Body Iron Stores in Relation to Risk of Type 2 Diabetes in Apparently Healthy Women

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Abstract
Excessive iron stores can cause type 2 diabetes among patients with hemochromatosis.1 However, it is not clear whether moderately elevated iron stores predict the risk of developing type 2 diabetes among healthy individuals. Iron is a catalyst in the formation of hydroxyl radicals, which are powerful prooxidants that attack cellular membrane lipids, proteins, and nucleic acids.2-4 It has been hypothesized that formation of hydroxyl radicals catalyzed by iron contributes initially to insulin resistance and subsequently to decreased insulin secretion and then to the development of type 2 diabetes.5-7 Findings on the association between serum ferritin concentration and insulin resistance or type 2 diabetes risk from cross-sectional or case-control studies have been inconsistent. Several of these studies observed positive associations7-12; however, serum ferritin concentrations may reflect systemic inflammation coexisting with diabetes rather than high iron stores because blood samples are collected after the diagnosis of diabetes. Also, the directionality of the associations cannot be established based on retrospective or cross-sectional data.