PubMedCrossRef Yang W, Lu J, Weng J, Jia W, Ji L et al (2010) Prevalence of diabetes among men and women in China. N Engl J Med 362:1090–1101PubMedCrossRef
4.
Zurück zum Zitat Adams PC (2012) Diabetes: serum ferritin levels and T2DM–are body iron stores elevated? Nat Rev Endocrinol 8:573–575PubMedCrossRef Adams PC (2012) Diabetes: serum ferritin levels and T2DM–are body iron stores elevated? Nat Rev Endocrinol 8:573–575PubMedCrossRef
5.
Zurück zum Zitat Dekker LH, Nicolaou M, van der AD, Busschers WB, Brewster LM et al (2013) Sex differences in the association between serum ferritin and fasting glucose in type 2 diabetes among South Asian Surinamese, African Surinamese, and ethnic Dutch: the population-based SUNSET study. Diabetes Care 36:965–971PubMedCentralPubMedCrossRef Dekker LH, Nicolaou M, van der AD, Busschers WB, Brewster LM et al (2013) Sex differences in the association between serum ferritin and fasting glucose in type 2 diabetes among South Asian Surinamese, African Surinamese, and ethnic Dutch: the population-based SUNSET study. Diabetes Care 36:965–971PubMedCentralPubMedCrossRef
6.
Zurück zum Zitat Jung CH, Lee MJ, Hwang JY, Jang JE, Leem J et al (2013) Elevated serum ferritin level is associated with the incident type 2 diabetes in healthy Korean men: a 4 year longitudinal study. PLoS One 8:e75250PubMedCentralPubMedCrossRef Jung CH, Lee MJ, Hwang JY, Jang JE, Leem J et al (2013) Elevated serum ferritin level is associated with the incident type 2 diabetes in healthy Korean men: a 4 year longitudinal study. PLoS One 8:e75250PubMedCentralPubMedCrossRef
7.
Zurück zum Zitat Sun L, Zong G, Pan A, Ye X, Li H et al (2013) Elevated plasma ferritin is associated with increased incidence of type 2 diabetes in middle-aged and elderly Chinese adults. J Nutr 143:1459–1465PubMedCrossRef Sun L, Zong G, Pan A, Ye X, Li H et al (2013) Elevated plasma ferritin is associated with increased incidence of type 2 diabetes in middle-aged and elderly Chinese adults. J Nutr 143:1459–1465PubMedCrossRef
8.
Zurück zum Zitat Pham NM, Nanri A, Yi S, Kurotani K, Akter S et al (2013) Serum ferritin is associated with markers of insulin resistance in Japanese men but not in women. Metabolism 62:561–567PubMedCrossRef Pham NM, Nanri A, Yi S, Kurotani K, Akter S et al (2013) Serum ferritin is associated with markers of insulin resistance in Japanese men but not in women. Metabolism 62:561–567PubMedCrossRef
9.
Zurück zum Zitat Li J, Wang R, Luo D, Li S, Xiao C (2013) Association between serum ferritin levels and risk of the metabolic syndrome in Chinese adults: a population study. PLoS One 8:e74168PubMedCentralPubMedCrossRef Li J, Wang R, Luo D, Li S, Xiao C (2013) Association between serum ferritin levels and risk of the metabolic syndrome in Chinese adults: a population study. PLoS One 8:e74168PubMedCentralPubMedCrossRef
10.
Zurück zum Zitat Park SK, Ryoo JH, Kim MG, Shin JY (2012) Association of serum ferritin and the development of metabolic syndrome in middle-aged Korean men: a 5-year follow-up study. Diabetes Care 35:2521–2526PubMedCentralPubMedCrossRef Park SK, Ryoo JH, Kim MG, Shin JY (2012) Association of serum ferritin and the development of metabolic syndrome in middle-aged Korean men: a 5-year follow-up study. Diabetes Care 35:2521–2526PubMedCentralPubMedCrossRef
11.
