Highlights
- •Low iron status was associated with cardiovascular disease risk in patients with type 2 diabetes (T2D) in two studies.
- •The association was evident also in incident cases prospectively followed.
- •The pattern was consistent in populations at different cardiovascular risk.
- •Low iron status seems to be harmful for cardiovascular health in T2D and it may be a target for intervention.
Abstract
Background and aims
The possible contribution of iron to cardiovascular complications of type 2 diabetes
(T2D) has been scarcely investigated. We aimed to study whether serum ferritin is
linked to prevalent/incident cardiovascular disease (CVD) in T2D.
Methods
The prevalence of coronary heart disease (CHD), cerebrovascular disease (CEVD) and
CVD was evaluated in the SIDIAP study (n = 38,617) and prevalence and 7-year incidence
were analysed in the Edinburgh Type 2 Diabetes Study (ET2DS) (n = 821). Logistic and
Cox regressions were used to describe associations between serum ferritin and CVD
adjusting for confounding variables.
Results
Increase of 1 SD unit in log-ferritin was associated with lower CVD prevalence in
fully-adjusted models (ET2DS odds ratio (OR) 95% confidence interval (CI): 0.81 (0.68–0.96),
p = 0.018; SIDIAP study: 0.91 (0.88–0.94), p < 0.001). In ET2DS, ferritin in the highest (vs. the lowest) quintile was associated with lower incidence of CVD (fully adjusted HR
95% CI: 0.46 (0.26–0.83), p = 0.010). This association persisted after removing subjects with CVD at baseline
(n = 536) (HR 95% CI: 0.34 (0.14–0.81), p = 0.016).
Conclusions
Low iron status was associated with CVD risk in T2D. This pattern was consistent in
populations at different cardiovascular risk. Low iron status seems to be harmful
for cardiovascular health in T2D and it may be a target for intervention.
Keywords
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Article Info
Publication History
Published online: March 22, 2018
Accepted:
March 15,
2018
Received in revised form:
February 27,
2018
Received:
December 7,
2017
Identification
Copyright
© 2018 Published by Elsevier B.V.