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Iron status and cardiometabolic risk in children
Milton Fabian Suárez-Ortegón1, Anna Prats-Puig2, Judit Bassols3
1Departamento de Alimentación y Nutrición, Pontificia Universidad Javeriana Seccional Cali, Cali, Colombia; Grupo de Ciencias Básicas y Clínicas de la Salud, Pontificia Universidad Javeriana Seccional Cali, Cali, Colombia.
Insights
Lower iron status in children is linked to higher HbA1c and metabolic syndrome (MetS) risk. Higher ferritin levels showed associations with other cardiometabolic markers, influenced by inflammation and body mass.
Area of Science:
- Pediatric Endocrinology
- Nutritional Biochemistry
- Metabolic Health
Background:
- Metabolic syndrome (MetS) is a growing concern in pediatric populations.
- Iron status, indicated by serum ferritin and transferrin, plays a role in various physiological processes.
- Understanding the relationship between iron status and MetS components in children is crucial for early intervention.
Purpose of the Study:
- To investigate the associations between serum ferritin and transferrin levels and metabolic syndrome (MetS) variables in children.
- To examine the longitudinal changes in MetS components in relation to baseline iron status.
Main Methods:
- A longitudinal study involving 832 prepubertal children aged 3-14 years.
- A subset of 203 children underwent re-examination after a mean follow-up of 3.7 years.
- Outcomes included MetS, MetS components, glycosylated hemoglobin (HbA1c), and their changes over time.
Main Results:
- Lower ferritin levels were independently associated with increased HbA1c Z scores and glycaemia.
- Transferrin levels correlated with diastolic blood pressure and insulin resistance (HOMA-IR).
- MetS risk score worsened during follow-up in children with the lowest baseline ferritin; higher ferritin was linked to other MetS markers, but these associations were attenuated after adjustments.
Conclusions:
- Reduced iron status in children is independently linked to glycaemic control and MetS.
- Higher ferritin levels are associated with other cardiometabolic risk factors, influenced by inflammation, liver function, and body mass.
- Further research is needed to determine if these findings represent early risk or normal developmental changes.
Aim:
We aimed to evaluate associations between serum ferritin and transferrin and variables related to the metabolic syndrome (MetS) in children.
Methods:
Cross-sectional and longitudinal study in prepubertal children (n = 832) aged 3-14 years. A subset (n = 203) were re-examined after a mean follow-up of 3.7 ± 0.8 years[range 2-6]. Outcomes were MetS and MetS components scores, glycosylated haemoglobin (HbA1c), and their follow-up change.
Results:
Children with low ferritin had increased HbA1c Z scores (ANCOVA, P = 0.003). Ferritin was inversely associated with glycaemia [fully adjusted β (95% confidence interval): -2.35(-4.36 to -0.34)]. Transferrin was associated with diastolic blood pressure [β: 0.02(0.01-0.04)] and log-HOMA-IR [β:0.001(0.0005-0.002)]. MetS risk score worsened during follow-up in children with the lowest baseline ferritin levels. In contrast, at baseline ferritin was positively associated with all (except glycaemia) the MetS-related variables but adjustments for inflammatory, hepatic function, and body mass markers attenuated those associations (P > 0.05).
Conclusions:
Lower iron status was independently associated with glycaemic markers and MetS in children, whereas higher ferritin levels were related to other cardiometabolic risk markers under the influence of inflammation, hepatic injury and body mass. Research is required to study whether this mixed pattern is part of an early risk or would be explained by a normal transition during growth and development.
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