Zurück zum Zitat Kim MK, Baek KH, Song KH, Kang MI, Choi JH et al (2012) Increased serum ferritin predicts the development of hypertension among middle-aged men. Am J Hypertens 25:492–497PubMedCrossRef Kim MK, Baek KH, Song KH, Kang MI, Choi JH et al (2012) Increased serum ferritin predicts the development of hypertension among middle-aged men. Am J Hypertens 25:492–497PubMedCrossRef
12.
Zurück zum Zitat Bao W, Rong Y, Rong S, Liu L (2012) Dietary iron intake, body iron stores, and the risk of type 2 diabetes: a systematic review and meta-analysis. BMC Med 10:119PubMedCentralPubMedCrossRef Bao W, Rong Y, Rong S, Liu L (2012) Dietary iron intake, body iron stores, and the risk of type 2 diabetes: a systematic review and meta-analysis. BMC Med 10:119PubMedCentralPubMedCrossRef
13.
Zurück zum Zitat Bd Benoist, Mclean E, Egli I, Cogswell M (eds) (2008) Worldwide prevalence of anaemia 1993–2005. World Health Organization, Geneva Bd Benoist, Mclean E, Egli I, Cogswell M (eds) (2008) Worldwide prevalence of anaemia 1993–2005. World Health Organization, Geneva
15.
Zurück zum Zitat Popkin BM, Du S, Zhai F, Zhang B (2010) Cohort Profile: the China Health and Nutrition Survey–monitoring and understanding socio-economic and health change in China, 1989-2011. Int J Epidemiol 39:1435–1440PubMedCentralPubMedCrossRef Popkin BM, Du S, Zhai F, Zhang B (2010) Cohort Profile: the China Health and Nutrition Survey–monitoring and understanding socio-economic and health change in China, 1989-2011. Int J Epidemiol 39:1435–1440PubMedCentralPubMedCrossRef
16.
Zurück zum Zitat Sun X, Du T, Huo R, Xu L (2014) Hemoglobin A1c as a marker for identifying diabetes and cardiovascular risk factors: the China Health and Nutrition Survey 2009. Acta Diabetol 51:353–360PubMedCrossRef Sun X, Du T, Huo R, Xu L (2014) Hemoglobin A1c as a marker for identifying diabetes and cardiovascular risk factors: the China Health and Nutrition Survey 2009. Acta Diabetol 51:353–360PubMedCrossRef
17.
Zurück zum Zitat Forouhi NG, Harding AH, Allison M, Sandhu MS, Welch A et al (2007) Elevated serum ferritin levels predict new-onset type 2 diabetes: results from the EPIC-Norfolk prospective study. Diabetologia 50:949–956PubMedCrossRef Forouhi NG, Harding AH, Allison M, Sandhu MS, Welch A et al (2007) Elevated serum ferritin levels predict new-onset type 2 diabetes: results from the EPIC-Norfolk prospective study. Diabetologia 50:949–956PubMedCrossRef
18.
Zurück zum Zitat Kunutsor SK, Apekey TA, Walley J, Kain K (2013) Ferritin levels and risk of type 2 diabetes mellitus: an updated systematic review and meta-analysis of prospective evidence. Diabetes Metab Res Rev 29:308–318PubMedCrossRef Kunutsor SK, Apekey TA, Walley J, Kain K (2013) Ferritin levels and risk of type 2 diabetes mellitus: an updated systematic review and meta-analysis of prospective evidence. Diabetes Metab Res Rev 29:308–318PubMedCrossRef
19.
Zurück zum Zitat Wrede CE, Buettner R, Bollheimer LC, Scholmerich J, Palitzsch KD et al (2006) Association between serum ferritin and the insulin resistance syndrome in a representative population. Eur J Endocrinol 154:333–340PubMedCrossRef Wrede CE, Buettner R, Bollheimer LC, Scholmerich J, Palitzsch KD et al (2006) Association between serum ferritin and the insulin resistance syndrome in a representative population. Eur J Endocrinol 154:333–340PubMedCrossRef
20.
