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Association between iron status and incident coronary artery disease: a population based-cohort study. Sci Rep 2022; 12:17490. [PMID: 36261681 PMCID: PMC9581887 DOI: 10.1038/s41598-022-22275-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 10/12/2022] [Indexed: 01/12/2023] Open
Abstract
Disorders of iron metabolism has been implicated in cardiovascular disease. However, the association of serum iron stores and coronary artery disease (CAD) remains inconsistent. Here, we investigated the associations of serum iron metabolism with the incidence of CAD, the severity of coronary artery stenosis, metabolic biomarkers, and the risk of major adverse cardiovascular event (MACE). A total of 643 CAD patients and 643 healthy controls were enrolled to assess the associations of serum iron status with the presence of CAD, the severity of CAD, and the risk of MACE. Serum iron metabolism and other metabolic markers were measured in all subjects. All statistical analyses were analyzed using SPSS22.0 software and STATA statistical package. Serum level of iron metabolism markers, including serum iron, unsaturated transferrin iron binding capacity (UIBC), Total iron binding capacity (TIBC) levels, in CAD groups was significantly lower than the control group (P < 0.001). UIBC and TIBC were negatively correlated with ferritin in both sexes. Each unit increase of serum iron and TIBC were found to have a protective role for CAD in women (iron: OR 0.794, 95% CI (0.647-0.973), TIBC: OR 0.891, 95% CI (0.795-0.999), P < 0.05). However, high ferritin level was significant associated the CAD incident in both sexes (OR 1.029, 95% CI (1.002-1.058) in men, OR 1.013, 95% CI (1.0-1.025) in women, P < 0.05). Serum iron metabolism markers exhibited no significant association with the severity of CAD. Increased serum level of iron and TIBC levels were found to have a protective role for CAD in women, but not in men. Elevated serum ferritin is independently and positively associated with CAD in men and women.
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Xu C, Li W, Li T, Yuan J, Pang X, Liu T, Liang B, Cheng L, Sun X, Dong S. Iron metabolism-related genes reveal predictive value of acute coronary syndrome. Front Pharmacol 2022; 13:1040845. [PMID: 36330096 PMCID: PMC9622999 DOI: 10.3389/fphar.2022.1040845] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/04/2022] [Indexed: 11/25/2022] Open
Abstract
Iron deficiency has detrimental effects in patients with acute coronary syndrome (ACS), which is a common nutritional disorder and inflammation-related disease affects up to one-third people worldwide. However, the specific role of iron metabolism in ACS progression is opaque. In this study, we construct an iron metabolism-related genes (IMRGs) based molecular signature of ACS and to identify novel iron metabolism gene markers for early stage of ACS. The IMRGs were mainly collected from Molecular Signatures Database (mSigDB) and two relevant studies. Two blood transcriptome datasets GSE61144 and GSE60993 were used for constructing the prediction model of ACS. After differential analysis, 22 IMRGs were differentially expressed and defined as DEIGs in the training set. Then, the 22 DEIGs were trained by the Elastic Net to build the prediction model. Five genes, PADI4, HLA-DQA1, LCN2, CD7, and VNN1, were determined using multiple Elastic Net calculations and retained to obtain the optimal performance. Finally, the generated model iron metabolism-related gene signature (imSig) was assessed by the validation set GSE60993 using a series of evaluation measurements. Compared with other machine learning methods, the performance of imSig using Elastic Net was superior in the validation set. Elastic Net consistently scores the higher than Lasso and Logistic regression in the validation set in terms of ROC, PRC, Sensitivity, and Specificity. The prediction model based on iron metabolism-related genes may assist in ACS early diagnosis.
