Conway Rebecca Baqiyyah, Pratte Katherine A, Bowler Russell Paul, Young Kendra A, Kinney Gregory L, Austin Erin, Li Yisha, McClain Donald, Hokanson John, Crapo James D
Department of Epidemiology, University of Colorado, Anschutz Medical Campus, Aurora, CO, 80045, USA.
Division of Biostatistics and Bioinformatics, National Jewish Health, Denver, CO, 80206, USA.
Diabetes Metab Syndr Obes. 2024 Dec 11;17:4767-4776. doi: 10.2147/DMSO.S492124. eCollection 2024.
Little information is available on iron with diabetes risk among African Americans, a population where both anemia and elevated ferritin are common. We tested whether plasma proteomic measurements of ferritin and transferrin were associated with increased diabetes risk in a cohort of current and former African American (NHB) and Non-Hispanic White (NHW) smokers.
NHB and NHW participants from the COPDGene study who were free of diabetes (n = 4693) at baseline were followed for incident diabetes. The SomaScan was used to determine the relative amounts of natural log-transformed ferritin, transferrin, and hepcidin.
During an average of 5.6 years of follow-up, diabetes incidence was 7.9%. Ferritin at follow-up was higher in NHB than NHW participants (p = <0.0001). Ferritin at follow-up was associated with increased diabetes risk (OR = 1.36, 95% CI = 1.08-1.70), while transferrin was associated with decreased risk (OR = 0.25, 95% CI = 0.08-0.77) controlling for age, sex, BMI, smoking pack-years, hepcidin, CRP, and Il-6. Race-specifically, increased risk associated with higher ferritin levels among NHB (OR = 1.56, 95% CI = 1.13-2.16) but not NHW (OR = 1.22, 95% CI = 0.89-1.68) participants. Sex-specifically, ferritin's relationship was similar among NHB men and women and NHW women (ORs ranging from 1.41-1.59); but not NHW men (OR = 0.98, 95% CI = 0.64-1.49). Similarly, transferrin ORs non-significantly ranged from 0.19-0.30 for NHB men and women and NHW women, but was significant for NHW men (OR = 0.07, 95% CI = 0.01-0.63).
Higher body iron stores is associated with increased diabetes risk among both NHB and NHW people. Unsuspected elevated iron stores may increase diabetes risk in NHB patients and should be monitored.
非裔美国人中，关于铁与糖尿病风险的信息较少，而在这一人群中，贫血和铁蛋白升高都很常见。我们在一组现患和既往的非裔美国（NHB）和非西班牙裔白人（NHW）吸烟者队列中，测试了铁蛋白和转铁蛋白的血浆蛋白质组学测量值是否与糖尿病风险增加相关。
对慢性阻塞性肺疾病基因研究中基线时无糖尿病（n = 4693）的NHB和NHW参与者进行随访，观察糖尿病发病情况。使用SomaScan测定自然对数转换后的铁蛋白、转铁蛋白和铁调素的相对含量。
在平均5.6年的随访期间，糖尿病发病率为7.9%。随访时，NHB参与者的铁蛋白水平高于NHW参与者（p = <0.0001）。随访时的铁蛋白与糖尿病风险增加相关（OR = 1.36，95%CI = 1.08 - 1.70），而转铁蛋白与风险降低相关（OR = 0.25，95%CI = 0.08 - 0.77），校正了年龄、性别、体重指数、吸烟包年数、铁调素、CRP和白细胞介素-6。按种族分层，NHB参与者中铁蛋白水平升高与风险增加相关（OR = 1.56，95%CI = 1.13 - 2.16），而NHW参与者则不然（OR = 1.22，95%CI = 0.89 - 1.68）。按性别分层，铁蛋白在NHB男性和女性以及NHW女性中的关系相似（OR值在1.41 - 1.59之间）；但在NHW男性中并非如此（OR = 0.98，95%CI = 0.64 - 1.49）。同样，转铁蛋白的OR值在NHB男性和女性以及NHW女性中无显著差异，范围在0.19 - 0.30之间，但在NHW男性中显著（OR = 0.07，95%CI = 0.01 - 0.63）。
较高的体内铁储存与NHB和NHW人群的糖尿病风险增加相关。未被怀疑的铁储存升高可能会增加NHB患者的糖尿病风险，应予以监测。
