Original articleClinicalRelationship of Cardiovascular Risk Factors and Serum Ferritin with C-reactive Protein
Introduction
Many studies have suggested a link between abnormal iron storage and the development of atherosclerotic CAD 1, 2, 3, 4, 5. A study on Finnish subjects reported that 2.2 times greater levels of cardiovascular disease were observed in the group with high serum iron compared to the group with low serum iron (6) and serum ferritin was reported to be associated with cardiovascular disease and cardiovascular mortality (7). This link has been referred to as the “iron hypothesis” (3). The rationale for the hypothesis is that iron donates electrons to promote the formation of reactive oxygen species (ROS) such as the hydroxyl radical (•OH) from hydrogen peroxide (H2O2) via the Fenton reaction. Excessive iron in tissues may catalyze the formation of highly reactive forms of oxygen free radicals. Unstable free radicals such as the hydroxyl radical, singlet oxygen or H2O2 can cause oxidation of low-density lipoprotein (LDL), which is a trigger for the development of atherosclerotic CAD (8). Recently a study has reported an association between ferritin and C-reactive protein (CRP) (9). It has been reported that chronic inflammatory reactions promote the progression of atherosclerosis and induce cardiovascular disease. The increase of one inflammatory reaction marker, CRP, is a risk factor for future cardiac events even in healthy individuals 10, 11. CRP has also been shown to be related to various cardiovascular risk factors such as age, total cholesterol levels, triglyceride, blood glucose levels, systolic blood pressure and insulin resistance 12, 13. However, there have been insufficient data (and especially about apparently healthy Asians), to suggest a correlation between CRP and oxidative stress and serum ferritin 6, 14, 15. Therefore, this study investigated the effects of serum ferritin and the cardiovascular risk factors on the CRP levels in Korean subjects.
Section snippets
Study Population
The study population was selected from among subjects who underwent health screening at Kangbuk Samsung Hospital from September to December 2003. We selected a total of 808 subjects (465 males and 343 females) who had their serum ferritin levels measured.
We excluded those subjects who were taking statins, antihypertensive agents or antidiabetic agents, and who had acute or chronic inflammatory diseases, thyroid diseases or any suspicion of malignancies. All subjects gave written informed
Clinical Characteristics of the Study Population
The mean age of the total study population was 47.7 ± 11.1 years, with 43% of the subjects being >50 years old. The male:female ratio was 1.36:1. Of the subjects, 2.6% had a body mass index >30, 6.3% had diabetes, and 28.1% were smokers. The mean body mass index was 24.2 ± 2.9 kg/m2 and 10.0% of the subjects had hypertension. Subjects' mean serum total cholesterol was 209.6 ± 38.4 mg/dL, mean HDL-cholesterol was 55.4 ± 13.1 mg/dL, mean LDL-cholesterol was 118.1 ± 30.9 mg/dL, mean hsCRP was 1.22
Discussion
Inflammatory reactions are well known to induce and accelerate atherosclerosis. Several studies have reported the correlation of the inflammatory reaction marker CRP and the risk of cardiovascular disease 10, 11, 12, 13, 18. CRP and serum ferritin are acute phase reactants that are elevated during inflammation or infection. Salonen (6) reported that increases in serum ferritin accelerate the oxidation of LDL-cholesterol. This oxidized LDL-cholesterol induced inflammation in blood vessels,
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Cited by (14)
Decreased iron stores are associated with cardiovascular disease in patients with type 2 diabetes both cross-sectionally and longitudinally
2018, AtherosclerosisCitation Excerpt :CRP, haemoglobin and fibrinogen levels were measured at the original baseline of ET2DS, one year before ferritin was measured. However, CRP and haemoglobin levels were related to ferritin quintiles in a dose-response manner, which is in line with the positive associations between these markers observed in diverse populations [22,23], although with variable and modest strength in the case of CRP [24–26]. There were slight differences in definitions of CHD and CEVD in the ET2DS and SIDIAP studies due to predetermined ways of establishing variables of disease in each study.
The role of iron in type 2 diabetes in humans
2009, Biochimica et Biophysica Acta - General SubjectsAssociation of γ-Glutamyltransferase with Cardiovascular Risk: A Prognostic Outlook
2009, Archives of Medical ResearchCitation Excerpt :It is also a key component of numerous pathways implicated in inflammation (16). Considerable association of high-sensitivity C-reactive protein, a major inflammatory marker for cardiovascular risk, with GGT and other cardiovascular risk factors has been described implying that elevation of serum GGT (conceivably acting as a marker of oxidative stress) is correlated with subclinical microinflammatory response involved in the pathogenesis of atherosclerosis (17,18). Then, baseline GGT testing can plausibly have an adjunctive merit in estimating cardiovascular risk.
Relation between Serum Ferritin Level and the Risk of Acute Myocardial Infarction
2022, Journal of Association of Physicians of India
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These authors contributed equally to this manuscript.