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Affiliation(s)
- Cong Xu
- Shenzhen People’s Hospital, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medicine College of Jinan University, Shenzhen, China
| | - Wanyang Li
- School of Mathematics, South China University of Technology, Guangzhou, China
| | - Tangzhiming Li
- Shenzhen People’s Hospital, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medicine College of Jinan University, Shenzhen, China
| | - Jie Yuan
- Shenzhen People’s Hospital, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medicine College of Jinan University, Shenzhen, China
| | - Xinli Pang
- Shenzhen People’s Hospital, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medicine College of Jinan University, Shenzhen, China
| | - Tao Liu
- International Digital Economy Academy, Shenzhen, China
| | - Benhui Liang
- Department of Cardiology, Xiangya Hospital, Central South University, Changsha, China
| | - Lixin Cheng
- Shenzhen People’s Hospital, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medicine College of Jinan University, Shenzhen, China
- *Correspondence: Lixin Cheng, ; Xin Sun, ; Shaohong Dong,
| | - Xin Sun
- Shenzhen People’s Hospital, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medicine College of Jinan University, Shenzhen, China
- *Correspondence: Lixin Cheng, ; Xin Sun, ; Shaohong Dong,
| | - Shaohong Dong
- Shenzhen People’s Hospital, First Affiliated Hospital of Southern University of Science and Technology, Second Clinical Medicine College of Jinan University, Shenzhen, China
- *Correspondence: Lixin Cheng, ; Xin Sun, ; Shaohong Dong,
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Abstract
Context and aims: Iron is a pro-oxidant factor in the pathogenesis of CAD. The association of body iron status was investigated relative to the occurrence and severity of CAD.Design and methods: The subjects consisted of 110 males and 115 females who were classified as either a CAD case or a control according to the results of coronary angiography.Results: A new parameter, the "serum free iron index," was defined as the ratio of serum iron to UIBC. The level of ferritin showed significant increase [97.2 (67.0-171.2) µg/L vs. 85.6 (52.5-129.4), p = .034], whereas serum total iron, free iron index, transferrin, UIBC and iron saturation were unchanged in CAD patients relative to control group. Among the indices of body iron only serum ferritin had significant association with the likelihood (OR of 1.004 (1.000-1.007), p = .04) and severity of CAD [χ2(3)= 7.99, p = .01], but the correlation was lessened in the presence of classical risk factors. Serum ferritin had also the highest and significant efficiency to predict CAD (AUC = 0.61, p = .020).Conclusions: Serum ferritin as a marker of intracellular iron has significant association with CAD; nevertheless, the correlation is not independent. Since iron deficiency is prevalent in elderly patients, iron hypothesis needs to expand to the both sides of iron deficiency and toxicity.
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Affiliation(s)
- Hossein Mokhtari
- Department of Clinical Biochemistry and Immunogenetic Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Iran
| | - Babak Bagheri
- Department of Cardiology and Immunogenetic Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Iran
| | - Mehdi Rasouli
- Department of Clinical Biochemistry and Immunogenetic Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Mazandaran, Iran
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von Haehling S, Jankowska EA, van Veldhuisen DJ, Ponikowski P, Anker SD. Iron deficiency and cardiovascular disease. Nat Rev Cardiol 2015; 12:659-69. [DOI: 10.1038/nrcardio.2015.109] [Citation(s) in RCA: 171] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Muñoz-Bravo C, Gutiérrez-Bedmar M, Gómez-Aracena J, García-Rodríguez A, Navajas JFC. Iron: protector or risk factor for cardiovascular disease? Still controversial. Nutrients 2013; 5:2384-404. [PMID: 23857219 PMCID: PMC3738979 DOI: 10.3390/nu5072384] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 06/09/2013] [Accepted: 06/11/2013] [Indexed: 01/12/2023] Open
Abstract
Iron is the second most abundant metal in the Earth’s crust. Despite being present in trace amounts, it is an essential trace element for the human body, although it can also be toxic due to oxidative stress generation by the Fenton reaction, causing organic biomolecule oxidation. This process is the basis of numerous pathologies, including cardiovascular diseases (CVD). The relationship between iron and cardiovascular disease was proposed in 1981 by Jerome Sullivan. Since then, numerous epidemiological studies have been conducted to test this hypothesis. The aim of this review is to present the main findings of the chief epidemiological studies published during the last 32 years, since Sullivan formulated his iron hypothesis, suggesting that this element might act as a risk factor for cardiovascular disease. We have analyzed 55 studies, of which 27 supported the iron hypothesis, 20 found no evidence to support it and eight were contrary to the iron hypothesis. Our results suggest that there is not a high level of evidence which supports the hypothesis that the iron may be associated with CVD. Despite the large number of studies published to date, the role of iron in cardiovascular disease still generates a fair amount of debate, due to a marked disparity in results.
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Affiliation(s)
- Carlos Muñoz-Bravo
- Department of Preventive Medicine and Public Health, University of Málaga, Boulevard Louis Pasteur 32, Málaga 29071, Spain.
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