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Li H, Zhang H, Wang T, Zhang L, Wang H, Lu H, Yang R, Ding Y. Grape Seed Proanthocyanidins Protect Pancreatic β Cells Against Ferroptosis via the Nrf2 Pathway in Type 2 Diabetes. Biol Trace Elem Res 2024:10.1007/s12011-024-04093-9. [PMID: 38367173 DOI: 10.1007/s12011-024-04093-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/01/2024] [Indexed: 02/19/2024]
Abstract
Pancreatic β cell damage is the primary contributor to type 2 diabetes mellitus (T2DM); however, the underlying mechanism remains nebulous. This study explored the role of ferroptosis in pancreatic β cell damage and the protective effects of grape seed proanthocyanidin extract (GSPE). In T2DM model rats, the blood glucose, water intake, urine volume, HbA1c, and homeostasis model assessment-insulin resistance were significantly increased, while the body weight and the insulin level were significantly decreased, indicating the successful establishment of the T2DM model. MIN6 mouse insulinoma β cells were cultured in high glucose and sodium palmitate conditions to obtain a glycolipid damage model, which was administered with GSPE, ferrostatin-1 (Fer-1), or nuclear factor erythroid 2-related factor 2 (Nrf2) small interfering (si) RNA. GSPE and Fer-1 treatment significantly improved pancreatic β-cell dysfunction and protected against cell death. Both treatments increased the superoxide dismutase and glutathione activity, reduced the malondialdehyde and reactive oxygen species levels, and improved iron metabolism. Furthermore, the treatments reversed the expression of ferroptosis markers cysteine/glutamate transporter (XCT) and glutathione peroxidase 4 (GPX4) caused by glycolipid toxicity. GSPE treatments activated the expression of Nrf2 and related proteins. These effects were reversed when co-transfected with si-Nrf2. GSPE inhibits ferroptosis by activating the Nrf2 signaling pathway, thus reducing β-cell damage and dysfunction in T2DM. Therefore, GSPE is a potential treatment strategy against T2DM.
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Affiliation(s)
- Haiyan Li
- Key Laboratory of Environmental Exposome, Xinjiang Medical University, No.393 Xinyi Road, Urumqi, 830011, China
- Department of Public Health, Shihezi University School of Medicine, Shihezi, 832000, China
| | - Haowei Zhang
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, V8P 5C2, Canada
| | - Tongling Wang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, 832000, China
| | - Liyuan Zhang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, 832000, China
| | - Hao Wang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, 832000, China
| | - Heng Lu
- Department of Public Health, Shihezi University School of Medicine, Shihezi, 832000, China
| | - Ruirui Yang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, 832000, China
| | - Yusong Ding
- Key Laboratory of Environmental Exposome, Xinjiang Medical University, No.393 Xinyi Road, Urumqi, 830011, China.
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Engin AB, Engin ED, Engin A. Macrophage Activation Syndrome in Coinciding Pandemics of Obesity and COVID-19: Worse than Bad. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1460:919-954. [PMID: 39287877 DOI: 10.1007/978-3-031-63657-8_31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
Epigenetic changes have long-lasting impacts, which influence the epigenome and are maintained during cell division. Thus, human genome changes have required a very long timescale to become a major contributor to the current obesity pandemic. Whereas bidirectional effects of coronavirus disease 2019 (COVID-19) and obesity pandemics have given the opportunity to explore, how the viral microribonucleic acids (miRNAs) use the human's transcriptional machinery that regulate gene expression at a posttranscriptional level. Obesity and its related comorbidity, type 2 diabetes (T2D), and new-onset diabetes due to severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) are additional risk factors, which increase the severity of COVID-19 and its related mortality. The higher mortality rate of these patients is dependent on severe cytokine storm, which is the sum of the additional cytokine production by concomitant comorbidities and own cytokine synthesis of COVID-19. Patients with obesity facilitate the SARS-CoV-2 entry to host cell via increasing the host's cell receptor expression and modifying the host cell proteases. After entering the host cells, the SARS-CoV-2 genome directly functions as a messenger ribonucleic acid (mRNA) and encodes a set of nonstructural proteins via processing by the own proteases, main protease (Mpro), and papain-like protease (PLpro) to initiate viral genome replication and transcription. Following viral invasion, SARS-CoV-2 infection reduces insulin secretion via either inducing β-cell apoptosis or reducing intensity of angiotensin-converting enzyme 2 (ACE2) receptors and leads to new-onset diabetes. Since both T2D and severity of COVID-19 are associated with the increased serum levels of pro-inflammatory cytokines, high glucose levels in T2D aggravate SARS-CoV-2 infection. Elevated neopterin (NPT) value due to persistent interferon gamma (IFN-γ)-mediated monocyte-macrophage activation is an indicator of hyperactivated pro-inflammatory phenotype M1 macrophages. Thus, NPT could be a reliable biomarker for the simultaneously occurring COVID-19-, obesity- and T2D-induced cytokine storm. While host miRNAs attack viral RNAs, viral miRNAs target host transcripts. Eventually, the expression rate and type of miRNAs also are different in COVID-19 patients with different viral loads. It is concluded that specific miRNA signatures in macrophage activation phase may provide an opportunity to become aware of the severity of COVID-19 in patients with obesity and obesity-related T2D.