Zurück zum Zitat Jehn ML, Guallar E, Clark JM, Couper D, Duncan BB et al (2007) A prospective study of plasma ferritin level and incident diabetes: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Epidemiol 165:1047–1054PubMedCrossRef Jehn ML, Guallar E, Clark JM, Couper D, Duncan BB et al (2007) A prospective study of plasma ferritin level and incident diabetes: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Epidemiol 165:1047–1054PubMedCrossRef
21.
Zurück zum Zitat Fumeron F, Pean F, Driss F, Balkau B, Tichet J et al (2006) Ferritin and transferrin are both predictive of the onset of hyperglycemia in men and women over 3 years: the data from an epidemiological study on the Insulin Resistance Syndrome (DESIR) study. Diabetes Care 29:2090–2094PubMedCrossRef Fumeron F, Pean F, Driss F, Balkau B, Tichet J et al (2006) Ferritin and transferrin are both predictive of the onset of hyperglycemia in men and women over 3 years: the data from an epidemiological study on the Insulin Resistance Syndrome (DESIR) study. Diabetes Care 29:2090–2094PubMedCrossRef
22.
Zurück zum Zitat Gonzalez AS, Guerrero DB, Soto MB, Diaz SP, Martinez-Olmos M et al (2006) Metabolic syndrome, insulin resistance and the inflammation markers C-reactive protein and ferritin. Eur J Clin Nutr 60:802–809PubMedCrossRef Gonzalez AS, Guerrero DB, Soto MB, Diaz SP, Martinez-Olmos M et al (2006) Metabolic syndrome, insulin resistance and the inflammation markers C-reactive protein and ferritin. Eur J Clin Nutr 60:802–809PubMedCrossRef
23.
Zurück zum Zitat Sun L, Franco OH, Hu FB, Cai L, Yu Z et al (2008) Ferritin concentrations, metabolic syndrome, and type 2 diabetes in middle-aged and elderly Chinese. J Clin Endocrinol Metab 93:4690–4696PubMedCrossRef Sun L, Franco OH, Hu FB, Cai L, Yu Z et al (2008) Ferritin concentrations, metabolic syndrome, and type 2 diabetes in middle-aged and elderly Chinese. J Clin Endocrinol Metab 93:4690–4696PubMedCrossRef
24.
Zurück zum Zitat Chen T, Ren Y, Liu Y, Long Y, Zhang X et al (2010) Serum gamma-glutamyl transferase, ferritin and the risk of type 2 diabetes in women from a Chinese minority. Diabetes Res Clin Pract 90:352–357PubMedCrossRef Chen T, Ren Y, Liu Y, Long Y, Zhang X et al (2010) Serum gamma-glutamyl transferase, ferritin and the risk of type 2 diabetes in women from a Chinese minority. Diabetes Res Clin Pract 90:352–357PubMedCrossRef
25.
Zurück zum Zitat Guo X, Zhou D, An P, Wu Q, Wang H et al (2013) Associations between serum hepcidin, ferritin and Hb concentrations and type 2 diabetes risks in a Han Chinese population. Br J Nutr 110:2180–2185PubMedCrossRef Guo X, Zhou D, An P, Wu Q, Wang H et al (2013) Associations between serum hepcidin, ferritin and Hb concentrations and type 2 diabetes risks in a Han Chinese population. Br J Nutr 110:2180–2185PubMedCrossRef
26.
Zurück zum Zitat Batchuluun B, Matsumata T, Erdenebileg N, Tsagaantsooj G, Boldbaatar K et al (2014) Serum ferritin level is higher in poorly controlled patients with Type 2 diabetes and people without diabetes, aged over 55 years. Diabet Med 31:419–424 Batchuluun B, Matsumata T, Erdenebileg N, Tsagaantsooj G, Boldbaatar K et al (2014) Serum ferritin level is higher in poorly controlled patients with Type 2 diabetes and people without diabetes, aged over 55 years. Diabet Med 31:419–424
27.
