title: Is an elevated serum transferrin saturation associated with the development of diabetes?
abstract: OBJECTIVE
  Diabetes mellitus is a common comorbid condition of hemochromatosis and is often identified as a complication of untreated hemochromatosis. However, there are few primary data examining the development of diabetes secondary to hemochromatosis. Our objective was to determine the likelihood of developing diabetes in a nationally representative cohort of patients who have an elevated serum transferrin saturation rate but no current diagnosis of diabetes.
  
  
  METHODS
  This is a retrospective cohort study based on merging the National Health and Nutrition Examination Survey I (1971-1974; NHANES I) with the NHANES I Epidemiologic Followup Study (1992).
  
  
  METHODS
  Individuals aged 25 to 74 years at the time of the NHANES I without diabetes (n = 9274).
  
  
  METHODS
  The outcome was development of diabetes according to patient report, proxy report, or death certificate by the time of the follow-up interview.
  
  
  RESULTS
  The incidence of diagnosed diabetes in the cohort was 10.2%. Among individuals with serum transferrin saturation levels above 55%, 7.5% developed diagnosed diabetes compared with 10.2% with a serum transferrin saturation of no more than 45% (P =.38). The relation remained nonsignificant in models adjusted for risk factors of diabetes and in analyses that assumed 10% of patients had received treatment for hemochromatosis.
  
  
  CONCLUSIONS
  In this nationally representative cohort of adults, elevated serum transferrin saturation was not significantly associated with the development of diabetes.
authors.affiliation: Dept of Family Medicine, Medical University of South Carolina, PO Box 250192, 295 Calhoun Street, Charleston, SC 29425, USA. mainouag@musc.edu
authors.forename: Arch G
authors.initials: AG
authors.lastname: Mainous
authors.forename: Dana E
authors.initials: DE
authors.lastname: King
authors.forename: William S
authors.initials: WS
authors.lastname: Pearson
authors.forename: David R
authors.initials: DR
authors.lastname: Garr
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006432:Hemochromatosis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018962:Phlebotomy / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D014168:Transferrin / Q000032:analysis*
chemical_list: D015415:Biomarkers; D014168:Transferrin