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Affiliation(s)
- Ayse Basak Engin
- Faculty of Pharmacy, Department of Toxicology, Gazi University, Hipodrom, Ankara, Turkey
| | - Evren Doruk Engin
- Biotechnology Institute, Ankara University, Gumusdere Campus, Gumusdere, Ankara, Turkey
| | - Atilla Engin
- Faculty of Medicine, Department of General Surgery, Gazi University, Besevler, Ankara, Turkey
- Mustafa Kemal Mah. 2137. Sok. 8/14, 06520, Cankaya, Ankara, Turkey
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Zhao Y, Lv X, Chen C, Li K, Wang Y, Liu J. The association between triglyceride-glucose index and hyperferritinemia in patients with type 2 diabetes mellitus. Hormones (Athens) 2023; 22:403-412. [PMID: 37233914 DOI: 10.1007/s42000-023-00453-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 05/12/2023] [Indexed: 05/27/2023]
Abstract
PURPOSE To investigate the relationship between the triglyceride-glucose (TyG) index and serum ferritin (SF) levels in patients with type 2 diabetes mellitus (T2DM). METHODS A total of 881 T2DM patients were divided into T1(TyG index < 1.66), T2 (1.66 ≤ TyG index < 2.21), and T3 (TyG index ≥ 2.21) groups according to the tertiles of the TyG index. The differences in SF levels and the prevalence of hyperferritinemia (SF ≥ 300 ng/mL for male or SF ≥ 150 ng/mL for female) were compared. The independent correlations between the TyG index and SF, and between hyperferritinemia and TyG in T2DM patients were analyzed, respectively. RESULTS SF levels in male T2DM patients were higher in the T3 group (250.12 ng/mL) than in the T1 and T2 groups (180.45 and 196.56 ng/mL, both p < 0.01),while in female patients with T2DM,SF levels were higher in the T3 group (157.25 ng/mL) than in the T1 group (111.06 ng/mL, p < 0.05).The prevalence of hyperferritinemia in male T2DM patients was higher in the T3 group (31.3%) than those in the T1 and T2 groups (10.4% and 17.3%, both p < 0.05).The TyG index was positively correlated with SF levels in T2DM patients (R = 0.178, p < 0.001).TyG index was independently and positively correlated with SF levels after adjusting for confounders (β = 0.097, 95%CI [2.870,38.148], p = 0.023).The TyG index was positively independently correlated with hyperferritinemia in male T2DM patients (OR = 1.651, 95%CI [1.120,2.432], p = 0.011). CONCLUSIONS In parallel with increasing TyG index SF levels gradually increased. The TyG index was positively correlated with SF levels in patients with T2DM and was positively correlated with hyperferritinemia in male T2DM patients.
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Affiliation(s)
- Yangting Zhao
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Xiaoyu Lv
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Chongyang Chen
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Kai Li
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Yawen Wang
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Jingfang Liu
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China.
- Department of Endocrinology, the First Hospital of Lanzhou University, Donggang West Road, Lanzhou, Gansu, 730000, People's Republic of China.
