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Published on: October 12, 2017
Association of ferritin and lipids with C-reactive protein
Arch G Mainous1, Brian J Wells, Charles J Everett
1Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina 29425, USA. mainouag@musc.edu
Insights
Elevated iron stores (ferritin) and lipids, particularly low high-density lipoprotein, are linked to increased cardiovascular inflammation (CRP). This suggests iron and lipids together may promote vascular inflammation.
Area of Science:
- Biochemistry
- Cardiovascular Medicine
- Public Health
Background:
- C-reactive protein (CRP) and low-density lipoprotein (LDL) are established cardiovascular disease risk markers.
- The correlation between CRP and LDL is not strong, suggesting other factors influence vascular inflammation.
- Iron, through oxidative stress, may contribute to lipid-induced vascular inflammation.
Purpose of the Study:
- To investigate the relationship between ferritin (a marker of iron stores), lipids, and CRP in US adults.
- To determine if ferritin and lipid levels independently or interactively predict elevated CRP.
- To explore the role of iron in lipid-induced inflammation.
Main Methods:
- Analysis of data from the National Health and Nutrition Examination Survey III (1988-1994).
- Inclusion of US adults aged 25 years and older.
- Statistical models adjusted for age, gender, race, and other potential confounders to assess associations between ferritin, lipids (total cholesterol, LDL, HDL), and CRP.
Main Results:
- Neither elevated ferritin nor elevated LDL alone was significantly associated with elevated CRP in adjusted models.
- Individuals with both elevated ferritin and elevated LDL showed a significantly higher likelihood of elevated CRP.
- Individuals with elevated ferritin and low high-density lipoprotein also demonstrated a significantly increased likelihood of elevated CRP.
Conclusions:
- Both iron stores and lipid profiles appear to contribute to systemic inflammation.
- The combination of elevated iron stores and abnormal lipid levels synergistically increases the risk of elevated CRP.
- Further research into preventive strategies targeting iron reduction in patients with dyslipidemia is warranted.
Abstract:
C-reactive protein (CRP) and lipids (e.g., low-density lipoprotein [LDL]) are both markers of cardiovascular disease risk, yet they are not highly correlated. Oxidative stress of lipids induced by iron may play a role in vascular inflammation, as indicated by CRP. The purpose of this study was to examine, in a representative sample of United States adults, the relation between ferritin, lipids, and CRP. We analyzed data on adults (aged > or =25 years) in the National Health and Nutrition Examination Survey III, a national public-use data set collected between 1988 and 1994. Ferritin, total cholesterol, LDL, high-density lipoprotein, and ferritin-lipid combinations were analyzed in relation to CRP in age-, gender-, and race-adjusted models as well as models with other potential confounding variables. In adjusted models, neither elevated ferritin (odds ratio [OR] 1.11, 95% confidence interval [CI] 0.94 to 1.32) nor elevated LDL was significantly associated with elevated CRP (OR 1.03, 95% CI 0.79 to 1.33). Patients with elevated ferritin and elevated LDL were more likely to have elevated CRP (OR 1.68; 95% CI 1.06 to 2.68). Patients with elevated ferritin and low high-density lipoprotein were also more likely to have elevated CRP (OR 1.71; 95% CI 1.28 to 2.27). These results suggest that both iron and lipids induce inflammation. Future research needs to focus on preventive medicine to decrease iron in patients with elevated lipids.
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