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Diabetes and endocrinology
Research
Prediabetes, elevated iron and all-cause mortality: a cohort study
  1. Arch G Mainous III1,2,
  2. Rebecca J Tanner1,
  3. Thomas D Coates3,
  4. Richard Baker4
  1. 1Department of Health Services Research, Management and Policy, University of Florida, Gainesville, Florida, USA
  2. 2Department of Community Health and Family Medicine, University of Florida, Gainesville, Florida, USA
  3. 3Department of Pediatrics and Pathology, University of Southern California, Keck School of Medicine, Los Angeles, California, USA
  4. 4Department of Health Sciences, University of Leicester, Leicester, UK
  1. Correspondence to Professor Arch G Mainous III; arch.mainous{at}ufl.edu

Abstract

Objectives Data have indicated low to non-existent increased mortality risk for individuals with prediabetes, but it is unclear if the risk is increased when the patient has elevated iron markers. Our purpose was to examine the mortality risk among adults with prediabetes in the context of coexisting elevated transferrin saturation (TS) or serum ferritin.

Setting Data collected by the third National Health and Nutrition Examination Survey 1988–1994 (NHANES III) in the USA and by the National Center for Health Statistics for the National Death Index from 1988 to 2006.

Participants Individuals age 40 and older who participated in the NHANES and provided a blood sample.

Primary outcome variable Mortality was measured as all-cause mortality.

Results Adjusted analyses show that prediabetes has a small increased mortality risk (HR=1.04; 95% CI 1.00 to 1.08). Persons who had prediabetes and elevated serum ferritin had an increased HR for death (HR=1.14; 95% CI 1.04 to 1.24) compared with those who had normal ferritin and normal glucose. Among persons with prediabetes who had elevated TS, they had an increased mortality risk (HR=1.88; 95% CI 1.06 to 3.30) compared with those with normal TS levels and normal glucose.

Conclusions The mortality risk of prediabetes is low. However, among individuals who have coexisting elevated iron markers, particularly TS, the risk rises substantially.

  • HAEMATOLOGY
  • DIABETES & ENDOCRINOLOGY

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2014-006491

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