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Ferritin and Percent Transferrin Saturation Levels Predict Type 2 Diabetes Risk and Cardiovascular Disease Outcomes.

Leo R Zacharski1, Galina Shamayeva2, Bruce K Chow2

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Current Diabetes Reviews
|May 6, 2017
PubMed
Summary

New research suggests modified normal ranges for ferritin and percent transferrin saturation (%TS) may better identify type 2 diabetes (T2D) and cardiovascular disease (CVD) risk. These iron biomarkers could help assess and potentially lower T2D and CVD risk.

Keywords:
Ironcardiovasculardiabetesferritinnormal valuestransferrin

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Area of Science:

  • Biochemistry
  • Clinical Medicine
  • Hematology

Background:

  • Type 2 diabetes (T2D) and cardiovascular disease (CVD) risk are associated with ferritin and percent transferrin saturation (%TS) levels.
  • Increased T2D and CVD risk have been observed even at ferritin and %TS levels considered within the typical "normal range".

Purpose of the Study:

  • To define normative ranges for ferritin and %TS that are specifically associated with T2D and CVD risk.
  • To investigate the relationship between iron biomarkers and physiological markers in a clinical trial setting.

Main Methods:

  • Analysis of six-monthly ferritin, %TS, and hemoglobin levels from 1,277 participants in an iron reduction clinical trial.
  • Participants had existing CVD, with 37% also having diabetes.
  • Loess Locally Weighted Smoothing plots were used for pair-wise analysis to model continuous relationships between iron biomarkers, hemoglobin, and risk factors.

Main Results:

  • Increasing ferritin (up to ~80 ng/mL) and %TS (up to ~25%) correlated with higher hemoglobin and minimal T2D/CVD risk.
  • Diabetic participants showed lower hemoglobin levels compared to non-diabetics.
  • Ferritin levels up to ~100 ng/mL with %TS up to ~55% were associated with further risk limitation, while ferritin >100 ng/mL coincided with increased T2D/CVD risk.

Conclusions:

  • Modified normal ranges for ferritin (approx. 15-100 ng/mL) and %TS (approx. 15-55%) may enhance the utility of iron biomarkers.
  • These adjusted ranges could improve the assessment of T2D and CVD risk.
  • Potential exists to utilize these refined biomarker ranges for risk mitigation strategies.