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Wu L, Si H, Zeng Y, Wu Y, Li M, Liu Y, Shen B. Association between Iron Intake and Progression of Knee Osteoarthritis. Nutrients 2022; 14:nu14081674. [PMID: 35458236 PMCID: PMC9033045 DOI: 10.3390/nu14081674] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Iron overload is drawing attention in the development of knee osteoarthritis (OA). To identify the modifiable risk factors for iron-related pathological conditions, we examined the association between iron intake and the risk of knee OA progression. Methods: A total of 1912 participants in the Osteoarthritis Initiative (OAI), aged 45−79 years and with at least one knee radiographic OA at baseline, were identified and were followed up to 6 years. The iron and other nutrient intake was measured by the validated Block Brief 2000 Food Frequency Questionnaire. The outcome measures were by radiographic progression on the basis of the Kellgren−Lawrence (KL) grade and the joint-space-narrowing (JSN) score. The association between the iron intake and the knee OA progression was examined by Cox proportional hazards models and restricted cubic spline (RCS) regression. Results: Among the study participants, 409 participants experienced KL-grade progression, and 684 participants experienced JSN-score progression within 6 years. Overall, the association between iron intake and the risk of KL-grade progression followed a U shape (p for nonlinearity < 0.001). The risk of KL-grade progression was significantly lower in participants with iron intakes of <16.5 mg/day (per mg/day: adjusted hazard ratio (HR), 0.75; 95% CI (confidence interval), 0.64−0.89), and it was higher in those with iron intakes ≥16.5 mg/day (per mg/day: HR, 1.20; 95% CI, 1.04−1.38). Consistently, when the iron intake was assessed as deciles, compared to those in Deciles 3−5 (10.9−23.3 mg/day), the risk of KL-grade progression was higher for Deciles 1−2 (≤10.9 mg/day: HR, 1.57; 95% CI, 1.17−2.10) and for Deciles 6−10 (>23.3 mg/day: adjusted HR, 1.60; 95% CI, 1.19−2.16). Similar U-shaped relations were found for iron intake with the risk of JSN-score progression (p for nonlinearity = 0.035). Conclusions: There was a U-shaped association between the iron intake and the progression of knee OA, with an inflection point at about 16.5 mg/day, and minimal risk from 10.9 to 23.3 mg/day of iron intake. An appropriate iron intake was advisable for knee OA, whereas excessive or deficient iron intake increased the risk of knee OA progression.
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Sakuma Y, Ogino J, Iwai R, Inoue T, Takahashi H, Suzuki Y, Kinoshita D, Takemura K, Takahashi H, Shimura H, Sato Y, Yoshida S, Hashimoto N. Hyperferritinemia Is a Predictor of Onset of Diabetes in Japanese Males Independently of Decreased Renal Function and Fatty Liver: A Fifteen-Year Follow-Up Study. J Clin Med Res 2022; 13:541-548. [PMID: 35059072 PMCID: PMC8734509 DOI: 10.14740/jocmr4635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 11/24/2021] [Indexed: 01/22/2023] Open
Abstract
Background Type 2 diabetes is an important health concern worldwide. The disease etiology may depend on multiple environmental and genetic factors that cause insulin resistance, including dysregulation of iron storage. The goal of this study was to examine the relationship of the serum ferritin concentration with onset of diabetes over a long period. Methods Correlations of serum ferritin and metabolic markers with onset of diabetes mellitus were examined over 15 years in 150 males participating in a health screening program. Results HOMA-β showed a gradual significant decrease in the first 4 years in subjects with ferritin > 190 ng/mL (group H) compared to those with ferritin ≤ 190 ng/mL, but there was no difference in HOMA-R between these groups. A significant number of cases with onset of diabetes was observed over 15 years (hazard ratio (HR): 3.97), and obesity, fasting blood glucose level, hemoglobin A1c (HbA1c), HOMA-R, fasting immunoreactive insulin (IRI) and C-peptide immunoreactivity (CPR) were all significant in univariate comparison between non-diabetes and diabetes-onset groups. In multivariate analysis, ferritin in group H (HR: 3.25), fatty liver (HR: 3.38), estimated glomerular filtration rate (eGFR) < 70 mL/min/1.73 m2 (HR: 3.48) and high-density lipoprotein (HDL) < 40 mg/dL (HR: 2.61) were significant predictive factors for onset of type 2 diabetes mellitus. Conclusions These results suggest that the serum ferritin level is an important index for priority intervention in preventive medicine for reduction of onset of diabetes.
