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Published online April 6, 2007
Diabetes Care 30:1795-1801, 2007
DOI: 10.2337/dc06-2312
© 2007 by the American Diabetes Association
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Pathophysiology/Complications
Original Article

Ferritin and Transferrin Are Associated With Metabolic Syndrome Abnormalities and Their Change Over Time in a General Population

Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR)

Istvan S. Vari, BSC1,2,3, Beverley Balkau, PHD1,2, Adrian Kettaneh, MD1,2, Philippe André, MD1,2, Jean Tichet, MD4, Frédéric Fumeron, PHD5, Emile Caces, PHARMD4, Michel Marre, MD, PHD5,6, Bernard Grandchamp, MD, PHD7,8, Pierre Ducimetière, PHD1,2 for the DESIR Study Group

1 Institut National de la Santé et de la Recherche Médicale, Unité 780-IFR69, Epidemiological and Biostatistical Research, Villejuif, France
2 Université Paris Sud, Villejuif, France
3 Ecoles des Hautes Etudes en Sciences Sociales, Paris, France
4 Institut inter-Régionale pour la Santé, La Riche, France
5 Institut National de la Santé et de la Recherche Médicale Unité 695, Genetic Determinants for Type 2 Diabetes and Its Vascular Complications, Université Paris 7, Xavier Bichat Medical School, Paris, France
6 Department of Endocrinology, Diabetology, Nutrition and Metabolic Diseases, Xavier Bichat Hospital, Paris, France
7 Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 773, Denis Diderot Medical School, Université Paris 7, Paris, France
8 Service de Biochimie Hormonale et Génétique, Assistance Publique-Hopitaux de Paris, Xavier Bichat Hospital, Paris, France

Address correspondence and reprint requests to Beverley Balkau, INSERM U780, Villejuif 94807, France. E-mail: balkau{at}vjf.inserm.fr

OBJECTIVE—The aim of this work was to study cross-sectional and longitudinal relations between iron stocks (ferritin) and the iron transport protein (transferrin) with the metabolic syndrome and its abnormalities.

RESEARCH DESIGN AND METHODS—A total of 469 men and 278 premenopausal and 197 postmenopausal women from the French Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR) cohort, aged 30–65 years, were followed over 6 years.

RESULTS—Higher concentrations of both ferritin and transferrin were associated with the International Diabetes Federation (IDF) and the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults Adult Treatment Panel III original and revised definitions of the metabolic syndrome at baseline: for the IDF definition of the metabolic syndrome, the standardized, age-adjusted odds ratios (95% CI) for log(ferritin) were 1.49 (1.14–1.94) for men, 2.10 (1.27–3.48) for premenopausal women, and 1.80 (1.21–2.68) for postmenopausal women; for transferrin they were, respectively, 1.94 (1.53–2.47), 2.22 (1.32–3.75), and 2.14 (1.47–3.10). After 6 years of follow-up, the change in the presence of the metabolic syndrome was associated with higher baseline values in all three groups: log(ferritin), 1.46 (1.13–1.89), 1.28 (0.85–1.94), and 1.62 (1.10–2.38); and transferrin, 1.41 (1.10–1.81), 1.63 (1.05–2.52), and 1.51 (1.02–2.22). Among syndrome components, hypertriglyceridemia at 6 years was the component most strongly associated with baseline ferritin and transferrin. The odds of an incident IDF-defined metabolic syndrome after 6 years was more than fourfold higher when ferritin and transferrin values were both above the group-specific top tertile, in comparison with participants with both parameters below these thresholds.

CONCLUSIONS—This is the first prospective study associating ferritin and transferrin with the metabolic syndrome and its components. When both markers of the iron metabolism are elevated, the incidence of the metabolic syndrome is increased in men and both pre- and postmenopausal women.

Abbreviations: ALT, alanine aminotransferase • CRP, C-reactive protein • DESIR, Data from an Epidemiological Study on the Insulin Resistance Syndrome • GGT, {gamma}-glutamyl transferase • HOMA, homeostasis model assessment • HOMA-%ß, homeostasis model assessment of ß-cell function • HOMA-IR, homeostasis model assessment of insulin resistance • IDF, International Diabetes Federation • NCEP-ATP III, National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults Adult Treatment Panel III


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