title: Body iron stores and risk of type 2 diabetes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study.
abstract: OBJECTIVE
  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
  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.
authors: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.
authors: J
authors: J
authors: Montonen
authors: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.
authors: H
authors: H
authors: Boeing
authors: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany. annika.steffen@dife.de.
authors: A
authors: A
authors: Steffen
authors: Central Laboratory/Clinical Chemistry and Pathobiochemistry, University Hospital Tübingen, Tübingen, Germany.|Paul Langerhans Institute Tübingen (Inst. for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen), Tübingen, Germany.
authors: R
authors: R
authors: Lehmann
authors: Paul Langerhans Institute Tübingen (Inst. for Diabetes Research and Metabolic Diseases of the Helmholtz Centre Munich at the University of Tübingen), Tübingen, Germany.|Department of Internal Medicine IV, University of Tübingen, Tübingen, Germany.
authors: A
authors: A
authors: Fritsche
authors: Department of Pharmacology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
authors: H-G
authors: HG
authors: Joost
authors: Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
authors: M B
authors: MB
authors: Schulze
authors: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany.|Molecular Epidemiology Group, Max Delbrück Center for Molecular Medicine (MDC), Berlin-Buch, Germany.
authors: T
authors: T
authors: Pischon
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000378:metabolism*; D005060:Europe; D005260:Female; D005293:Ferritins / Q000097:blood; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007501:Iron / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011990:Receptors, Transferrin / Q000097:blood; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D011990:Receptors, Transferrin; D005293:Ferritins; D007501:Iron