PDF
ePub
Citation
Print
Abstract
Objectives
The purpose of this study was to examine the relationship between serum ferritin and metabolic syndrome in peri- and postmenopausal women.
Methods
The study subjects consisted of 2,091 peri- and postmenopausal women who visited the hospital for a health check-up in 2007. They were divided into the metabolic syndrome group (MetS) and the non-metabolic syndrome group (Non-MetS).
Results
Mean serum ferritin values were 65.16 ± 33.69 ng/mL in MetS and 57.82 ± 32.51 ng/mL in Non-MetS (P = 0.000). In MetS, serum ferritin had a positive correlation with hemoglobin (Hb), insulin, homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride, aspartate transaminase (SGOT), alanine transaminase (SGPT), uric acid, and high-sensitivity C-reactive protein (hs-CRP) but a negative correlation with high-density lipoprotein (HDL)-cholesterol and low-density lipoprotein (LDL)-cholesterol (P < 0.05). From multiple linear models, hs-CRP, HDL-cholesterol, SGOT, HOMA-IR, and hemoglobin level were found to be the best predictors of serum ferritin in MetS (R2 = 0.106; P < 0.05).
Figures and Tables
Table 1
Comparison of baseline characteristics between metabolic syndrome and non-metabolic syndrome
HbA1c: hemoglobin A1c, Values given are number of patients (%) or mean ± SD. HOMA-IR: homeostasis model assessment insulin resistance, HDL: high-density lipoprotein, LDL: low-density lipoprotein, SGOT: aspartate transaminase, SGPT: alanine transaminase, γGTP: γ-glutamyl transpeptidase, hs-CRP: high-sensitivity C-reactive protein. T-test (continuous variables): *P value using chi-square test (categorical variables).
Table 2
Correlations between serum ferritin§ and various parameters in total, metabolic syndrome and non-metabolic syndrome
HbA1c: hemoglobin A1c, HOMA-IR: homeostasis model assessment insulin resistance, HDL: high-density lipoprotein, LDL: low-density lipoprotein, SGOT: aspartate transaminase, SGPT: alanine transaminase, γGTP: γ-glutamyl transpeptidase, hs-CRP: high-sensitivity C-reactive protein. Pearson correlation coefficient: *spearman's correlation coefficient; †P < 0.05; ‡P < 0.01. §Log-transformed values were used for analysis.
Table 3
Associations of serum ferritin with various parameters by multiple linear regression analysis
References
1. Expert Panel on Detection Evaluation and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001. 285:2486–2497.
2. Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002. 288:2709–2716.
3. Hanson RL, Imperatore G, Bennett PH, Knowler WC. Components of the "metabolic syndrome" and incidence of type 2 diabetes. Diabetes. 2002. 51:3120–3127.
4. Cook JD, Skikne BS. Serum ferritin: a possible model for the assessment of nutrient stores. Am J Clin Nutr. 1982. 35:1180–1185.
5. Gillum RF. Association of serum ferritin and indices of body fat distribution and obesity in Mexican American men--the Third National Health and Nutrition Examination Survey. Int J Obes Relat Metab Disord. 2001. 25:639–645.
6. Freixenet N, Remacha A, Berlanga E, Caixas A, Gimenez-Palop O, Blanco-Vaca F, et al. Serum soluble transferrin receptor concentrations are increased in central obesity. Results from a screening programme for hereditary hemochromatosis in men with hyperferritinemia. Clin Chim Acta. 2009. 400:111–116.
7. Piperno A, Trombini P, Gelosa M, Mauri V, Pecci V, Vergani A, et al. Increased serum ferritin is common in men with essential hypertension. J Hypertens. 2002. 20:1513–1518.
8. Halle M, Konig D, Berg A, Keul J, Baumstark MW. Relationship of serum ferritin concentrations with metabolic cardiovascular risk factors in men without evidence for coronary artery disease. Atherosclerosis. 1997. 128:235–240.
9. Williams MJ, Poulton R, Williams S. Relationship of serum ferritin with cardiovascular risk factors and inflammation in young men and women. Atherosclerosis. 2002. 165:179–184.
10. Tuomainen TP, Nyyssonen K, Salonen R, Tervahauta A, Korpela H, Lakka T, et al. Body iron stores are associated with serum insulin and blood glucose concentrations. Population study in 1,013 eastern Finnish men. Diabetes Care. 1997. 20:426–428.
11. Walker BL, Tiong JW, Jefferies WA. Iron metabolism in mammalian cells. Int Rev Cytol. 2001. 211:241–278.
12. Richardson DR, Ponka P. The molecular mechanisms of the metabolism and transport of iron in normal and neoplastic cells. Biochim Biophys Acta. 1997. 1331:1–40.
13. Ferrannini E. Insulin resistance, iron, and the liver. Lancet. 2000. 355:2181–2182.
14. Niederau C, Berger M, Stremmel W, Starke A, Strohmeyer G, Ebert R, et al. Hyperinsulinaemia in non-cirrhotic haemochromatosis: impaired hepatic insulin degradation. Diabetologia. 1984. 26:441–444.
15. Salonen JT, Tuomainen TP, Nyyssonen K, Lakka HM, Punnonen K. Relation between iron stores and non-insulin dependent diabetes in men: case-control study. BMJ. 1998. 317:727.