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Affiliation(s)
- Yukie Sakuma
- Clinical Research Support Center, Asahi General Hospital, Chiba, Japan
| | - Jun Ogino
- Department of Diabetes and Metabolic Diseases, Asahi General Hospital, Chiba, Japan
| | - Rie Iwai
- Department of Clinical Laboratory, Asahi General Hospital, Chiba, Japan
| | - Takashi Inoue
- Clinical Research Support Center, Asahi General Hospital, Chiba, Japan
| | - Haruo Takahashi
- Clinical Research Support Center, Asahi General Hospital, Chiba, Japan
| | - Yoshifumi Suzuki
- Department of Diabetes and Metabolic Diseases, Asahi General Hospital, Chiba, Japan
| | - Daisuke Kinoshita
- Department of Diabetes and Metabolic Diseases, Asahi General Hospital, Chiba, Japan
| | - Koji Takemura
- Department of Diabetes and Metabolic Diseases, Asahi General Hospital, Chiba, Japan
| | - Hidenori Takahashi
- Preventive Medicine Research Center, Asahi General Hospital, Chiba, Japan
| | - Haruhisa Shimura
- Preventive Medicine Research Center, Asahi General Hospital, Chiba, Japan.,Department of Internal Medicine, Asahi General Hospital, Chiba, Japan
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Shouji Yoshida
- Department of Internal Medicine, Asahi General Hospital, Chiba, Japan
| | - Naotake Hashimoto
- Preventive Medicine Research Center, Asahi General Hospital, Chiba, Japan
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Zhou J, Wang N, Wang D, Zhao R, Zhao D, Ouyang B, Peng X, Hao L. Interactive effects of serum ferritin and high sensitivity C-reactive protein on diabetes in hypertensive patients. J Trace Elem Med Biol 2021; 68:126824. [PMID: 34352498 DOI: 10.1016/j.jtemb.2021.126824] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/07/2021] [Accepted: 07/26/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Hypertensive patients, often characterized by chronic inflammation, are susceptible to diabetes. Evidence suggests that the positive association between serum ferritin (SF) and diabetes was affected by high-sensitivity C-reactive protein (hs-CRP), an inflammation marker. We investigate whether there was an interaction between SF and hs-CRP on diabetes in hypertensive patients. METHODS We analysed data of 1,735 hypertensive people in this cross-sectional study. Diabetes was diagnosed when fasting blood glucose ≥ 7.0 mmol/L and/or a previous clinical diagnosis of diabetes. Logistic regression models were used to estimate the association of the SF and hs-CRP with diabetes. Multiplicative interaction was evaluated by incorporating a cross-product term for SF and hs-CRP to the logistic regression model. Additive interaction was assessed by calculating the relative excess risk of interaction (RERI) and attributed proportion due to interaction (AP). RESULTS In the adjusted analysis, SF (highest vs lowest tertile: odds ratio [OR], 1.61; 95 % confidence interval [CI], 1.20-2.16) was positively associated with diabetes. There was no multiplicative interaction between SF and hs-CRP, but evidence of additive interaction in regard to diabetes (RERI: 0.86; 95 % CI: 0.06-1.67). Compared to the patients with low SF (lower two thirds) and low hs-CRP (≤ 2 mg/L), those with high SF (upper one third) and high hs-CRP (> 2 mg/L) had increased OR for diabetes (adjusted OR: 2.33 [1.65-3.30]), with 37.0 % of the effects attributed to the additive interaction (AP: 0.37; 95 % CI: 0.09-0.65). CONCLUSIONS Within a cross-sectional study consisting of hypertensive patients, co-exposure to high SF and high hs-CRP was synergistically associated with diabetes. Dietary intervention or pharmacological treatment to lowering SF concentration may help to reduce diabetes morbidity in hypertensive patient with chronic inflammation.
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Affiliation(s)
- Juan Zhou
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, and Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, PR China
| | - Ning Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, and Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, PR China
| | - Dongxia Wang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, and Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, PR China
| | - Rui Zhao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, and Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, PR China
| | - Dan Zhao
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, Guangdong Province, 518051, PR China
| | - Binfa Ouyang
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, Guangdong Province, 518051, PR China
| | - Xiaolin Peng
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, Guangdong Province, 518051, PR China
| | - Liping Hao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, and Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430030, PR China.
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Li J, Zhao D, Liu J, Wang M, Sun J, Liu J, Li Y, Deng Q, Qi Y. Association of apolipoprotein Cs with new-onset type 2 diabetes mellitus: findings from the Chinese multi-provincial cohort study. BMJ Open 2021; 11:e052388. [PMID: 34785554 PMCID: PMC8596042 DOI: 10.1136/bmjopen-2021-052388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Apolipoprotein Cs (apoCs), especially apoC-II and apoC-III, as the components of triglyceride-rich lipoproteins, play a key role in the pathophysiology of diabetes. However, prospective studies examining direct associations between apoCs and diabetes are not reproducible. The aim of this study was to evaluate the impact of apoCs on the risk of developing diabetes in a middle-aged population, and to explore possible mediators responsible for the relationship between apoCs and diabetes. DESIGN Prospective cohort study. SETTING Community-based study carried out in Beijing. METHODS ApoCs were measured in 1085 participants aged 45-74 years and free of type 2 diabetes mellitus (T2DM) at baseline from the Chinese Multi-Provincial Cohort Study-Beijing Project. Multivariate logistic regression was performed to examine the association of apoCs with a 5-year risk of new-onset T2DM. The impacts of triglycerides, insulin and high-sensitivity C reactive protein (hs-CRP) on the association between apoC-III and the risk of T2DM were explored by a mediation test. RESULTS During the 5 years of follow-up, 97 (8.9%) participants developed T2DM. ApoC-III was significantly associated with the risk of developing T2DM after multivariable adjustment (OR=1.40; 95% CI 1.07 to 1.82). This association was mainly mediated by triglyceride levels with a significant indirect effect (OR 1.61; 95% CI 1.19 to 2.18), followed by hs-CRP and insulin. CONCLUSIONS Our findings demonstrated that higher serum apoC-III was independently associated with increased 5-year risk of new-onset T2DM in the Chinese population, and triglyceride plays a crucial role in mediating this relationship. More attention should be paid to preventive strategies of T2DM targeting apoC-III.
