Iron Status Correlates Strongly to Insulin Resistance Among US Adults: A Nationwide Population-Based Study
Authors' 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 2 and provide a solid foundation for future exploration of the mechanisms underlying their relationship.
Study context
- Population
- US adults, National Health and Nutrition Examination Survey (NHANES) 2003–2006, 2017–2020; Insulin resistance (IR) defined as HOMA-IR ≥2.5
- Participants
- 2,993 adults
- Exposure
- Iron status markers vs IR
- Outcome
- IR (HOMA-IR ≥2.5) in relation to iron status
Methodological detailsnationwide population-based, NHANES 2003-2006, 2017-2020, weighted linear and multivariable logistic regression, restricted cubic splines, stratified analyses, ROC analysis
- Nationwide population-based
- NHANES 2003-2006, 2017-2020
- Weighted linear and multivariable logistic regression
- Restricted cubic splines
- Stratified analyses
- ROC analysis
Main finding
As reported in the abstract
Association of iron status markers with HOMA-IR and IR
Odds ratio (IR) (95% CI)P value
Iron intakepositive correlation
1.02(1.00–1.04)
P = 0.04sTfRpositive correlation
1.07(1.02–1.13)
P = 0.01Serum ironnegative correlation; adjusted for confounders
0.96(0.94–0.98)
P < 0.0001TSATnegative correlation; adjusted for confounders
0.98(0.97–0.99)
P < 0.001- Serum iron · negative correlation
- β (HOMA-IR, weighted linear) −0.03 (95% CI −0.05 to −0.01); P = 0.01
Observational data: associations, not effects.
Further findings
Dose-response (restricted cubic splines (RCS)) and subgroups
- Nonlinear dose-response relationship between serum transferrin receptor (sTfR) and transferrin saturation (TSAT) and IR; consistent across population subgroups
ROC prediction of IR
- TSAT performed better than iron intake, serum iron (SI) and sTfR for IR prediction
Original publication
Iron Status Correlates Strongly to Insulin Resistance Among US Adults: A Nationwide Population-Based Study. J Clin Endocrinol Metab. Published 27 August 2024. doi:10.
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