Highlights
- •The iron-Metabolic syndrome (MetS) link in early life has been little studied.
- •Sustained high ferritin during childhood was related to higher MetS score in boys.
- •The change of ferritin per year was positively associated with MetS in girls.
Abstract
Background and aim
Increased ferritin levels have been widely associated with cardiovascular risk in
adults. Whether ferritin levels and their changes during childhood are related to
metabolic syndrome (MetS) at adolescence is unknown. We aimed to evaluate these associations
using levels of ferritin at 5, 10 and 16 years and their linear increases and patterns
of sustained increased levels across childhood.
Methods and results
There were four samples evaluated according to non-missing values for study variables
at each stage (5 years: 562; 10 years: 381; and 16 years: 567 children; non-missing
values at any stage: 379). MetS risk was evaluated as a continuous Z score. Patterns
of sustained increased ferritin (highest tertile) and slope of the change of ferritin
per year across the follow-up were calculated. Ferritin levels in the highest versus
lowest tertile at five and 16 years were significantly positively associated with
MetS risk Z score at adolescence in boys and these associations were unaffected by
adjustment for covariates. Having high, compared to low/moderate ferritin level at
2 or more time periods between 5 and 16 years was related to higher Mets Z-score in
boys only [e.g. 5–10 years adjusted-beta (95 %CI):0.26 (0.05–0.48),P < 0.05]. In girls,
ferritin Z score at 10 and 16 years was positively and independently associated with
HOMA-IR Z score. In girls, the slope of ferritin per year in the highest tertile was
positively associated with MetS risk Z-score [adjusted-beta (95 %CI):0.21 (0.05–0.38),P < 0.05].
Conclusions
Ferritin levels throughout childhood are positively related to cardiometabolic risk
in adolescence, with associations varying by sex.
Keywords
Abbreviations:
MetS (Metabolic syndrome), HDL-C (High density lipoprotein cholesterol), SBP (Systolic blood pressure), DBP (Diastolic blood pressure), TG (Triglyceride), BMI (Body mass index), WC (Waist circumference), CRP (C-reactive protein), HOMA-IR (homeostasis model assessment-Insulin Resistance)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Nutrition, Metabolism and Cardiovascular DiseasesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Ferritin levels and risk of metabolic syndrome: meta-analysis of observational studies.BMC Public Health. 2014; 14: 483
- Dietary iron intake, body iron stores, and the risk of type 2 diabetes: a systematic review and meta-analysis.BMC Med. 2012; 10: 119
- Association of iron indices and type 2 diabetes: a meta-analysis of observational studies.Diabetes Metabol Res Rev. 2014; 30: 372-394
- Cross-talk between iron metabolism and diabetes.Diabetes. 2002; 51: 2348-2354
- Mechanisms linking glucose homeostasis and iron metabolism toward the onset and progression of type 2 diabetes.Diabetes Care. 2015; 38: 2169-2176
- Iron deficiency and cardiovascular disease: an updated review of the evidence.Curr Atheroscler Rep. 2013; 15: 358
- Behavioral and developmental effects of preventing iron-deficiency anemia in healthy full-term infants.Pediatrics. 2003; 112: 846-854
- High cardiometabolic risk in healthy Chilean adolescents: associations with anthropometric, biological and lifestyle factors.Publ Health Nutr. 2016; 19: 486-493
- Features of the metabolic syndrome are associated with objectively measured physical activity and fitness in Danish children: the European Youth Heart Study (EYHS).Diabetes Care. 2004; 27: 2141-2148
- Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man.Diabetologia. 1985; 28: 412-419
- Iron in child obesity. Relationships with inflammation and metabolic risk factors.Nutrients. 2013; 5: 2222-2230
- Relationship between serum levels of body iron parameters and insulin resistance and metabolic syndrome in Korean children.Osong Publ Health Res Perspect. 2014; 5: 204-210
- Hepcidin and iron metabolism associated with cardiometabolic risk factors in children: a case-control study. Nutrition, metabolism, and cardiovascular diseases.Nutr Metabol Cardiovasc Dis. 2016; 26: 525-533
- Serum ferritin level is higher in male adolescents with obesity: results from the Korean National Health and Nutrition Examination Survey 2010.Ann Pediatr Endocrinol Metabol. 2013; 18: 141-147
- Relationship between serum ferritin levels and dyslipidemia in Korean adolescents.PLoS One. 2016; 11: e0153167
- Serum ferritin concentrations predict incidence of metabolic syndrome in rural Korean adults.Clin Chem Lab Med : CCLM / FESCC. 2012; 50: 2057-2059
- Ferritin and transferrin are associated with metabolic syndrome abnormalities and their change over time in a general population: data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR).Diabetes Care. 2007; 30: 1795-1801
- Iron metabolism and incidence of metabolic syndrome.Nutr Metabol Cardiovasc Dis : Nutr Metabol Cardiovasc Dis. 2015;
- Serum ferritin and risk of the metabolic syndrome in U.S. adults.Diabetes Care. 2004; 27: 2422-2428
- Association of elevated serum ferritin concentration with insulin resistance and impaired glucose metabolism in Korean men and women.Metab Clin Exp. 2011; 60: 414-420
- Coexistence of anaemia and the metabolic syndrome in adults in Jiangsu, China.Asia Pac J Clin Nutr. 2008; 17: 505-513
- Serum ferritin levels and the development of metabolic syndrome and its components: a 6.5-year follow-up study.Diabetol Metab Syndrome. 2014; 6: 114
- Iron stores, liver transaminase levels and metabolic risk in healthy teenagers.Eur J Clin Investig. 2010; 40: 155-163
- The association of multiple biomarkers of iron metabolism and type 2 diabetes: the EPIC-interact study.Diabetes Care. 2016; 39: 572-581
- Obesity and iron deficiency: a quantitative meta-analysis.Obes Rev. 2015; 16: 1081-1093
- Ferritin is a marker of inflammation rather than iron deficiency in overweight and obese people.J Obes. 2016; 2016: 1937320
- A diagnostic approach to hyperferritinemia with a non-elevated transferrin saturation.J Hepatol. 2011; 55: 453-458
- Hepatic steatosis in obese patients: clinical aspects and prognostic significance.Obes Rev. 2004; 5 ([Review]): 27-42
- A review of iron studies in overweight and obese children and adolescents: a double burden in the young?.Eur J Nutr. 2016; 55: 2179-2197
- Adiponectin and development of type 2 diabetes in the Pima Indian population.Lancet. 2002; 360: 57-58
- Risk factors, atherosclerosis, and cardiovascular disease among aboriginal people in Canada: the study of health assessment and risk evaluation in aboriginal peoples (SHARE-AP).Lancet. 2001; 358: 1147-1153
- C-reactive protein, cardiovascular risk, and renal disease in a remote Australian Aboriginal community.Clin Sci. 2004; 106: 121-128
- Iron deficiency and cardiovascular disease: an updated review of the evidence.Curr Atheroscler Rep. 2013; 15: 358
Article info
Publication history
Published online: December 04, 2018
Accepted:
November 26,
2018
Received in revised form:
October 10,
2018
Received:
February 27,
2018
Handling Editor: Dr. A. SianiIdentification
Copyright
© 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.
