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Association Between Iron Status and Insulin Resistance in Adults From the US
TAKE-HOME MESSAGE
- This study using NHANES data investigated the relationship between iron levels and insulin resistance in adults from the US. The results showed that higher serum iron levels were associated with lower insulin resistance, whereas higher hemoglobin levels were associated with increased insulin resistance. Weighted multivariate logistic regression models showed that higher iron intake and soluble transferrin receptor levels were associated with increased insulin resistance, whereas higher serum iron and transferrin saturation levels were associated with lower insulin resistance. However, no significant relationship was found between hemoglobin or serum ferritin and insulin resistance. Additionally, a sensitivity analysis was conducted to confirm the results.
- These findings emphasize the significance of iron levels in terms of insulin resistance, potentially leading to clinical implications. However, additional studies are required to thoroughly assess this relationship.
abstract
This abstract is available on the publisher's site.
Access this abstract nowBACKGROUND
Evidence on the link between iron status markers and insulin resistance (IR) is limited. We aimed to explore the relationship between iron status and IR among U.S. adults.
METHODS
This study involved 2993 participants from the National Health and Nutrition Examination Survey (NHANES) 2003-2006, 2017-2020. IR is characterized by a HOMA-IR value of ≥2.5. Weighted linear and multivariable logistic regression analyses were used to examine the linear relationships between iron status and IR. Furthermore, restricted cubic splines (RCS) were used to identify the non-linear dose-response associations. Stratified analyses by age, sex, BMI and PA were also performed. Last, ROC curve was used to evaluate the predictive value of iron status in IR.
RESULTS
In weighted linear analyses, serum iron (SI) exhibited a negative correlation with HOMA-IR (β (95% CI) = -0.03(-0.05, -0.01), P = 0.01). In weighted multivariate logistic analyses, iron intake and serum transferrin receptor (sTfR) were positively correlated with IR (OR =1.02; 95% CI=1.00-1.04, P = 0.04; OR =1.07; 95% CI=1.02-1.13, P = 0.01). Also, SI and transferrin saturation (TSAT) were negatively correlated with IR (OR =0.96; 95% CI=0.94-0.98, P <0.0001; OR =0.98; 95% CI=0.97-0.99, P <0.001) after adjusting for confounding factors. RCS depicted a nonlinear dose-response relationship between sTfR and TSAT and IR. This correlation remained consistent across various population subgroups. ROC curve showed that TSAT performed better than iron intake, SI, sTfR and TSAT in ROC analyses for IR prediction.
CONCLUSION
All biomarkers demonstrated significantly lower risk of IR with increasing iron levels, which will contribute to a more comprehensive and in-depth understanding of the relationship between the two and provide a solid foundation for future exploration of the mechanisms underlying their relationship.
Additional Info
Disclosure statements are available on the authors' profiles:
Iron status correlates strongly to Insulin Resistance among U.S. adults: A nationwide population-base study
J. Clin. Endocrinol. Metab. 2024 Aug 27;[EPub Ahead of Print], X Liu, Y Zhang, Y Chai, Y Li, J Yuan, L Zhang, H ZhangFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.