Background High body iron store has been associated with an increased risk of type 2 diabetes (T2D); it remains unknown whether the genetic variants related to body iron status affect T2D risk. We aimed at comprehensively investigating the associations between the genetic variants related to body iron status and the T2D risk. Methodology/Principal Findings Six common SNPs related to body iron status from recent genome-wide association (GWA) studies were determined in the Nurses’ Health Study (NHS; 1,467 diabetic cases and 1,754 controls) and the Health Professionals Follow-up Study (HPFS; 1,124, diabetic cases and 1,298 controls). Plasma levels of ferritin, soluble transferrin receptor (sTfR), and transferrin were measured in NHS. Significant associations were observed for loci in TPMRSS6 with sTfR (P = 3.47×10?6), TF with transferrin (P = 0.0002 to 1.72×10?10); and HFE with ferritin (P = 0.017 to 1.6×10?8), sTfR (P = 0.007 to 7.9×10?6), and transferrin (P = 0.006 to 0.0007). The six SNPs together explained 5.7%, 2.7%, and 13.3% of the variation in plasma levels of ferritin, sTfR, and transferrin. After adjustment for the conventional risk factors, the T allele of SNP rs855791 in the TPMRSS6 gene was significantly associated with a 19% decreased risk of T2D (OR = 0.81; 95% CI = 0.66–0.98; P = 0.03) in men. Multiple tests attenuated this significant association to null. No associations were observed in women. SNPs at HFE and TF were not associated with diabetes risk in either sex. Dietary iron intake did not modify the associations of the newly identified loci with diabetes risk. Conclusions/Significance The newly identified iron-related SNP rs855791 in TPMRSS6 was nominally associated with a decreased risk of T2D in men but not in women. The apparent differences by gender warrant further study.
References
[1]
Wolff SP (1993) Diabetes mellitus and free radicals. Free radicals, transition metals and oxidative stress in the aetiology of diabetes mellitus and complications. Br Med Bull 49: 642–652.
[2]
Reddy MB, Clark L (2004) Iron, oxidative stress, and disease risk. Nutr Rev 62: 120–124.
[3]
Jiang R, Manson JE, Meigs JB, Ma J, Rifai N, et al. (2004) Body iron stores in relation to risk of type 2 diabetes in apparently healthy women. Jama 291: 711–717.
[4]
Fumeron F, Pean F, Driss F, Balkau B, Tichet J, et al. (2006) Ferritin and transferrin are both predictive of the onset of hyperglycemia in men and women over 3 years: the data from an epidemiological study on the Insulin Resistance Syndrome (DESIR) study. Diabetes Care 29: 2090–2094.
[5]
Jehn ML, Guallar E, Clark JM, Couper D, Duncan BB, et al. (2007) A prospective study of plasma ferritin level and incident diabetes: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Epidemiol 165: 1047–1054.
[6]
Forouhi NG, Harding AH, Allison M, Sandhu MS, Welch A, et al. (2007) Elevated serum ferritin levels predict new-onset type 2 diabetes: results from the EPIC-Norfolk prospective study. Diabetologia 50: 949–956.
[7]
Salonen JT, Tuomainen TP, Nyyssonen K, Lakka HM, Punnonen K (1998) Relation between iron stores and non-insulin dependent diabetes in men: case-control study. Bmj 317: 727.
[8]
Adams PC, Pankow JS, Barton JC, Acton RT, Leiendecker-Foster C, et al. (2009) HFE C282Y homozygosity is associated with lower total and low-density lipoprotein cholesterol: The hemochromatosis and iron overload screening study. Circ Cardiovasc Genet 2: 34–37.
[9]
Benyamin B, McRae AF, Zhu G, Gordon S, Henders AK, et al. (2009) Variants in TF and HFE explain approximately 40% of genetic variation in serum-transferrin levels. Am J Hum Genet 84: 60–65.
[10]
Benyamin B, Ferreira MA, Willemsen G, Gordon S, Middelberg RP, et al. (2009) Common variants in TMPRSS6 are associated with iron status and erythrocyte volume. Nat Genet 41: 1173–1175.
[11]
Fernandez-Real JM, Mercader JM, Ortega FJ, Moreno-Navarrete JM, Lopez-Romero P, et al. (2010) Transferrin receptor-1 gene polymorphisms are associated with type 2 diabetes. Eur J Clin Invest 40: 600–607.
[12]
Qi L, Meigs J, Manson JE, Ma J, Hunter D, et al. (2005) HFE genetic variability, body iron stores, and the risk of type 2 diabetes in U.S. women. Diabetes 54: 3567–3572.
[13]
Whitfield JB, Treloar S, Zhu G, Powell LW, Martin NG (2003) Relative importance of female-specific and non-female-specific effects on variation in iron stores between women. Br J Haematol 120: 860–866.
