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Meta-Analysis
. 2020 Jul;11(4):946-955.
doi: 10.1111/jdi.13216. Epub 2020 Feb 23.

Iron metabolism and type 2 diabetes mellitus: A meta-analysis and systematic review

Jingfang Liu  1 , Qingxiu Li  1 , Yaxian Yang  1 , Lihua Ma  1
Affiliations
Meta-Analysis

Iron metabolism and type 2 diabetes mellitus: A meta-analysis and systematic review

Jingfang Liu et al. J Diabetes Investig. 2020 Jul.

Abstract

Aims/introduction: Iron metabolism can directly or indirectly affect the occurrence and development of type 2 diabetes. This meta-analysis and systematic review aimed to analyze the association between serum iron metabolism indicators and type 2 diabetes.

Materials and methods: The databases PubMed and Embase were searched for studies on the correlations between serum iron metabolism indicators (iron, ferritin, transferrin, hepcidin and soluble transferrin receptor) and type 2 diabetes since January 2006. Relevant data were extracted from the included studies, and meta-analysis was carried out.

Results: A total of 12 case-control and cohort studies were analyzed. Of the 12 studies, 11 described the correlation between serum ferritin levels and type 2 diabetes. The median and high serum ferritin concentrations were significantly associated with the risks of type 2 diabetes (odds ratio [OR] 1.20, 95% confidence interval [CI] 1.08-1.33 and OR 1.43, 95% CI 1.29-1.59, respectively). However, the low concentration was not correlated with the risk of type 2 diabetes (OR 0.99, 95% CI 0.89-1.11). No significant association was observed between serum soluble transferrin receptor and type 2 diabetes, whereas the soluble transferrin receptor-to-ferritin ratio was significantly inversely related to the risk of type 2 diabetes in the median and high ratio subgroups (OR 0.71, 95% CI 0.51, 0.99 and OR 0.65, 95% CI 0.45-0.95).

Conclusions: The elevated serum ferritin was one of the risk factors for type 2 diabetes, and soluble transferrin receptor-to-ferritin ratio was inversely related to the risk of type 2 diabetes. A systematic review showed that serum transferrin and hepcidin might be directly or indirectly related to the development of diabetes.

Keywords: Ferritin; Soluble transferrin receptor; Type 2 diabetes.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Literature screening flowchart.
Figure 2
Figure 2
The association between serum ferritin and type 2 diabetes in ferritin concentration stratified group. CI, confidence interval; OR, odds ratio.
Figure 3
Figure 3
The association between serum soluble transferrin receptor and type 2 diabetes in the ferritin unstratified group. CI, confidence interval; OR, odds ratio.
Figure 4
Figure 4
The association between serum ferritin and type 2 diabetes, excluding one study. CI, confidence interval; OR, odds ratio.
Figure 5
Figure 5
The association between serum soluble transferrin receptor and type 2 diabetes. CI, confidence interval; OR, odds ratio.
Figure 6
Figure 6
The association between serum soluble transferrin receptor to ferritin ratio and type 2 diabetes. CI, confidence interval; OR, odds ratio.
See this image and copyright information in PMC

Comment in

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