Correlations Between Iron Status and Body Composition in Patients With Type 2 Diabetes Mellitus

Chen Zimiao; Luo Dongdong; Chen Shuoping; Zhou Peng; Zheng Fan; Chen Rujun; Gong Xiaohua

doi:10.3389/fnut.2022.911860

Correlations Between Iron Status and Body Composition in Patients With Type 2 Diabetes Mellitus

Front Nutr. 2022 Jul 13:9:911860. doi: 10.3389/fnut.2022.911860. eCollection 2022.

Authors

Chen Zimiao¹, Luo Dongdong², Chen Shuoping¹, Zhou Peng³, Zheng Fan⁴, Chen Rujun⁵, Gong Xiaohua¹

Affiliations

¹ Department of Endocrinology and Metabolism, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
² Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Dalian Medical University, Dalian Medical University, Dalian, China.
³ Central Hospital of Qiaoxia Town, Wenzhou, China.
⁴ College of Psychiatry, Wenzhou Medical University, Wenzhou, China.
⁵ Department of Burn, 906 Hospital of the Joint Logistics Team, PLA, Wenzhou, China.

Abstract

Background: Our study aimed to investigate the association between iron metabolism and body composition in patients with type 2 diabetes mellitus (T2DM).

Methods: A total of 824 patients with T2DM were enrolled. Measurements of body composition were obtained by dual-energy X-ray absorptiometry. Patients were stratified into three groups according to their sex-specific ferritin levels. Basic information, laboratory results, and body composition were collected.

Results: Serum iron and transferrin saturation (TSAT) were increased significantly with increased serum ferritin (all p < 0.05). Total iron-binding capacity (TIBC) was decreased significantly with increased serum ferritin (p < 0.05). Visceral fat mass (VF), android fat/total body fat mass, android-to-gynoid fat ratio (A/G ratio), and high-sensitivity C-reactive protein were all increased significantly with increased serum ferritin (all p < 0.05). Patients with a high A/G ratio (A/G ratio ≧ 1) had significantly higher serum iron, ferritin, and TSAT, but significantly lower TIBC. In the model adjusted for age and gender, higher ferritin levels were associated with a higher VF (all p < 0.05). Serum iron was positively correlated with the occurrence of a high A/G ratio (A/G ratio ≧ 1) after the adjustment of confounding factors [an odds ratio (OR = 1.09, 95% CI, 1.02-1.19, p = 0.02)]. With receiver operating curve analysis, the cutoff value of serum iron for a high A/G ratio was 18.56, and the area under the curve was 0.771 (sensitivity 88.9%and specificity 63.9%, p = 0.01).

Conclusion: Higher serum iron and ferritin concentrations were positively associated with a higher VF. Higher serum iron concentrations were positively correlated with a high A/G ratio. This study indicates the potential relationship between iron overload and the body composition in patients with T2DM.

Keywords: android-to-gynoid fat ratio; body composition; iron metabolism; type 2 diabetes mellitus; visceral fat mass.