[14]
Witte DL, Crosby WH, Edwards CQ, Fairbanks VF, Mitros FA (1996) Practice guideline development task force of the College of American Pathologists. Hereditary hemochromatosis. Clin Chim Acta 245: 139–200.
[15]
Du X, She E, Gelbart T, Truksa J, Lee P, et al. (2008) The serine protease TMPRSS6 is required to sense iron deficiency. Science 320: 1088–1092.
[16]
Nemeth E, Tuttle MS, Powelson J, Vaughn MB, Donovan A, et al. (2004) Hepcidin regulates cellular iron efflux by binding to ferroportin and inducing its internalization. Science 306: 2090–2093.
[17]
Green A, Basile R, Rumberger JM (2006) Transferrin and iron induce insulin resistance of glucose transport in adipocytes. Metabolism 55: 1042–1045.
Davis RJ, Corvera S, Czech MP (1986) Insulin stimulates cellular iron uptake and causes the redistribution of intracellular transferrin receptors to the plasma membrane. J Biol Chem 261: 8708–8711.
[20]
Leggett BA, Fletcher LM, Ramm GA, Powell LW, Halliday JW (1993) Differential regulation of ferritin H and L subunit mRNA during inflammation and long-term iron overload. J Gastroenterol Hepatol 8: 21–27.
[21]
Qi L, Cornelis MC, Kraft P, Stanya KJ, Linda Kao WH, et al. Genetic variants at 2q24 are associated with susceptibility to type 2 diabetes. Hum Mol Genet 19: 2706–2715.
[22]
Field AE, Coakley EH, Must A, Spadano JL, Laird N, et al. (2001) Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med 161: 1581–1586.
[23]
Colditz GA, Hankinson SE (2005) The Nurses’ Health Study: lifestyle and health among women. Nat Rev Cancer 5: 388–396.
[24]
Willett WC (1998) Nutritional Epidemiology. New York: Oxford University Press.
[25]
Rimm EB, Giovannucci EL, Willett WC, Colditz GA, Ascherio A, et al. (1991) Prospective study of alcohol consumption and risk of coronary disease in men. Lancet 338: 464–468.
[26]
Rimm EB, Giovannucci EL, Stampfer MJ, Colditz GA, Litin LB, et al. (1992) Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals. Am J Epidemiol 135: 1114–1126; discussion 1127–1136.
[27]
Hu FB, Doria A, Li T, Meigs JB, Liu S, et al. (2004) Genetic variation at the adiponectin locus and risk of type 2 diabetes in women. Diabetes 53: 209–213.
[28]
Qi L, van Dam RM, Meigs JB, Manson JE, Hunter D, et al. (2006) Genetic variation in IL6 gene and type 2 diabetes: tagging-SNP haplotype analysis in large-scale case-control study and meta-analysis. Hum Mol Genet 15: 1914–1920.
[29]
Hu FB, Leitzmann MF, Stampfer MJ, Colditz GA, Willett WC, et al. (2001) Physical activity and television watching in relation to risk for type 2 diabetes mellitus in men. Arch Intern Med 161: 1542–1548.
[30]
Manson JE, Rimm EB, Stampfer MJ, Colditz GA, Willett WC, et al. (1991) Physical activity and incidence of non-insulin-dependent diabetes mellitus in women. Lancet 338: 774–778.
[31]
Group NDD (1997) Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 28: 1039–1057.
[32]
Manson JE, Colditz GA, Stampfer MJ, Willett WC, Kroleswki AS, et al. (1991) A prospective study of maturity-onset diabetes mellitus and risk of coronary heart disease and stroke in women. Arch Intern Med 151: 1141–1147.
[33]
The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (1997) Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. diabetes care 20: 1183–1197.
[34]
Colditz GA, Manson JE, Hankinson SE (1997) The Nurses' Health Study: 20-year contribution to the understanding of health among women. J Womens Health 6: 49–62.
[35]
Wolf AM, Hunter DJ, Colditz GA, Manson JE, Stampfer MJ, et al. (1994) Reproducibility and validity of a self-administered physical activity questionnaire. Int J Epidemiol 23: 991–999.
[36]
Rimm EB, Stampfer MJ, Colditz GA, Chute CG, Litin LB, et al. (1990) Validity of self-reported waist and hip circumferences in men and women. Epidemiology 1: 466–473.
[37]
Liu JM, Hankinson SE, Stampfer MJ, Rifai N, Willett WC, et al. (2003) Body iron stores and their determinants in healthy postmenopausal US women. Am J Clin Nutr 78: 1160–1167.
[38]
Hu FB, Meigs JB, Li TY, Rifai N, Manson JE (2004) Inflammatory markers and risk of developing type 2 diabetes in women. Diabetes 53: 693–700.
[39]
Altman D (1991) Practical statistics for medical research. London:Chapman and Hall. pp. 211–212.