Journal
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
Volume 93, Issue 12, Pages 4690-4696Publisher
ENDOCRINE SOC
DOI: 10.1210/jc.2008-1159
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Funding
- Chief Scientist Program of Shanghai Institutes for Biological Sciences
- Chinese Academy of Sciences [SIBS2008006]
- Ministry of Science and Technology of China [2006CB503902, 2008DFA3196]
- Knowledge Innovation Program Project of the Chinese Academy of Sciences [KSCX2-YW-R-73, KSCX2-YW-R-116, KSCX1-YW-02]
- National Natural Science Foundation of China [30571562]
- ShanghaiUnilever Research Development Fund [CH-2006-0941]
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Context: Elevated ferritin concentrations frequently cluster with well-established risk factors of diabetes including obesity, metabolic syndrome, chronic inflammation, and altered circulating adipokines. Few studies, however, have systematically evaluated the effect of these risk factors on ferritin-diabetes association, particularly in Chinese populations. Objective: We aimed to investigate, in a middle-aged and elderly Chinese population, whether elevated ferritin concentrations are associated with higher risk of metabolic syndrome and type 2 diabetes and to what extent the associations were influenced by obesity, inflammation, and adipokines. Design and Methods: We conducted a population-based, cross-sectional survey of 3289 participants aged 50-70 yr in Beijing and Shanghai in 2005. Fasting plasma ferritin, glucose, insulin, lipid profile, glycohemoglobin, inflammatory markers, adipokines, and dietary profile were measured. Results: Median ferritin concentrations were 155.7 ng/ml for men and 111.9 ng/ml for women. After multiple adjustment, the odds ratios (ORs) were substantially higher for type 2 diabetes (OR 3.26, 95% confidence interval 2.36-4.51) and metabolic syndrome [OR 2.80 (95% confidence interval 2.24-3.49)] in the highest ferritin quartile compared with those in the lowest quartile. These associations remained significant after further adjustment for dietary factors, body mass index, inflammatory markers, and adipokines. Conclusions: Elevated circulating ferritin concentrations were associated with higher risk of type 2 diabetes and metabolic syndrome in middle-aged and elderly Chinese independent of obesity, inflammation, adipokines, and other risk factors. Our data support the crucial role of iron overload for metabolic diseases, even in a country with relatively high prevalence of iron deficiency. (J Clin Endocrinol Metab 93: 4690-4696, 2008)
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