Gestational diabetes mellitus in the last trimester – a feature of maternal iron excess?

Lao, Terence T.; Chan, Polin; Tam, Kwok-kan

doi:10.1046/j.1464-5491.2001.00453.x

Cited by 114 publications

(106 citation statements)

References 37 publications

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“…In the apparently healthy general population, serum levels of ferritin were also positively correlated with baseline serum glucose and with the area under the curve for glucose during the glucose oral tolerance test (20,21). In gestational diabetes, both BMI and serum ferritin levels were found to be independent predictors of 2-h glucose during an oral glucose tolerance test (8,9). Ferritin levels also correlated with diastolic arterial blood pressure, even after adjustment for BMI.…”

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confidence: 89%

“…In the general population, body iron stores are positively associated with the development of glucose intolerance, type 2 diabetes (1-7), and gestational diabetes (8,9). Among U.S. adults, men with newly diagnosed diabetes had an odds ratio (OR) of 4.94 (95% confidence interval [CI] 3.05-8.01) and women had an OR of 3.61 (2.01-6.48) of having elevated ferritin concentrations (6).…”

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confidence: 99%

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Cross-Talk Between Iron Metabolism and Diabetes

Fernández‐Real¹,

López‐Bermejo²,

Ricart³

2002

Diabetes

593

411

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Emerging scientific evidence has disclosed unsuspected influences between iron metabolism and type 2 diabetes. The relationship is bi-directional-iron affects glucose metabolism, and glucose metabolism impinges on several iron metabolic pathways. Oxidative stress and inflammatory cytokines influence these relationships, amplifying and potentiating the initiated events. The clinical impact of these interactions depends on both the genetic predisposition and the time frame in which this network of closely related signals acts. In recent years, increased iron stores have been found to predict the development of type 2 diabetes while iron depletion was protective. Iron-induced damage might also modulate the development of chronic diabetes complications. Iron depletion has been demonstrated to be beneficial in coronary artery responses, endothelial dysfunction, insulin secretion, insulin action, and metabolic control in type 2 diabetes. Here, we show that iron modulates insulin action in healthy individuals and in patients with type 2 diabetes. The extent of this influence should be tested in large-scale clinical trials, searching for the usefulness and cost-effectiveness of therapeutic measures that decrease iron toxicity. The study of individual susceptibility and of the mechanisms that influence tissue iron deposition and damage are proposed to be valuable in anticipating and treating diabetes complications. Diabetes 51:2348 -2354, 2002

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confidence: 89%

mentioning

confidence: 99%

Cross-Talk Between Iron Metabolism and Diabetes

Fernández‐Real¹,

López‐Bermejo²,

Ricart³

2002

Diabetes

593

411

View full text Add to dashboard Cite

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“…Several studies have suggested a possible link between high body iron stores and metabolic parameters (9 -13) (serum insulin and glucose) as well as hyp e r t e n s i o n ( 9 , 1 4 ) , d y s l i p i d e m i a (9,15,16), and obesity (9,17). In addition, epidemiological studies have reported an association between high iron stores and increased risk of cardiovascular disease (18), metabolic syndrome (10,12,19), gestational diabetes (20,21), and type 2 diabetes (22)(23)(24)(25)(26)(27). The major source of body iron is derived from the diet.…”

