Iron status can independently predict long-term outcomes in patients with type 2 diabetes and coronary artery disease (CAD), according to a study published in Diabetes Care.
Beata Ponikowska, M.D., Ph.D., from Wroclaw Medical University in Poland, and colleagues measured serum ferritin, transferrin saturation, and soluble transferrin receptor (sTfR) in 287 patients with type 2 diabetes and stable CAD (average age, 65 years; 78 percent men). Participants were followed for a mean of 45 months.
The researchers found that, during the study period, 21 percent of patients died and 21 percent had cardiovascular hospitalizations. The five-year all-cause mortality rates were strongly predicted by both serum ferritin and sTfR, independent of other variables (including hemoglobin, measures of renal function, inflammation, and neurohormonal activation). The relationship between sTfR and mortality was exponential (adjusted hazard ratio [HR] per 1 log mg/L, 4.24; P = 0.01), while a U-shaped relationship was seen for ferritin and mortality (for the lowest and the highest quintiles versus the middle quintile, respectively: adjusted HRs, 7.18 and 5.12).
“Both low and high serum ferritin (possibly reflecting depleted and excessive iron stores, respectively) along with high serum sTfR (reflecting reduced metabolically available iron) identify patients with type 2 diabetes and CAD who have a poor prognosis,” the authors conclude.
Several authors disclosed financial ties to the pharmaceutical industry.