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Association between Iron Status and Incident Type 2 Diabetes: A Population-Based Cohort Study.

Andrés Díaz-López1,2,3, Lucía Iglesias-Vázquez1,2,4, Meritxell Pallejà-Millán5

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Higher serum ferritin (SF), an iron status marker, is linked to increased type 2 diabetes risk. Monitoring iron stores may aid in diabetes diagnosis and management.

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Area of Science:

  • Endocrinology
  • Public Health
  • Nutritional Science

Background:

  • Type 2 diabetes is a significant global health concern.
  • Iron status, indicated by serum ferritin (SF), is being investigated for its role in metabolic health.
  • Previous research suggests potential links between iron overload and insulin resistance.

Purpose of the Study:

  • To investigate the association between baseline serum ferritin (SF) levels and the incidence of type 2 diabetes.
  • To assess SF as an independent predictor of new-onset type 2 diabetes in a large primary healthcare cohort.
  • To inform clinical practice regarding iron status monitoring for diabetes prevention and management.

Main Methods:

  • A large cohort study of 206,115 primary healthcare patients aged 35-75 without diabetes in Catalonia.
  • Baseline measurements included sociodemographics, anthropometry, lifestyle, morbidity, and iron status (SF, serum iron, hemoglobin).
  • Incident type 2 diabetes was tracked from 2006-2016 using ICD-10 codes; Cox proportional-hazards models were employed for analysis.

Main Results:

  • Over 8.4 years median follow-up, 12,371 new type 2 diabetes cases were diagnosed.
  • Higher baseline SF concentrations were observed in individuals who developed type 2 diabetes (107.0 µg/L vs. 60.3 µg/L).
  • Multivariable-adjusted HRs showed a significant, dose-dependent increase in type 2 diabetes risk with higher SF quartiles (HR=1.51 for highest quartile).

Conclusions:

  • Elevated baseline serum ferritin is an independent predictor of increased risk for new-onset type 2 diabetes.
  • These findings highlight the clinical relevance of monitoring iron stores in primary care.
  • Optimizing iron status assessment may improve the diagnosis and management strategies for type 2 diabetes.