Racial Health Disparities, and Variant Red Cell and Iron Homeostasis

Area of Science:

• Biochemistry
• Hematology
• Health Disparities

Background:

• Oxidative stress from excess iron is a potential contributor to racial health disparities.
• Previous research indicated differing clinical outcomes based on ferritin and transferrin saturation (%TS) in White versus Black participants with peripheral arterial disease.

Purpose of the Study:

• To investigate racially variant interactions between hemoglobin, ferritin, and %TS levels.
• To explore potential mechanisms underlying racial health disparities related to iron metabolism.

Main Methods:

• Analysis of hemoglobin, ferritin, and %TS levels across racial groups within cardiovascular disease risk categories.
• Examination of the relationship between ferritin levels and hemoglobin, and the impact of ferritin on %TS in White and Black participants.

Main Results:

• Black participants exhibited lower hemoglobin and %TS levels, and higher ferritin levels compared to White participants.
• Ferritin levels near 80 ng/mL correlated with higher hemoglobin in White but not Black individuals.
• The effect of higher %TS with ferritin > 80 ng/mL was diminished in Black participants.
• Ferritin/%TS ratios were significantly higher in Black than White participants.

Conclusions:

• Iron incorporation into hemoglobin and scavenging by transferrin may be less effective in buffering iron toxicity in Black individuals.
• Metabolic vulnerability to iron excess may partially explain observed racial health disparities.