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confidence: 99%

Iron Intake and the Risk of Type 2 Diabetes in Women

et al. 2006

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OBJECTIVE -Epidemiological studies suggest that high body iron stores are associated with insulin resistance and type 2 diabetes. The aim of this study was to evaluate the association between dietary intake of iron and the risk of type 2 diabetes.RESEARCH DESIGN AND METHODS -We conducted a prospective cohort study within the Nurses' Health Study. We followed 85,031 healthy women aged 34 -59 years from 1980 to 2000. Dietary data were collected every 4 years, and data on medical history and lifestyle factors were updated biennially.RESULTS -During the 20 years of follow-up, we documented 4,599 incident cases of type 2 diabetes. We found no association between total, dietary, supplemental, or nonheme iron and the risk of type 2 diabetes. However, heme iron intake (derived from animal products) was positively associated with risk; relative risks (RRs) across increasing quintiles of cumulative intake were 1.00, 1.08 (95% CI 0.97-1.19), 1.20 (1.09 -1.33), 1.27 (1.14 -1.41), and 1.28 (1.14 -1.45) (P trend Ͻ 0.0001) after controlling for age, BMI, and other nondietary and dietary risk factors. In addition, when we modeled heme iron in seven categories, the multivariate RR comparing women who consumed Ն2.25 mg/day and those with intake Ͻ0.75 mg/day was 1.52 (1.22-1.88). The association between heme iron and the risk of diabetes was significant in both overweight and lean women.CONCLUSIONS -This large cohort study suggests that higher heme iron intake is associated with a significantly increased risk of type 2 diabetes. Diabetes Care 29:1370 -1376, 2006D iet and lifestyle play a major role in the prevention of type 2 diabetes. The quality and quantity of macronutrients (especially fat and carbohydrates) are known to have an impact on the risk of type 2 diabetes; however, the role of micronutrients is not well established (1). Several studies have suggested a possible role of minerals such as magnesium (2,3), chromium (4,5), calcium (6), and iron (7) in insulin resistance or diabetes.Iron is a transitional metal and a potential catalyst in many cellular reactions that produce reactive oxygen species. Such reactions contribute to tissue damage and increase oxidative stress, thereby potentially altering the risk of type 2 diabetes (8). Several studies have suggested a possible link between high body iron stores and metabolic parameters (9 -13) (serum insulin and glucose) as well as hyp e r t e n s i o n ( 9 , 1 4 ) , d y s l i p i d e m i a (9,15,16), and obesity (9,17). In addition, epidemiological studies have reported an association between high iron stores and increased risk of cardiovascular disease (18), metabolic syndrome (10,12,19), gestational diabetes (20,21), and type 2 diabetes (22-27). The major source of body iron is derived from the diet. Dietary iron exists as either heme (derived from meat and meat products) or nonheme iron. In two recent prospective cohort studies (28,29), intake of total or nonheme iron was not associated with the risk of type 2 diabetes, but heme iron was associated with elevated risk. Th...

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“…risk of Type 2 diabetes [1,2,3,4,5]. In addition, low iron status or iron depletion is associated with better insulin action and metabolic control in healthy individuals and Type 2 diabetic patients [6,7,8].…”

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confidence: 99%

Dietary iron intake and Type 2 diabetes incidence in postmenopausal women: the Iowa Women’s Health Study

2004

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Aims/hypothesis. Recently, a clear biological link between iron metabolism and diabetes has emerged from epidemiological and experimental studies. We carried out a prospective study of dietary iron intake and incidence of Type 2 diabetes. Methods. 35,698 postmenopausal women initially aged 55 to 69 years were followed for 11 years. Diet was assessed with a food frequency questionnaire at baseline. Results. Intake of heme iron showed a positive association with incident Type 2 diabetes; the relative risks were 1.0, 1.07, 1.12, 1.14, and 1.28 across quintiles of heme iron (p trend =0.02) after adjustment for non-dietary and dietary risk factors. Heme iron showed a weak positive association among non-drinkers, but the association appeared to be stronger among subjects who consumed more alcohol. For example, in a model restricted to those who drank alcohol at least 15 g/day, adjusted relative risks across quintiles of heme iron were 1.0, 2.26, 3.22, 1.92, and 4.42 (p trend =0.05); and consumers of 30 g/day of more of supplemental iron had an adjusted relative risk equal to 3.03 (95% CI, 1.29-7.12)], compared to those who took no iron supplement. Non-heme iron was inversely associated with incidence of Type 2 diabetes. Amongst nondrinkers adjusted relative risks were 1.0, 0.83, 0.87, 0.72, and 0.67 across quintiles (p trend <0.01). This inverse association was lost among drinkers, in whom there was no association of diabetes incidence with non-heme iron. Conclusions/interpretation. Greater dietary heme-iron intake and/or supplemental iron were associated with an increased risk of Type 2 diabetes, especially amongst those who drink alcohol. [Diabetologia (2004) 47:185-194] Keywords Type 2 diabetes · Iron · Alcohol consumption · Meat intake

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Gestational diabetes mellitus in the last trimester – a feature of maternal iron excess?

Abstract: The results suggest an association between increased iron stores and glucose intolerance at the third trimester in non-anaemic women. The role of iron excess in the pathogenesis of GDM needs to be examined.

Cited by 114 publications

References 37 publications

Cross-Talk Between Iron Metabolism and Diabetes

Cross-Talk Between Iron Metabolism and Diabetes

Iron Intake and the Risk of Type 2 Diabetes in Women

Dietary iron intake and Type 2 diabetes incidence in postmenopausal women: the Iowa Women’s Health Study

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