Serum Transferrin Predicts New-Onset Type 2 Diabetes in Koreans: A 4-Year Retrospective Longitudinal Study

Endocrinol Metab (Seoul). 2020 Sep;35(3):610-617. doi: 10.3803/EnM.2020.721. Epub 2020 Sep 22.

Abstract

Background: It is well known that high serum ferritin, a marker of iron storage, predicts incident type 2 diabetes. Limited information is available on the association between transferrin, another marker of iron metabolism, and type 2 diabetes. Thus, we investigated the association between transferrin and incident type 2 diabetes.

Methods: Total 31,717 participants (mean age, 40.4±7.2 years) in a health screening program in 2005 were assessed via cross-sectional analysis. We included 30,699 subjects who underwent medical check-up in 2005 and 2009 and did not have type 2 diabetes at baseline in this retrospective longitudinal analysis.

Results: The serum transferrin level was higher in the type 2 diabetes group than in the non-type 2 diabetes group (58.32±7.74 μmol/L vs. 56.17±7.96 μmol/L, P<0.001). Transferrin correlated with fasting serum glucose and glycosylated hemoglobin in the correlational analysis (r=0.062, P<0.001 and r=0.077, P<0.001, respectively) after full adjustment for covariates. Transferrin was more closely related to homeostasis model assessment of insulin resistance than to homeostasis model assessment of β cell function (r=0.042, P<0.001 and r=-0.019, P=0.004, respectively) after full adjustment. Transferrin predicted incident type 2 diabetes in non-type 2 diabetic subjects in a multivariate linear regression analysis; the odds ratio (95% confidence interval [CI]) of the 3rd tertile compared to that in the 1st tertile of transferrin for incident diabetes was 1.319 (95% CI, 1.082 to 1.607) after full adjustment (P=0.006).

Conclusion: Transferrin is positively associated with incident type 2 diabetes in Koreans.

Keywords: Diabetes mellitus, type 2; Insulin resistance; Transferrin.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Blood Glucose / metabolism*
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / blood*
  • Fasting
  • Female
  • Glycated Hemoglobin / metabolism*
  • Humans
  • Insulin Resistance
  • Linear Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Republic of Korea
  • Retrospective Studies
  • Transferrin / metabolism*

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • Transferrin