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DOI: 10.2337/dc05-2471
© 2006 by the American Diabetes Association
Cardiovascular and Metabolic Risk |
Common Presence of Non–Transferrin-Bound Iron Among Patients With Type 2 Diabetes
1 Department of Preventive Medicine and Health Promotion Research Center, School of Medicine, Kyungpook National University, Daegu, Korea
2 Department of Pharmacy, King’s College London, London, U.K
3 Department of Epidemiology, School of Public Health, University of Minnesota, Minnesota
4 Department of Nutrition, University of Oslo, Oslo, Norway
5 Division of Cancer Control and Epidemiology, National Cancer Center, Ilsan, Korea
6 Department of Clinical Pathology, School of Medicine, Kyungpook National University, Daegu, Korea
7 Department of Endocrinology, School of Medicine, Kyungpook National University, Daegu, Korea
Address correspondence and reprint requests to Duk-Hee Lee, MD, Department of Preventive Medicine, School of Medicine, Kyungpook University, 101 Dongin-dong, Jung-gu, Daegu, Korea 700-422. E-mail: lee_dh{at}knu.ac.kr
OBJECTIVE—Recently, we reported increased cardiovascular disease mortality among supplemental vitamin C users with type 2 diabetes in a prospective cohort study. Because vitamin C may cause oxidative stress in the presence of redox active iron, we hypothesized that non–transferrin-bound iron (NTBI), a form of iron susceptible to redox activity, may be present in patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS—We measured serum NTBI levels using high-performance liquid chromatography in 48 patients with known diabetes (at least 5 years duration since diagnosis), 49 patients with newly diagnosed diabetes, and 47 healthy control subjects (frequency matched on age and sex).
RESULTS—NTBI was commonly present in diabetes: 59% in newly diagnosed diabetes and 92% in advanced diabetes. Mean NTBI values varied significantly between the three groups, with the highest values being observed in patients with known diabetes and the lowest in the control subjects (0.62 ± 0.43 vs. 0.24 ± 0.29 vs. 0.04 ± 0.13 µmol/l Fe). Serum total iron or percent transferrin saturation were very similar among the three groups, yet NTBI was strongly associated with serum total iron (r = 0.74, P < 0.01) and percent transferrin saturation (r = 0.70, P < 0.01) among the patients with known diabetes.
CONCLUSIONS—Consistent with our hypothesis, these data demonstrate the common existence of NTBI in type 2 diabetic patients with a strong gradient with severity. Prospective cohort studies are required to clarify the clinical relevance of increased NTBI levels.
Abbreviations: ALT, alanine aminotransferase • AST, aspartate aminotransferase • CRP, C-reactive protein • CVD, cardiovascular disease • GGT, 
-glutamyl transferase • HPLC, high-performance liquid chromatography • NTBI, non–transferrin-bound iron
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