Zurück zum Zitat Kim CH, Kim HK, Bae SJ, Park JY, Lee KU (2011) Association of elevated serum ferritin concentration with insulin resistance and impaired glucose metabolism in Korean men and women. Metabolism 60:414–420PubMedCrossRef Kim CH, Kim HK, Bae SJ, Park JY, Lee KU (2011) Association of elevated serum ferritin concentration with insulin resistance and impaired glucose metabolism in Korean men and women. Metabolism 60:414–420PubMedCrossRef
28.
Zurück zum Zitat Yu FJ, Huang MC, Chang WT, Chung HF, Wu CY et al (2012) Increased ferritin concentrations correlate with insulin resistance in female type 2 diabetic patients. Ann Nutr Metab 61:32–40PubMedCrossRef Yu FJ, Huang MC, Chang WT, Chung HF, Wu CY et al (2012) Increased ferritin concentrations correlate with insulin resistance in female type 2 diabetic patients. Ann Nutr Metab 61:32–40PubMedCrossRef
29.
Zurück zum Zitat Deray G, Heurtier A, Grimaldi A, Launay Vacher V, Isnard Bagnis C (2004) Anemia and diabetes. Am J Nephrol 24:522–526PubMedCrossRef Deray G, Heurtier A, Grimaldi A, Launay Vacher V, Isnard Bagnis C (2004) Anemia and diabetes. Am J Nephrol 24:522–526PubMedCrossRef
30.
Zurück zum Zitat Thomas MC, MacIsaac RJ, Tsalamandris C, Power D, Jerums G (2003) Unrecognized anemia in patients with diabetes: a cross-sectional survey. Diabetes Care 26:1164–1169PubMedCrossRef Thomas MC, MacIsaac RJ, Tsalamandris C, Power D, Jerums G (2003) Unrecognized anemia in patients with diabetes: a cross-sectional survey. Diabetes Care 26:1164–1169PubMedCrossRef
31.
Zurück zum Zitat Emerit J, Beaumont C, Trivin F (2001) Iron metabolism, free radicals, and oxidative injury. Biomed Pharmacother 55:333–339PubMedCrossRef Emerit J, Beaumont C, Trivin F (2001) Iron metabolism, free radicals, and oxidative injury. Biomed Pharmacother 55:333–339PubMedCrossRef
32.
Zurück zum Zitat Wolff SP (1993) Diabetes mellitus and free radicals. Free radicals, transition metals and oxidative stress in the aetiology of diabetes mellitus and complications. Br Med Bull 49:642–652PubMed Wolff SP (1993) Diabetes mellitus and free radicals. Free radicals, transition metals and oxidative stress in the aetiology of diabetes mellitus and complications. Br Med Bull 49:642–652PubMed
33.
Zurück zum Zitat Messner DJ, Rhieu BH, Kowdley KV (2013) Iron overload causes oxidative stress and impaired insulin signaling in AML-12 hepatocytes. Dig Dis Sci 58:1899–1908PubMedCentralPubMedCrossRef Messner DJ, Rhieu BH, Kowdley KV (2013) Iron overload causes oxidative stress and impaired insulin signaling in AML-12 hepatocytes. Dig Dis Sci 58:1899–1908PubMedCentralPubMedCrossRef
Metadaten
Titel
Serum ferritin, diabetes, diabetes control, and insulin resistance
verfasst von
Yiqiang Zhan
Zheng Tang
Jinming Yu
Publikationsdatum
01.12.2014
Verlag
Springer Milan
Erschienen in
Acta Diabetologica / Ausgabe 6/2014
Print ISSN: 0940-5429
Elektronische ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-014-0656-1

Weitere Artikel der Ausgabe 6/2014

Acta Diabetologica 6/2014 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.