期刊
AMERICAN JOURNAL OF EPIDEMIOLOGY
卷 165, 期 9, 页码 1047-1054出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwk093
关键词
cohort studies; diabetes mellitus; type 2; ferritins; incidence; iron
资金
- NHLBI NIH HHS [N01-HC-55018, N01-HC-55016, N01-HC-55019, N01-HC-55020, N01-HC-55021, N01-HC-55022, N01-HC-55015] Funding Source: Medline
The authors performed a case-cohort study nested within the Atherosclerosis Risk in Communities (ARIC) Study to determine the association between plasma ferritin level and risk of type 2 diabetes mellitus. Persons with incident cases of type 2 diabetes diagnosed over an average follow-up period of 7.9 years (n = 599) were compared with a random sample of the cohort (n = 690). After adjustment for age, gender, menopausal status, ethnicity, center, smoking, and alcohol intake, the hazard ratio for diabetes, comparing the fifth quintile of ferritin with the first quintile, was 1.74 (95% confidence interval: 1.14, 2.65; p-trend < 0.001). After further adjustment for body mass index and components of the metabolic syndrome, the hazard ratio was 0.81 (95% confidence interval: 0.49, 1.34; p-trend 0.87). From a causal perspective, there are two alternative interpretations of these findings. Elevated iron stores, reflected in elevated plasma ferritin levels, may induce baseline metabolic abnormalities that ultimately result in diabetes. Alternatively, elevated ferritin may be just one of several metabolic abnormalities related to the underlying process that ultimately results in diabetes, rather than a causal factor for diabetes. Longitudinal studies with repeated measurements of glucose and iron metabolism parameters are needed to establish the role of iron stores and plasma ferritin in diabetes development.
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