Ferritin Concentrations, Metabolic Syndrome, and Type 2 Diabetes in Middle-Aged and Elderly Chinese

Graduate School, Chinese Academy of Sciences, Peping, Beijing, China
Journal of Clinical Endocrinology &amp Metabolism (Impact Factor: 6.21). 10/2008; 93(12):4690-6. DOI: 10.1210/jc.2008-1159
Source: PubMed


Elevated ferritin concentrations frequently cluster with well-established risk factors of diabetes including obesity, metabolic syndrome, chronic inflammation, and altered circulating adipokines. Few studies, however, have systematically evaluated the effect of these risk factors on ferritin-diabetes association, particularly in Chinese populations.
We aimed to investigate, in a middle-aged and elderly Chinese population, whether elevated ferritin concentrations are associated with higher risk of metabolic syndrome and type 2 diabetes and to what extent the associations were influenced by obesity, inflammation, and adipokines.
We conducted a population-based, cross-sectional survey of 3,289 participants aged 50-70 yr in Beijing and Shanghai in 2005. Fasting plasma ferritin, glucose, insulin, lipid profile, glycohemoglobin, inflammatory markers, adipokines, and dietary profile were measured.
Median ferritin concentrations were 155.7 ng/ml for men and 111.9 ng/ml for women. After multiple adjustment, the odds ratios (ORs) were substantially higher for type 2 diabetes (OR 3.26, 95% confidence interval 2.36-4.51) and metabolic syndrome [OR 2.80 (95% confidence interval 2.24-3.49)] in the highest ferritin quartile compared with those in the lowest quartile. These associations remained significant after further adjustment for dietary factors, body mass index, inflammatory markers, and adipokines.
Elevated circulating ferritin concentrations were associated with higher risk of type 2 diabetes and metabolic syndrome in middle-aged and elderly Chinese independent of obesity, inflammation, adipokines, and other risk factors. Our data support the crucial role of iron overload for metabolic diseases, even in a country with relatively high prevalence of iron deficiency.

