Association between Serum Ferritin Levels and Risk of the Metabolic Syndrome in Chinese Adults: A Population Study

Abstract

Ferritin is a ubiquitous intracellular protein that can store and release iron and act as a buffer against iron deficiency and iron overload. Ferritin is widely used as a clinical biomarker to evaluate iron status. Increased serum ferritin concentrations have been reported to be associated with metabolic syndrome (MetS) features. However, serum ferritin concentrations differ significantly according to sex and ethnicity, and the data concerning the relationship between serum ferritin concentrations and MetS in Asian men and women are conflicting. This study aimed to explore the relationship between serum ferritin and MetS in Chinese population. Fasting blood samples and anthropometric data collected on 8,441 adults aged 18 and older in 2009 as part of the China Health and Nutrition Survey, a large-scale longitudinal, household-based survey in China. Data was collected by trained physicians and biomarkers were measured with Hitachi Clinical Autoanalyzer 7600 D model and P model. Median levels of serum ferritin were significantly higher in men compared with women (121.9 vs. 51.0 ng/ml, P < 0.001), and significantly lower in non metabolic syndrome population with MetS population (73.2 vs. 106.0 ng/ml, P < 0.001). The difference remained significant after further adjusted for age, nationality, Body mass index (BMI), smoking status, and alcohol consumption. For both men and women, the highest prevalence of MetS occurred in the highest quartile of serum ferritin. The odds ratios increased progressively across the ferritin quartiles (P<0.001 for trend). Increased serum ferritin concentrations are associated with the metabolic syndrome among men and women in China.

The Association of Serum Ferritin and Metabolic Syndrome and Metabolic Syndrome Score in Korean Adults

“…The results of our study showed that serum ferritin level of the MetS group was higher than that of the non-MetS group (p＜0.001) in the each of the gender-based groups. These results are consistent with previous studies [14,29] that did find significant differences in serum ferritin related to MetS.…”

“…Among previous studies on serum ferritin concentration and MetS, Li and colleagues reported that serum ferritin levels were positively associated with MetS in both Chinese men and women [29]. Moreover, Vari and colleagues reported that serum ferritin levels were positively associated with MetS in French men and premenopausal women and postmenopausal women [14].…”

“…However, the association of MetS and serum ferritin concentration is still being debated, as the findings vary across studies. That is, some report that MetS or its components are associated with serum ferritin concentration [14][15][16][17], others that they are not [18,19]. Some report that association of the MetS or serum ferritin levels differ according to sex [20,21].…”

Relationship between Alcohol Intake and Risk Factors for Metabolic Syndrome in Men

“…Some papers have reported an association between serum ferritin levels and risk for MetS; high-normal ferritin concentrations are associated with central adiposity (19), hypertension (20), elevated fasting insulin and blood glucose (21), dyslipidemia (22) and MetS (23). The relationships between ferritin and TG and between ferritin and FPG observed our study completely concurred with previous reports.…”

Biomarcadores del metabolismo y nutrición de hierro

“…Existe evidencia de que concentraciones séricas elevadas de ferritina se asocian con mayor riesgo de desarrollo de diabetes y sus complicaciones (28) , resistencia a la insulina (29) , síndrome metabólico (30) e hipertensión (31) . Cuando la exposición a la inflamación es alta, se recomiendan el uso como biomarcadores la concentración de receptor de transferrina soluble (RTfs) (ver abajo) o la relación de RTfs:ferritina ya que serían menos afectados por el proceso inflamatorio (27) .…”