Hyperferritinemia Is a Predictor of Onset of Diabetes in Japanese Males Independently of Decreased Renal Function and Fatty Liver: A Fifteen-Year Follow-Up Study

Yukie Sakuma; Jun Ogino; Rie Iwai; Takashi Inoue; Haruo Takahashi; Yoshifumi Suzuki; Daisuke Kinoshita; Koji Takemura; Hidenori Takahashi; Haruhisa Shimura; Yasunori Sato; Shouji Yoshida; Naotake Hashimoto

doi:10.14740/jocmr4635

Hyperferritinemia Is a Predictor of Onset of Diabetes in Japanese Males Independently of Decreased Renal Function and Fatty Liver: A Fifteen-Year Follow-Up Study

J Clin Med Res. 2021 Dec;13(12):541-548. doi: 10.14740/jocmr4635. Epub 2021 Dec 28.

Authors

Affiliations

¹ Clinical Research Support Center, Asahi General Hospital, Chiba, Japan.
² Department of Diabetes and Metabolic Diseases, Asahi General Hospital, Chiba, Japan.
³ Department of Clinical Laboratory, Asahi General Hospital, Chiba, Japan.
⁴ Preventive Medicine Research Center, Asahi General Hospital, Chiba, Japan.
⁵ Department of Internal Medicine, Asahi General Hospital, Chiba, Japan.
⁶ Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan.

Abstract

Background: Type 2 diabetes is an important health concern worldwide. The disease etiology may depend on multiple environmental and genetic factors that cause insulin resistance, including dysregulation of iron storage. The goal of this study was to examine the relationship of the serum ferritin concentration with onset of diabetes over a long period.

Methods: Correlations of serum ferritin and metabolic markers with onset of diabetes mellitus were examined over 15 years in 150 males participating in a health screening program.

Results: HOMA-β showed a gradual significant decrease in the first 4 years in subjects with ferritin > 190 ng/mL (group H) compared to those with ferritin ≤ 190 ng/mL, but there was no difference in HOMA-R between these groups. A significant number of cases with onset of diabetes was observed over 15 years (hazard ratio (HR): 3.97), and obesity, fasting blood glucose level, hemoglobin A1c (HbA1c), HOMA-R, fasting immunoreactive insulin (IRI) and C-peptide immunoreactivity (CPR) were all significant in univariate comparison between non-diabetes and diabetes-onset groups. In multivariate analysis, ferritin in group H (HR: 3.25), fatty liver (HR: 3.38), estimated glomerular filtration rate (eGFR) < 70 mL/min/1.73 m² (HR: 3.48) and high-density lipoprotein (HDL) < 40 mg/dL (HR: 2.61) were significant predictive factors for onset of type 2 diabetes mellitus.

Conclusions: These results suggest that the serum ferritin level is an important index for priority intervention in preventive medicine for reduction of onset of diabetes.

Keywords: Ferritin; Long-term follow-up; Males; Type 2 diabetes.