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Serum ferritin and incident cardiometabolic diseases in Scottish adults

Milton-Fabian Suárez-Ortegón1,2, Stela McLachlan3, José-Manuel Fernandez-Real4

  • 1Departamento de Alimentación Y Nutrición, Facultad de Ciencias de La Salud, Pontificia Universidad Javeriana Seccional Cali, Calle 18 No. 118-250, Cali, Colombia. fabian.suarezuv@gmail.com.

Cardiovascular Diabetology
|February 17, 2022
PubMed

Insights

High iron stores, indicated by serum ferritin levels, are linked to an increased risk of type 2 diabetes (T2D) and cerebrovascular disease (CEVD). This association is independent and highlights the differential impact of iron on cardiometabolic diseases.

Area of Science:

  • Cardiovascular and Metabolic Science
  • Nutritional Biochemistry
  • Epidemiology

Background:

  • Previous research suggests a link between iron stores (ferritin) and type 2 diabetes (T2D).
  • Associations between iron stores and coronary heart disease (CHD) or cerebrovascular disease (CEVD) remain unclear.
  • This study is the first to simultaneously assess iron stores against T2D, CHD, and CEVD in one population.

Purpose of the Study:

  • To investigate the relationship between serum ferritin levels and the risk of developing T2D, CHD, and CEVD.
  • To evaluate these associations within a large Scottish population across a broad spectrum of ferritin concentrations.

Main Methods:

  • A longitudinal study followed 6,497 participants from Scottish health surveys (1995/1998) until 2011.
  • Cox regression models were employed, adjusting for multiple risk factors including age, smoking, BMI, and blood pressure.
  • Serum ferritin was analyzed as both a continuous variable (Z-score) and categorized into quartiles, quintiles, and sextiles.

Main Results:

  • During follow-up, T2D developed in 4.9%, CHD in 5.3%, and CEVD in 2.3% of participants.
  • Higher ferritin levels showed a positive association with T2D, CHD, and CEVD.
  • After covariate adjustment, only the association between high ferritin and T2D remained significant (HR 1.59). However, using sextiles, a significant association emerged between high ferritin and CEVD (HR 2.08).

Conclusions:

  • Iron stores (serum ferritin) exhibit distinct relationships with different cardiometabolic diseases (CMD).
  • Serum ferritin is independently associated with an increased risk of incident T2D.
  • Elevated serum ferritin levels are also linked to incident CEVD, particularly when higher thresholds are considered.
Abstract

Keywords:
Cardiovascular diseaseCerebrovascular diseaseIron metabolismMetabolic syndromeObesityType 2 diabetes

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