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Affiliation(s)
- Jiangtao Li
- Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Dong Zhao
- Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jing Liu
- Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Miao Wang
- Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jiayi Sun
- Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jun Liu
- Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yan Li
- Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Qiuju Deng
- Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yue Qi
- Department of Epidemiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
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Sciacqua A, Ventura E, Tripepi G, Cassano V, D'Arrigo G, Roumeliotis S, Maio R, Miceli S, Perticone M, Andreozzi F, Sesti G, Perticone F. Ferritin modifies the relationship between inflammation and arterial stiffness in hypertensive patients with different glucose tolerance. Cardiovasc Diabetol 2020; 19:123. [PMID: 32758229 PMCID: PMC7409693 DOI: 10.1186/s12933-020-01102-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 07/25/2020] [Indexed: 12/11/2022] Open
Abstract
Background Ferritin, a crucial element for iron homeostasis, is associated with chronic diseases characterized by subclinical inflammation such as essential arterial hypertension and type 2 diabetes mellitus (T2DM), showing a prognostic value in different clinical settings. We investigated whether ferritin is associated with arterial stiffness (AS), an early indicator of atherosclerosis, and if it could act as effect modifier on the relationship between inflammation and AS in hypertensive patients with different glucose tolerance. Methods We enrolled 462 newly diagnosed untreated hypertensive (HT) patients. All subjects underwent an oral glucose tolerance test. Insulin sensitivity was assessed by MATSUDA index and ferritin levels were estimated by immunoradiometric assay. AS was defined by carotid-femoral pulse wave velocity (PWV). Results Out of 462 patients, 271 showed normal glucose tolerance (HT/NGT), 146 impaired glucose tolerance (HT/IGT) and 45 were diabetic (HT/T2DM). Iron levels significantly decreased and transferrin and ferritin significantly increased from the first to the third group. PWV values were significantly higher in HT/IGT and HT/T2DM patients. PWV was related directly with ferritin, high sensitivity C reactive protein (hs-CRP), transferrin, and inversely with MATSUDA index. Ferritin resulted the strongest determinant of PWV explaining a 14.9% of its variation; moreover it was a strong modifier of the relationship between hs-CRP and PWV. The estimated augmentation in PWV portended by a fixed increase in hs-CRP, was higher across increasing values of ferritin. Conclusion Ferritin represents an independent risk factor of arterial stiffness in our study population and a strong effect modifier on the relationship between inflammation and PWV. However, further studies are needed to fully elucidate the potential role of this biomarker in human atherosclerosis.
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Affiliation(s)
- Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy.
| | - Ettore Ventura
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Giovanni Tripepi
- Institute of Clinical Physiology (IFC-CNR), Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, Reggio Calabria, Italy
| | - Velia Cassano
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Graziella D'Arrigo
- Institute of Clinical Physiology (IFC-CNR), Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, Reggio Calabria, Italy
| | - Stefanos Roumeliotis
- Institute of Clinical Physiology (IFC-CNR), Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, Reggio Calabria, Italy.,Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Raffale Maio
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Sofia Miceli
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Maria Perticone
- Department of Experimental and Clinical Medicine, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, University of Rome-Sapienza, Rome, Italy
| | - Francesco Perticone
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
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Chen MY, Juengpanich S, Hu JH, Topatana W, Cao JS, Tong CH, Lin J, Cai XJ. Prognostic factors and predictors of postoperative adjuvant transcatheter arterial chemoembolization benefit in patients with resected hepatocellular carcinoma. World J Gastroenterol 2020; 26:1042-1055. [PMID: 32205995 PMCID: PMC7081004 DOI: 10.3748/wjg.v26.i10.1042] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/20/2019] [Accepted: 02/09/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) has improved overall survival (OS) in patients with hepatocellular carcinoma (HCC). However, the prognostic and predictive factors remain unclear. AIM To assess the prognostic factors and the predictors of PA-TACE benefit for OS in patients with resected HCC. METHODS Univariate and multivariate analyses were performed to identify the potential prognostic factors for OS. In order to assess the predictive factors of PA-TACE benefit, the interaction variables between treatments for each subgroup were evaluated using the Cox proportional hazards regression model. RESULTS A total of 378 patients (PA-TACE vs surgery alone, 189:189) from three centers were included after a propensity-score 1:1 matching analysis. Compared to the group receiving surgery alone, PA-TACE prolonged the OS rate in patients with resected HCC (P < 0.001). The Barcelona Clinic Liver Cancer system and ferritin-to-hemoglobin ratio (FHR) were used as the prognostic factors for OS in both groups. Age (P = 0.023) and microscopic vascular invasion (MVI) (P = 0.002) were also identified in the PA-TACE group, while gender (P = 0.027), hepatitis B virus (P = 0.034) and albumin-bilirubin grade (P = 0.027) were also selected in the surgery alone group. In addition, PA-TACE resulted in longer OS than surgery alone across subgroups [all hazard ratios (PA-TACE-to-surgery alone) < 1]. Notably, a significantly prolonged OS following PA-TACE was observed in patients with high FHR (P = 0.038) and without MVI (P = 0.048). CONCLUSION FHR and Barcelona Clinic Liver Cancer stages were regarded as prognostic factors for OS. Moreover, high FHR and the absence of MVI were important predictive factors, which can be used to assist clinicians in selecting which patients could achieve a better OS with PA-TACE.
