Body iron stores and risk of type 2 diabetes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study
Open accessAbstract
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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Iron status, as reflected in circulating ferritin, was shown to be related to the risk of diabetes in EPIC-Potsdam.
“Furthermore, iron status, as reflected in circulating ferritin, was shown to be related to the risk of diabetes in EPIC-Potsdam (13).”
From Amino acids, lipid metabolites, and ferritin as potential mediators linking red meat consumption to type 2 diabetes (2015) · cites this paper as [13]
Elevated iron status as assessed by ferritin was directly related to diabetes risk in EPIC-Potsdam.
“Consistent with other studies (44), elevated iron status as assessed by ferritin was directly related to the risk of diabetes in EPIC-Potsdam (13).”
From Amino acids, lipid metabolites, and ferritin as potential mediators linking red meat consumption to type 2 diabetes (2015) · cites this paper as [13]
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Self-citation
- Authors
- Montonen, J., Boeing, H., Steffen, A., Lehmann, R., Fritsche, A., Joost, H.-G., Schulze, M. B., & Pischon, T.
- Affiliations
- German Institute of Human Nutrition (DE)
- Universitätsklinikum Tübingen (DE)
- University of Tübingen (DE)
- Max Delbrück Center (DE)
- Corresponding author
- Steffen, A.
- Venue
- Diabetologia
- Published
- 2012-07-01
- Volume
- 55
- Issue
- 10
- Pages
- 2613-2621
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- PMC
- PMC3433660
- OpenAlex
- W3028448231
- Cited by
- 124
- References
- 38
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 9 · 2023: 4 · 2022: 9 · 2021: 6 · 2020: 13 · 2019: 8 · 2018: 10 · 2017: 7 · 2016: 13 · 2015: 11 · 2014: 16 · 2013: 12 · 2012: 1
- FWCI
- 8.53
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Diabetologia (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- MDC Repository (Max-Delbrueck-Center for Molecular Medicine) (acceptedVersion)
- Site cant be reached (submittedVersion)
- Funders
- Bundesministerium für Bildung und Forschung (0315381A)
- Topics
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Nursing › Nutrition and Dietetics › Trace Elements in Health
- Keywords
- type 2 diabetes, iron stores, serum ferritin, soluble transferrin receptor, hemochromatosis, iron metabolism, diabetes risk factors, EPIC-Potsdam cohort
- MeSH terms
- Adult, Aged, Diabetes Mellitus, Type 2, Europe, Female, Ferritins, Follow-Up Studies, Germany, Humans, Iron, Male, Middle Aged, Prospective Studies, Receptors, Transferrin, Risk Factors, Cohort Studies, Biomarkers
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