Serum Ferritin and Risk of the Metabolic Syndrome: a Population-based Study

血清鐵蛋白與代謝症候群危險性：族群基礎研究

Jung-Su Chang ； Shiue-Ming Lin ； Tzu-chieh Huang ； Jane C-J Chao ； Yi-Chun Chen ； Wen-Harn Pan ； Chyi-Huey Bai

《Asia Pacific Journal of Clinical Nutrition》 22卷3期 (2013/08) Pp. 400-407

https://doi.org/10.6133/apjcn.2013.22.3.07

摘要

Ferritin concentrations in circulation reflect iron stores in healthy individuals. However, elevated serum ferritin (SF) concentrations have recently been implicated in the pathogenesis of the metabolic syndrome (MetS). We aim to investigate factors associated with elevated SF and to evaluate the association between SF and risk of MetS in Taiwanese adults. Data was collected from 2654 healthy individuals aged ≥19 years old, who participated in the Nutrition and Health Survey in Taiwan (NAHSIT Adults 2005-2008). Mean concentrations of SF were 173±282ng/mL (men 229±349 ng/mL and women 119±180 ng/mL). Prevalence proportion of MetS was 34.6% (men 43.1% and women 26.5%). Prevalence proportion of iron overload was 18.6% (men 21.5% and women 15.8%) and iron deficiency anemia was 5.2% (2.0% for men and 8.3% for women). Individuals with the highest SF tertile (T3) were more likely to consume higher amount of animal protein (p=0.001), betel nuts (p=0.004), and lower amounts of carbohydrates (p＜0.0001), compared with the lowest SF group (T1). After adjustments, individuals with the highest SF tertile were associated with risk of MetS compared with those with the lowest (OR=1.724, 95% CI: 1.21-2.45). Serum ferritin concentrations showed a gradient relationship with individual components of MetS (all p＜0.0001). Individuals with the highest SF tertile were significantly associated with fasting serum glucose (OR=2.16, 95% CI: 1.75-2.65) and serum triglyceride (OR=2.58, 95% CI: 1.07-3.22) than those with the lowest. In conclusions, our results highlight the crucial role of serum ferritin in the pathogenesis of the MetS in healthy Taiwanese adults.

關鍵字

代謝症候群 ； 血清儲鐵蛋白 ； 臺灣國民營養調查 ； 膳食鐵攝取 ； 肥胖

並列摘要

Ferritin concentrations in circulation reflect iron stores in healthy individuals. However, elevated serum ferritin (SF) concentrations have recently been implicated in the pathogenesis of the metabolic syndrome (MetS). We aim to investigate factors associated with elevated SF and to evaluate the association between SF and risk of MetS in Taiwanese adults. Data was collected from 2654 healthy individuals aged ≥19 years old, who participated in the Nutrition and Health Survey in Taiwan (NAHSIT Adults 2005-2008). Mean concentrations of SF were 173±282ng/mL (men 229±349 ng/mL and women 119±180 ng/mL). Prevalence proportion of MetS was 34.6% (men 43.1% and women 26.5%). Prevalence proportion of iron overload was 18.6% (men 21.5% and women 15.8%) and iron deficiency anemia was 5.2% (2.0% for men and 8.3% for women). Individuals with the highest SF tertile (T3) were more likely to consume higher amount of animal protein (p=0.001), betel nuts (p=0.004), and lower amounts of carbohydrates (p＜0.0001), compared with the lowest SF group (T1). After adjustments, individuals with the highest SF tertile were associated with risk of MetS compared with those with the lowest (OR=1.724, 95% CI: 1.21-2.45). Serum ferritin concentrations showed a gradient relationship with individual components of MetS (all p＜0.0001). Individuals with the highest SF tertile were significantly associated with fasting serum glucose (OR=2.16, 95% CI: 1.75-2.65) and serum triglyceride (OR=2.58, 95% CI: 1.07-3.22) than those with the lowest. In conclusions, our results highlight the crucial role of serum ferritin in the pathogenesis of the MetS in healthy Taiwanese adults.

並列關鍵字

metabolic syndrome ； serum ferritin ； National Nutrition and Health Survey in Taiwan ； dietary iron intake ； obesity

參考文獻

Bentley DP, Williams P. Serum ferritin concentration as an index of storage iron in rheumatoid arthritis. J Clin Pathol. 1974;27:786-8. doi: 10.1136/jcp.27.10.786

Fernandez-Real JM, Penarroja G, Castro A, Garcia-Bragado F, Hernandez-Aguado I, Ricart W. Blood letting in highferritin type 2 diabetes: effects on insulin sensitivity and beta-cell function. Diabetes. 2002;51:1000-4. doi: 10.2337/ diabetes.51.4.1000

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;93:4690-6. doi: 10.1210/jc.2008-1159

Yang WS, Lee WJ, Funahashi T, Tanaka S, Matsuzawa Y, Chao C et al. Plasma adiponectin levels in overweight and obese Asians. Obes Res. 2002;10: 1104-10. doi: 10.1038/oby.2002.150

Phelps G, Chapman I, Hall P, Braund W, Mackinnon M. Prevalence of genetic haemochromatosis among diabetic patients. Lancet. 1989;2:233-4. doi: 10.1016/S0140-6736(89) 90426-1