Iron metabolism is prospectively associated with insulin resistance and glucose intolerance over a 7-year follow-up period: the CODAM study

Wlazlo, Nick, van Greevenbroek, Marleen M. J., Ferreira, Isabel, Jansen, Eugene H. J. M., Feskens, Edith J. M., van der Kallen, Carla J. H., Schalkwijk, Casper G., Bravenboer, Bert and Stehouwer, Coen D. A. (2015) Iron metabolism is prospectively associated with insulin resistance and glucose intolerance over a 7-year follow-up period: the CODAM study. Acta Diabetologica, 52 2: 337-348. doi:10.1007/s00592-014-0646-3


Author Wlazlo, Nick
van Greevenbroek, Marleen M. J.
Ferreira, Isabel
Jansen, Eugene H. J. M.
Feskens, Edith J. M.
van der Kallen, Carla J. H.
Schalkwijk, Casper G.
Bravenboer, Bert
Stehouwer, Coen D. A.
Title Iron metabolism is prospectively associated with insulin resistance and glucose intolerance over a 7-year follow-up period: the CODAM study
Journal name Acta Diabetologica   Check publisher's open access policy
ISSN 1432-5233
0940-5429
Publication date 2015-04-01
Year available 2015
Sub-type Article (original research)
DOI 10.1007/s00592-014-0646-3
Open Access Status Not yet assessed
Volume 52
Issue 2
Start page 337
End page 348
Total pages 12
Place of publication Milan, Italy
Publisher Springer-Verlag Italia Srl
Language eng
Formatted abstract
Objectives
Several markers of iron metabolism have been associated with insulin resistance (IR) and type 2 diabetes mellitus in cross-sectional studies. However, prospective data on these associations are scarce, and it is currently unclear in which tissues iron metabolism may contribute to IR. Therefore, we investigated whether markers of iron metabolism were associated with IR in muscle, liver, and adipocytes, and with glucose intolerance over a 7-year follow-up period.

Design and methods
Serum ferritin, transferrin, total iron, non-transferrin-bound iron, and transferrin saturation were determined at baseline of a prospective cohort study in 509 individuals (60 % men, age 59 ± 6.9 years, body mass index 28.5 ± 4.3). Both at baseline and after a 7-year follow-up (n = 386), measures of glucose, insulin (during glucose tolerance tests), and non-esterified fatty acids were obtained. Using generalized estimating equations, we investigated associations between baseline iron markers and indices of muscle, liver, and adipocyte insulin resistance (adipocyte IR), as well as glucose intolerance, over the 7-year period.
Results
Over a 7-year period, baseline serum ferritin (per 10 μg/L increase) was positively associated with homeostasis model assessment insulin resistance (HOMA2-IR) [β = 0.77 % (95 % CI 0.50–1.03)], hepatic insulin resistance (hepatic IR) [β = 0.39 % (0.23–0.55)], adipocyte IR [β = 1.00 % (0.65–1.35)], and AUCglucose [β = 0.32 % (0.18–0.46)] after adjustment for several covariates, including inflammatory markers (all p < 0.001). Similarly, serum transferrin (per 0.1 g/L) was associated with HOMA2-IR [β = 2.66 % (1.55–3.78)], hepatic IR [β = 1.16 % (0.47–1.85)], adipocyte IR [β = 3.75 % (2.27–5.25)], and AUCglucose [β = 1.35 % (0.74–1.96)] over 7 years.

Conclusions
Iron metabolism and related factors may contribute to IR in muscle, liver, and adipocytes, eventually leading to impaired glucose metabolism and hyperglycaemia.
Keyword Ferritin
Transferrin
Iron
HOMA2-IR
Fatty acids
Liver
Adipocytes
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Public Health Publications
 
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Created: Wed, 20 May 2015, 22:44:29 EST by Mr Mathew Carter on behalf of School of Public Health