What is the association between iron status biomarkers and all-cause or cause-specific mortality, and does this association differ between people with and without diabetes mellitus?
Ferritin / Iron-Status Test, studied in 29,166 adults (J Endocr Soc 2024, PMID 38623382) — during a median follow-up of 18.83 years, 9,378 deaths were observed, including 3,420 cardiovascular disease (CVD) deaths and 1,969 cancer deaths. Scope: 29,166 adults, and the abstract states no limitations.
Source: J Endocr Soc 2024, PMID 38623382 ↗ · Research map · How Magellan grades evidence · evidence confidence: medium
J Endocr Soc · 2024 · PMID 38623382 · DOI 10.1210/jendso/bvae063
Iron status is linked to mortality risk, with different associations observed in people with and without diabetes, suggesting personalized approaches to iron management.
The question
What is the association between iron status biomarkers and all-cause or cause-specific mortality, and does this association differ between people with and without diabetes mellitus?
What they tested
The study aimed to investigate associations between iron metabolic biomarkers and all-cause and cause-specific mortality risk in the general population, and to explore heterogeneities in these associations among populations with and without diabetes mellitus.
How they did it
The study included 29,166 adults from NHANES III and NHANES 1999-2010, with mortality data linked to the National Death Index up to December 31, 2019. Cox proportional-hazard models and Fine-Gray subdistribution hazard models were used to analyze the associations between iron metabolic biomarkers and mortality outcomes.
What they found
During a median follow-up of 18.83 years, 9,378 deaths were observed, including 3,420 cardiovascular disease (CVD) deaths and 1,969 cancer deaths. A linear association between serum ferritin (SF) and all-cause mortality was found in the overall population and those without diabetes. J-shaped associations between transferrin saturation (TSAT) and all-cause and CVD mortality were observed across all populations. In the overall population, the adjusted hazard ratio (HR) for all-cause mortality in the fourth quartile (Q4) of SF was 1.13 (1.05-1.21) compared to the first quartile (Q1), while for TSAT, the HR in Q4 was 0.93 (0.88-0.99). For individuals without diabetes, the adjusted HR of Q4 SF was 1.19 (1.03-1.37) for CVD mortality and 1.25 (1.05-1.48) for cancer mortality. In individuals with diabetes, the adjusted HRs of Q4 TSAT were 0.76 (0.62-0.93) for CVD mortality and 1.47 (1.07-2.03) for cancer mortality.
| SF Q2 | 1.07 | |
|---|---|---|
| SF Q3 | 1.05 | |
| SF Q4 | 1.13 | |
| TSAT Q2 | 0.94 | |
| TSAT Q3 | 0.92 | |
| TSAT Q4 | 0.93 |
Compared to the first quartile (Q1), the adjusted hazard ratios for all-cause mortality show varying associations with higher quartiles of serum ferritin (SF) and transferrin saturation (TSAT) in the overall population.
What it means
Abnormalities in iron metabolism increase mortality risk in the general population. The associations between iron status and mortality differ significantly between individuals with and without diabetes mellitus, suggesting a need for tailored strategies for iron homeostasis.
Limitations
The abstract does not explicitly state limitations of the study.
Where the published abstract does not list limitations, we say so rather than inventing them. Read the full paper on PubMed before drawing conclusions.
The paper at a glance
| Magellan’s evidence label | Serum ferritin (iron stores) (our label for this citation — see PubMed for the paper’s own title and authors) |
|---|---|
| Journal | J Endocr Soc |
| Year | 2024 |
| PMID | 38623382 ↗ |
| DOI | 10.1210/jendso/bvae063 ↗ |
| Topic | General aging biology & healthspan |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
Where Magellan uses this paper
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Ferritin / Iron-Status Test
Iron status has a U-shaped relationship with health: iron deficiency (low ferritin) is a leading cause of anemia and, even without anemia, is associated with fatigue that iron repletion can improve, while in older adults it has been linked to more severe infections;
Ferritin is the body's main intracellular iron-storage protein, and the concentration of ferritin…
Research describes the compound or intervention studied. It is not a claim about any specific product.
Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). What is the association between iron status biomarkers and all-cause or cause-specific mortality, and does this association differ between people with and without diabetes mellitus? [Plain-English summary of J Endocr Soc 2024, PMID 38623382, DOI 10.1210/jendso/bvae063]. Magellan Longevity. https://magellanlongevity.com/study/s147.html@misc{magellan_s147,
title = {What is the association between iron status biomarkers and all-cause or cause-specific mortality, and does this association differ between people with and without diabetes mellitus?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/s147.html}},
note = {Plain-English summary of PubMed PMID 38623382; DOI 10.1210/jendso/bvae063; J Endocr Soc 2024. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
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