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Affiliation(s)
- Ming-Yu Chen
- Department of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
- School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
- Engineering Research Center of Cognitive Healthcare of Zhejiang Province, Hangzhou 310000, Zhejiang Province, China
| | - Sarun Juengpanich
- School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Jia-Hao Hu
- School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Win Topatana
- School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
| | - Jia-Sheng Cao
- Department of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
| | - Chen-Hao Tong
- Department of General Surgery, Shaoxing People’s Hospital, Zhejiang University, Shaoxing 312000, Zhejiang Province, China
| | - Jian Lin
- Department of General Surgery, Longyou People’s Hospital, Quzhou 314400, Zhejiang Province, China
| | - Xiu-Jun Cai
- Department of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
- School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
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10
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Wang M, Zhao A, Szeto IMY, Wu W, Ren Z, Li T, Feng H, Wang P, Wang Y, Zhang Y. Association of serum ferritin with metabolic syndrome in eight cities in China. Food Sci Nutr 2020; 8:1406-1414. [PMID: 32180950 PMCID: PMC7063359 DOI: 10.1002/fsn3.1408] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/18/2019] [Accepted: 12/21/2019] [Indexed: 12/11/2022] Open
Abstract
Objective This study aims to evaluate the cross‐sectional association of serum ferritin (SF) and the risk of metabolic syndrome (MetS) and its components among adults in eight cities in China. Methods Subjects were recruited using a combination of systematic cluster random sampling and purposive sampling in eight cities in China. The sociodemographic characteristics, data of lifestyle factors, self‐reported disease history, and 24‐hr dietary intake were obtained using a validated questionnaire. Anthropometry was performed, and fasting blood was collected to test the SF, fasting blood glucose (FBG), insulin, high‐sensitivity C‐reactive protein (hs‐CRP), triglycerides (TG), and cholesterols. Logistic and linear regression analyses were conducted to investigate the associations, adjusting for age, city level, smoking, drinking, weekly moderate‐to‐vigorous activity, dietary factors, hs‐CRP, and BMI. Results Serum ferritin level is positively correlated with total cholesterol, TG, FBG, HOMA‐IR, and hs‐CRP after adjusting for age and BMI. The odds ratio (OR) for MetS in the highest quartile of SF was 2.23 (1.32, 3.77) after adjusting for men, compared with the lowest quartile. An elevated ferritin concentration was significantly related to hypertriglyceridemia (p < .001) and elevated glucose (p = .013) among men, but not among women. Furthermore, compared with Q1, the OR for insulin resistance in the ferritin Q4 group was 3.08 (1.50, 6.32) among men and 1.96 (1.19, 3.24) among women. Conclusion A positive association between elevated SF and MetS and its components including hypertriglyceridemia and elevated glucose was found in multivariate analyses among men, and SF levels are independently associated with IR.