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    • "for iron status (Sun et al., 2008), and low grade inflammation , which results in free radical damage to cells and tissues (Arosio and Levi, 2002). Accordingly, recent studies demonstrated that serum ferritin concentrations are correlated with diabetes mellitus (Lee et al., 2011), insulin resistance (Kim et al., 2011), metabolic syndrome (Jehn et al., 2004; Kang et al., 2012), ischemic heart disease (Milman and Kirchhoff, 1999), cardiovascular disease (Sempos et al., 2000), and nonalcoholic fatty liver disease (NAFLD) (Kim et al., 2012a) in healthy men and obese patients (Hsiao et al., 2004). "
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    ABSTRACT: The impact of simultaneously elevated serum ferritin and mercury concentrations on hypertension in the general population is not known. To determine the association of serum ferritin and mercury concentrations with hypertension, 6213 subjects (3060 men and 3153 women) over 20 years of age from 2008 to 2010 Korea National Health and Nutrition Examination Survey were divided into tertiles according to serum ferritin and mercury concentrations in each gender. Serum ferritin (258.2 vs. 94.8 pmol/L) and mercury concentrations (28.4 vs. 19.9 nmol/L) were higher in men than in women. Serum ferritin (men; P = 0.029, women; P < 0.001) and mercury (men; P < 0.001, women; P = 0.003) concentrations were significantly associated with the prevalence of hypertension. In addition, significant correlation between serum ferritin and mercury concentrations in both men (r = 0.193, P < 0.001) and women (r = 0.145, P < 0.001) were found. Also, the increase of serum ferritin concentrations were more prominent in men (P < 0.001) than in women (P = 0.017) as the serum mercury tertiles increased after proper adjustments. Furthermore, significantly higher odds ratios of hypertension were found in the second (OR = 1.86, 95% CI; 1.05-3.30), and third (OR = 1.84, 95% CI; 1.01-3.36) tertiles of serum ferritin with the top tertile of serum mercury in men. The current study indicate that serum ferritin and mercury concentrations are associated with the prevalence of hypertension and that simultaneously elevated serum ferritin and mercury concentrations are related to the risk for hypertension in men. © 2013 Wiley Periodicals, Inc. Environ Toxicol, 2013.
    Environmental Toxicology 01/2015; 30(1). DOI:10.1002/tox.21899 · 3.20 Impact Factor
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    • "Multiple studies have shown that excess body iron is associated with one or more components of metabolic syndrome (Jehn et al., 2004; Bozzini et al., 2005; Choi et al., 2005; Gonzalez et al., 2006; Sun et al., 2008a). To study the association of iron with metabolic syndrome in normal individuals, a cross-sectional study in 6044 US adults was conducted. "
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    ABSTRACT: Disruptions in iron homeostasis are linked to a broad spectrum of chronic conditions including cardiovascular, malignant, metabolic, and neurodegenerative disease. Evidence supporting this contention derives from a variety of analytical approaches, ranging from molecular to population-based studies. This review focuses on key epidemiological studies that assess the relationship between body iron status and chronic diseases, with particular emphasis on atherosclerosis ,metabolic syndrome and diabetes. Multiple surrogates have been used to measure body iron status, including serum ferritin, transferrin saturation, serum iron, and dietary iron intake. The lack of a uniform and standardized means of assessing body iron status has limited the precision of epidemiological associations. Intervention studies using depletion of iron to alter risk have been conducted. Genetic and molecular techniques have helped to explicate the biochemistry of iron metabolism at the molecular level. Plausible explanations for how iron contributes to the pathogenesis of these chronic diseases are beginning to be elucidated. Most evidence supports the hypothesis that excess iron contributes to chronic disease by fostering excess production of free radicals. Overall, epidemiological studies, reinforced by basic science experiments, provide a strong line of evidence supporting the association between iron and elevated risk of cardiovascular disease and diabetes. In this narrative review we attempt to condense the information from existing literature on this topic.
    Frontiers in Pharmacology 05/2014; 5:117. DOI:10.3389/fphar.2014.00117 · 3.80 Impact Factor
    • "Dietary heme iron intake calculated through multiplying the number 0.4 in total iron content of all meat items. Non-heme iron was also calculated through multiplying the number 0.6 in total iron content of all the meat items plus iron in nonmeat items,[39404142] although validity and reliability of the FFQ in this study have been proved in Tehran.[4344] "
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    ABSTRACT: Some studies have shown that increased rate of iron stores even in a normal range may increase cardiovascular diseases (CVDs) in some individuals. Lipid disorders are also the risk factors for CVDs. Therefore, the question is whether or not iron store is correlated with lipid profile, this study evaluates the association between dietary iron, iron stores and serum lipid profiles. This cross-sectional study was done on 82 healthy university students and university staff females in Isfahan University of Medical Sciences who were in reproductive age and announced their readiness to participate in the study. Serum ferritin concentration, components of lipid profile, blood glucose, and insulin were measured in all the subjects. Dietary intake was assessed by semi-quantitative food frequency questionnaire. Data analysis was done through SPSS software, version 18. Pearson correlation test showed a positive and significant correlation between serum ferritin concentration levels with triglyceride (r = 0.278; P = 0.006), total cholesterol (r = 0.267; P = 0.008), and blood glucose (r = 0.275; P = 0.006); however, the correlation between serum ferritin, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, and insulin was not significant. After adjustment of confounding factors, only the significant correlation occurred for blood glucose (P = 0.016). Before and after adjustment of confounding factors, there was no significant correlation between hemoglobin and hematocrit with concentration of lipid profile components, glucose and insulin. Before and after adjustment of confounding factors, there was no significant correlation between total amount of iron, heme iron, and non-heme dietary iron with concentration of lipid profile components, glucose and insulin. According to the current study, serum ferritin is directly and significantly correlated with concentration of fasting blood glucose, which emphasized on the amount of iron store with blood glucose even in healthy people. The results of the present study indicate no significant correlation between iron store and dietary iron intake with lipid parameters and insulin. Conducting more extensive epidemiologic studies in men and other age groups is recommended.
    02/2014; 3(1):15. DOI:10.4103/2277-9531.127586
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