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Diabetologia
Published in: Diabetologia 10/2012

Open Access 01-10-2012 | Article

Body iron stores and risk of type 2 diabetes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study

Authors: J. Montonen, H. Boeing, A. Steffen, R. Lehmann, A. Fritsche, H.-G. Joost, M. B. Schulze, T. Pischon

Published in: Diabetologia | Issue 10/2012

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Abstract

Aims/hypothesis

The aim of this study was to prospectively examine the association between body iron stores and risk of type 2 diabetes.

Methods

We designed a case–cohort study among 27,548 individuals within the population-based European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study. During 7 years of follow-up, 849 incident cases of type 2 diabetes were identified. Of these, 607 remained for analyses after exclusion of participants with missing data or abnormal glucose levels at baseline. A sub-cohort of 2,500 individuals was randomly selected from the full cohort, comprising 1,969 individuals after applying the same exclusion criteria.

Results

After adjustment for age, sex, BMI, waist circumference, sports activity, bicycling, education, occupational activity, smoking habit, alcohol consumption and circulating levels of γ-glutamyltransferase, alanine aminotransferase, fetuin-A, high-sensitivity C-reactive protein, adiponectin, HDL-cholesterol and triacylglycerol, higher serum ferritin concentrations were associated with a higher risk of type 2 diabetes (RR in the highest vs lowest quintile, 1.73; 95% CI 1.15, 2.61; p trend = 0.002). No significant association was observed for soluble transferrin receptor (RR 1.33; 95% CI 0.85, 2.09; p trend = 0.50). The soluble transferrin receptor-to-ferritin ratio was significantly inversely related to risk (RR 0.61; 95% CI 0.41, 0.91; p trend = 0.02).

Conclusions/interpretation

High ferritin levels are associated with higher risk of type 2 diabetes independently of established diabetes risk factors and a range of diabetes biomarkers whereas soluble transferrin receptor concentrations are not related to risk. These results support the hypothesis that higher iron stores below the level of haemochromatosis are associated with risk of type 2 diabetes.
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Metadata
Title
Body iron stores and risk of type 2 diabetes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study
Authors
J. Montonen
H. Boeing
A. Steffen
R. Lehmann
A. Fritsche
H.-G. Joost
M. B. Schulze
T. Pischon
Publication date
01-10-2012
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 10/2012
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-012-2633-y

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