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Affiliation(s)
- Meichen Wang
- Department of Nutrition and Food Hygiene School of Public Health Peking University Beijing China
| | - Ai Zhao
- Department of Social Science and Health Education School of Public Health Peking University Beijing China
| | - Ignatius Man-Yau Szeto
- Inner Mongolia Dairy Technology Research Institute Co. Ltd. Hohhot China.,Yili Innovation Center Inner Mongolia Yili Industrial Group Co. Ltd. Hohhot China
| | - Wei Wu
- Department of Nutrition and Food Hygiene School of Public Health Peking University Beijing China
| | - Zhongxia Ren
- Department of Nutrition and Food Hygiene School of Public Health Peking University Beijing China
| | - Ting Li
- Inner Mongolia Dairy Technology Research Institute Co. Ltd. Hohhot China.,Yili Innovation Center Inner Mongolia Yili Industrial Group Co. Ltd. Hohhot China
| | - Haotian Feng
- Inner Mongolia Dairy Technology Research Institute Co. Ltd. Hohhot China.,Yili Innovation Center Inner Mongolia Yili Industrial Group Co. Ltd. Hohhot China
| | - Peiyu Wang
- Department of Social Science and Health Education School of Public Health Peking University Beijing China
| | - Yan Wang
- Inner Mongolia Dairy Technology Research Institute Co. Ltd. Hohhot China.,Yili Innovation Center Inner Mongolia Yili Industrial Group Co. Ltd. Hohhot China
| | - Yumei Zhang
- Department of Nutrition and Food Hygiene School of Public Health Peking University Beijing China
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11
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Jiang L, Wang K, Lo K, Zhong Y, Yang A, Fang X, Akezhuoli H, Song Z, Chen L, An P, Xu M, Min J, Wang F. Sex-Specific Association of Circulating Ferritin Level and Risk of Type 2 Diabetes: A Dose-Response Meta-Analysis of Prospective Studies. J Clin Endocrinol Metab 2019; 104:4539-4551. [PMID: 31074789 DOI: 10.1210/jc.2019-00495] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 05/06/2019] [Indexed: 12/15/2022]
Abstract
CONTEXT Although the role of iron in the development of type 2 diabetes (T2D) has long been a concern, prospective studies directly linking body iron stores to T2D risk in a sex-dependent context have been inconsistent. OBJECTIVE A systematic meta-analysis was conducted to explore the sex-specific association of circulating ferritin with T2D risk. DATA SOURCES We searched PubMed, Web of Science, and EMBASE databases to identify available prospective studies through 1 August 2018. RESULTS Fifteen prospective studies comprising 77,352 participants and 18,404 patients with T2D, aged 20 to 80 years, and with ∼3 to 17 years of follow-up were identified. For each 100-μg/L increment in ferritin levels of overall participants, T2D risk increased by 22% (RR, 1.22; 95% CI, 1.14 to 1.31). Of note, major heterogeneities by sex were identified, with increased ferritin level having an apparently greater effect on T2D risk in women (RR, 1.53; 95% CI, 1.29 to 1.82) than in men (RR, 1.21; 95% CI, 1.15 to 1.27) after exclusion of a study with high heterogeneity (41,512 men and 6974 women for sex-specific analyses; P = 0.020 for sex difference). Further nonlinear analysis between circulating ferritin and T2D risk also showed sex-dimorphic association in that the T2D risk of women was twice as strong in magnitude as that of men at the same ferritin level. CONCLUSIONS Greater circulating ferritin levels were independently associated with increased T2D risk, which appeared stronger among women than men. Our findings provide prospective evidence for further testing of the utility of ferritin levels in predicting T2D risk in a sex-specific manner.
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Affiliation(s)
- Li Jiang
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, China Agricultural University, Beijing, China
- The First Affiliated Hospital, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Kai Wang
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Kenneth Lo
- Departments of Cardiology and Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Centre for Global Cardiometabolic Health, Department of Epidemiology, Brown University, Providence, Rhode Island
| | - Yueyang Zhong
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Aimin Yang
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Kong Kong SAR, China
| | - Xuexian Fang
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Hailati Akezhuoli
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Zijun Song
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Liyun Chen
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Peng An
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, China Agricultural University, Beijing, China
| | - Mingqing Xu
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, Shanghai, China
| | - Junxia Min
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
| | - Fudi Wang
- The First Affiliated Hospital, School of Public Health, Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, China Agricultural University, Beijing, China
- The First Affiliated Hospital, School of Public Health, Zhengzhou University, Zhengzhou, China
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12
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Shi Z, Li M, Wang Y, Liu J, El-Obeid T. High iron intake is associated with poor cognition among Chinese old adults and varied by weight status-a 15-y longitudinal study in 4852 adults. Am J Clin Nutr 2019; 109:109-116. [PMID: 30649164 PMCID: PMC6900563 DOI: 10.1093/ajcn/nqy254] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/24/2018] [Indexed: 02/07/2023] Open
Abstract
Background High body iron status has been shown to be associated with adverse health outcomes. However, the relation between high body iron status, body mass index (BMI), and cognition is still understudied. Objective This study aimed to examine the association between iron intake and cognitive function in Chinese adults and tested the interaction effect of iron intake and BMI on cognition. Design Longitudinal study data from a nationwide sample (n = 4852; age ≥55 y) from the China Health and Nutrition Survey during 1991-2006 were used. Of the participants, 3302 had completed cognitive screening tests in ≥2 surveys. Cognitive function was assessed in 1997, 2000, 2004, and 2006. Dietary iron intake was obtained from a 3-d food record during home visits in 1991, 1993, 1997, 2000, 2004, and 2006. Multivariable mixed linear regression and logistic regression were used. Results The cumulative mean ± SD iron intake in 1997 of tested subjects was 23.7 ± 11.3 mg/d (25.4 mg/d in men and 22.2 mg/d in women). High iron intake was associated with poor cognition. In fully adjusted models, across the quartiles of iron intake the regression coefficients (95% CIs) were 0, -0.39 (-0.77, -0.01), -0.55 (-0.95, -0.15), and -0.90 (-1.33, -0.47), respectively. Comparing extreme quartiles of iron intake (high), the OR (95% CI) for poor cognitive function was 1.30 (1.04, 1.64). There was a significant interaction between iron intake and BMI. The association between high iron intake and poor cognition was stronger among those with a high BMI than those with a low BMI. Among those with a BMI (kg/m2) >24, across quartiles of iron intake the ORs (95% CIs) for poor cognitive function were 1.00, 1.27 (0.91, 1.78), 1.41 (0.97, 2.04), and 2.04 (1.38, 3.01), respectively. Conclusion Higher iron intake is associated with poor cognition in Chinese adults, especially among those with a high BMI.