16. Wolff SP. Diabetes mellitus and free radicals. Free radicals, transition metals and oxidative stress in the aetiology of diabetes mellitus and complications. Br Med Bull. 1993. 49:642–652.
17. Gonzalez AS, Guerrero DB, Soto MB, Diaz SP, Martinez-Olmos M, Vidal O. Metabolic syndrome, insulin resistance and the inflammation markers C-reactive protein and ferritin. Eur J Clin Nutr. 2006. 60:802–809.
18. Mainous AG 3rd, Wells BJ, Everett CJ, Gill JM, King DE. Association of ferritin and lipids with C-reactive protein. Am J Cardiol. 2004. 93:559–562.
19. Yuan XM, Brunk UT, Olsson AG. Effects of iron- and hemoglobin-loaded human monocyte-derived macrophages on oxidation and uptake of LDL. Arterioscler Thromb Vasc Biol. 1995. 15:1345–1351.
20. Pratico D, Pasin M, Barry OP, Ghiselli A, Sabatino G, Iuliano L, et al. Iron-dependent human platelet activation and hydroxyl radical formation: involvement of protein kinase C. Circulation. 1999. 99:3118–3124.
21. Jehn M, Clark JM, Guallar E. Serum ferritin and risk of the metabolic syndrome in U.S. adults. Diabetes Care. 2004. 27:2422–2428.
22. Sun L, Franco OH, Hu FB, Cai L, Yu Z, Li H, et al. Ferritin concentrations, metabolic syndrome, and type 2 diabetes in middle-aged and elderly chinese. J Clin Endocrinol Metab. 2008. 93:4690–4696.
23. Jiang R, Manson JE, Meigs JB, Ma J, Rifai N, Hu FB. Body iron stores in relation to risk of type 2 diabetes in apparently healthy women. JAMA. 2004. 291:711–717.
24. Cho YS, Kang JH, Kim SA, Shim KW, Lee HS. Association of serum ferritin and abdominal obesity and insulin resistance. Korean J Obes. 2005. 14:76–81.
25. Lee BK, Kim Y, Kim YI. Association of serum ferritin with metabolic syndrome and diabetes mellitus in the South Korean general population according to the Korean National Health and Nutrition Examination Survey 2008. Metabolism. 2011. 60:1416–1424.
26. Kim CH, Kim HK, Bae SJ, Park JY, Lee KU. Association of elevated serum ferritin concentration with insulin resistance and impaired glucose metabolism in Korean men and women. Metabolism. 2011. 60:414–420.
27. Choi KM, Lee KW, Kim HY, Seo JA, Kim SG, Kim NH, et al. Association among serum ferritin, alanine aminotransferase levels, and metabolic syndrome in Korean postmenopausal women. Metabolism. 2005. 54:1510–1514.
28. Ryu SY, Kim KS, Park J, Kang MG, Han MA. Serum ferritin and risk of the metabolic syndrome in some Korean rural residents. J Prev Med Public Health. 2008. 41:115–120.
29. Kim HK, Lim JH, Kwon ER, Park YJ, Kim NE, Noh WY, et al. Serum ferritin and risk of the metabolic syndrome in Korean adults. Korean J Obes. 2010. 19:48–55.
30. Cho GJ, Shin JH, Yi KW, Park HT, Kim T, Hur JY, et al. Serum ferritin levels are associated with metabolic syndrome in postmenopausal women but not in premenopausal women. Menopause. 2011. 18:1120–1124.
31. Ryoo JH, Kim MG, Lee DW, Shin JY. The relationship between serum ferritin and metabolic syndrome in healthy Korean men. Diabetes Metab Res Rev. 2011. 27:597–603.
32. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985. 28:412–419.
33. Lee S, Park HS, Kim SM, Kwon HS, Kim DY, Kim DJ, et al. Cut-off points of waist circumference for defining abdominal obesity in the Korean population. Korean J Obes. 2006. 15:1–9.
34. Sullivan JL. Iron and the sex difference in heart disease risk. Lancet. 1981. 1:1293–1294.
35. Fischer JG, Glauert HP, Yin T, Sweeney-Reeves ML, Larmonier N, Black MC. Moderate iron overload enhances lipid peroxidation in livers of rats, but does not affect NF-kappaB activation induced by the peroxisome proliferator, Wy-14,643. J Nutr. 2002. 132:2525–2531.
36. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2002. 105:1135–1143.
37. Fernandez-Real JM, Ricart-Engel W, Arroyo E, Balanca R, Casamitjana-Abella R, Cabrero D, et al. Serum ferritin as a component of the insulin resistance syndrome. Diabetes Care. 1998. 21:62–68.
38. Han AR, Kwon KY, Kim SH, Lim JA, Lee DC, Lee HR. Relationship of serum ferritin with cardiovascular risk factors. J Korean Acad Fam Med. 2006. 27:358–363.
39. Oh ES, Shin HS, Lee JW, Lim JA, Lee DC, Lee HR. The Relationship between serum ferritin and high sensitivity C-reactive protein among adults in a health promotion center. J Korean Acad Fam Med. 2008. 29:908–914.
XML Download