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Affiliation(s)
- Zumin Shi
- Human Nutrition Department, Qatar University, Doha, Qatar
| | - Ming Li
- Center for Population Health Research, Division of Health Sciences, University of South Australia, Adelaide, Australia
| | - Youfa Wang
- Global Health Institute, Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Jianghong Liu
- University of Pennsylvania School of Nursing, Philadelphia, PA
| | - Tahra El-Obeid
- Human Nutrition Department, Qatar University, Doha, Qatar
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13
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Serum ferritin levels are associated with insulin resistance in Chinese men and post-menopausal women: the Shanghai Changfeng study. Br J Nutr 2018; 120:863-871. [PMID: 30189905 DOI: 10.1017/s0007114518002167] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Associations between ferritin and insulin sensitivity have been described in recent studies. The possible association showed conflicting results by sex and menopausal status. We aimed to investigate the cross-sectional association of ferritin levels with insulin resistance and β-cell function. A total of 2518 participants (1033 men, 235 pre-menopausal women and 1250 post-menopausal women) were enrolled from the Changfeng Study. A standard interview was conducted, as well as anthropometric measurements and laboratory analyses, for each participant. The serum ferritin level was measured using electrochemiluminescence immunoassay. Insulin resistance and β-cell function indices were derived from a homeostasis model assessment. The results showed that the serum ferritin levels were 250·4 (sd 165·2), 94·6 (sd 82·0) and 179·8 (sd 126·6) ng/ml in the men, pre-menopausal and post-menopausal women, respectively. In fully adjusted models (adjusting for age, current smoking, BMI, waist:hip ratio, systolic blood pressure, diastolic blood pressure, TAG, HDL-cholesterol, LDL-cholesterol, log urine albumin:creatinine ratio, leucocytes, alanine aminotransferase, aspartate aminotransferase and γ-glutamyl transpeptidase), serum ferritin concentrations are significantly associated with insulin resistance in men and post-menopausal females, and the null association was observed in pre-menopausal females. Interestingly, an increased β-cell function associated with higher ferritin was observed in post-menopausal participants, but not in male participants. In conclusion, these results suggested that elevated serum ferritin levels were associated with surrogate measures of insulin resistance among the middle-aged and elderly male and post-menopausal women, but not in pre-menopausal women.
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14
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Association of serum ferritin levels with non-alcoholic fatty liver disease in postmenopausal women. Climacteric 2018; 21:509-514. [PMID: 30106314 DOI: 10.1080/13697137.2018.1493451] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study aimed to investigate the association between serum ferritin levels and the presence of non-alcoholic fatty liver disease (NAFLD) in postmenopausal women. METHODS Two hundred and forty-one postmenopausal women who participated in a heath examination program were enrolled in the present study. Serum ferritin tertiles were categorized as follows: T1, ≤46.4 ng/ml; T2, 46.5-76.1 ng/ml; and T3, ≥76.2 ng/ml. The odds ratios (ORs) and 95% confidence intervals (CIs) for NAFLD were calculated after adjusting for confounding variables across serum ferritin tertiles using multiple logistic regression analysis. RESULTS The overall prevalence of NAFLD was 41.4% and was significantly increased in accordance with the serum ferritin tertiles as follows: 30.0% for T1, 40.7% for T2, and 54.3% for T3, respectively. As compared with the lowest tertile, the OR (95% CI) for NAFLD in the highest tertile was 2.69 (1.16-5.28) after adjusting for age, body mass index, regular exercise, mean arterial pressure, fasting plasma glucose, triglyceride, high-density lipoprotein cholesterol, alanine aminotransferase, and leukocyte count. CONCLUSION The serum ferritin level was positively and independently associated with NAFLD in postmenopausal women and could be a useful additional measure in assessing the risk of NAFLD in postmenopausal women.
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