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Taeubert MJ, Wiertsema CJ, Vermeulen MJ, Quezada-Pinedo HG, Reiss IK, Muckenthaler MU, Gaillard R. Maternal Iron Status in Early Pregnancy and Blood Pressure Throughout Pregnancy, Placental Hemodynamics, and the Risk of Gestational Hypertensive Disorders. J Nutr 2021; 152:525-534. [PMID: 34647596 PMCID: PMC8826859 DOI: 10.1093/jn/nxab368] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/27/2021] [Accepted: 10/08/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND In nonpregnant populations, higher serum ferritin, which reflects high iron stores, is associated with an increased risk of hypertension. We hypothesized that a dysregulated maternal iron status in early pregnancy may lead to impaired gestational hemodynamic adaptations, leading to an increased risk of gestational hypertensive disorders. OBJECTIVES We examined the associations of maternal iron status with maternal blood pressure, placental hemodynamic parameters, and the risks of gestational hypertensive disorders. METHODS In a population-based prospective cohort study among 5983 pregnant women, we measured maternal serum ferritin, transferrin saturation, serum iron, and transferrin concentrations at a median of 13.2 weeks gestation (95% range, 9.6-17.6). Maternal blood pressure was measured in early pregnancy, mid pregnancy, and late pregnancy, and placental hemodynamic parameters in mid pregnancy and late pregnancy were measured by ultrasound. Information on gestational hypertensive disorders was collected from medical records. We examined the associations of maternal early pregnancy iron status with maternal systolic and diastolic blood pressure, placental hemodynamic parameters, and the risks of gestational hypertensive disorders using linear and logistic regression models. RESULTS Higher maternal early pregnancy serum ferritin concentrations were associated with higher systolic and diastolic blood pressure throughout pregnancy in the basic models (P values < 0.05). After adjustment for maternal inflammation, sociodemographic and lifestyle factors, higher maternal early pregnancy serum ferritin concentrations were only associated with a higher early pregnancy diastolic blood pressure [0.27 (95% CI, 0.03-0.51) mmHg per SD score increase in serum ferritin] and with a higher mid pregnancy umbilical artery pulsatility index (P < 0.05). No associations with the risk of gestational hypertensive disorders were present. CONCLUSIONS No consistent associations were present of maternal iron status in early pregnancy with gestational hemodynamic adaptations or the risks of gestational hypertensive disorders. Further studies are needed to examine the potential role of iron metabolism in the development of gestational hypertensive disorders within higher-risk populations.
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Affiliation(s)
- Minerva J Taeubert
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Pediatric Oncology, Hematology and Immunology, University Medical Center, Heidelberg, Germany
| | - Clarissa J Wiertsema
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Pediatrics, Sophia's Children's Hospital, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Marijn J Vermeulen
- Department of Pediatrics, Sophia's Children's Hospital, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Hugo G Quezada-Pinedo
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,Department of Pediatrics, Sophia's Children's Hospital, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Irwin K Reiss
- Department of Pediatrics, Sophia's Children's Hospital, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Martina U Muckenthaler
- Department of Pediatric Oncology, Hematology and Immunology, University Medical Center, Heidelberg, Germany
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Characteristics of metabolic factors related to arterial stiffness in young and old adults. Clin Exp Hypertens 2019; 42:225-232. [PMID: 31116038 DOI: 10.1080/10641963.2019.1619754] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
It has not been adequately studied which biomarkers for cardiovascular risk indicate changes of atherosclerosis by aging process. The current study aimed to investigate the characteristics of metabolic factors related to arterial stiffness in young and old adults. Our cross-sectional study enrolled 851 healthy young adults and 719 old adults. Metabolic biomarkers included glucose, lipid profiles, and liver enzymes. In young adults, additional biomarkers such as C-reactive protein, apolipoproteins, lipoprotein(a), ferritin, and 25-hydroxycholecalciferol were measured. Arterial stiffness was evaluated by measuring brachial-ankle pulse wave velocity (baPWV). The mean age was 37.8 and 65.1 years old in the young and old groups, respectively. Without adjustment, most parameters were significantly correlated with baPWV in both young and old groups. Mean baPWV was significantly different according to metabolic syndrome (MetS) in both groups (13.1 and 12.1 m/s in the young subjects with and without MetS, respectively; 17.4 and 15.8 m/s, respectively, in the old group). After adjusting for age, sex, and hemodynamic factors, the difference in baPWV according to MetS was significant only in the old group. The relationship between most biomarkers and baPWV was influenced by metabolic disorders such as hypertension and diabetes in old adults. Total cholesterol (TC), low-density lipoprotein cholesterol (LDLC), and apolipoprotein B were significant in young group. In conclusion, the metabolic biomarkers related to arterial stiffness were different between young and old adults. Contrary to old adults, TC, LDLC, and apolipoprotein B were independent biomarkers for arterial stiffness in healthy young adults.
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Ha JY, Kim MK, Kang S, Nam JS, Ahn CW, Kim KR, Park JS. Serum ferritin levels are associated with arterial stiffness in healthy Korean adults. Vasc Med 2016; 21:325-30. [DOI: 10.1177/1358863x16629728] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although an association between serum ferritin and atherosclerosis has been suggested, limited epidemiologic data are available regarding the association between ferritin and arterial stiffness in healthy adults. A total of 2932 healthy subjects were enrolled in this study. Anthropometric and biochemical profiles including ferritin were measured. The arterial stiffness was measured using brachial–ankle pulse wave velocity (baPWV). Serum ferritin levels were classified into quartiles and baPWV values gradually increased with each ferritin quartile. Multiple regression analysis showed that ferritin levels were independently correlated with baPWV. After adjusting for multiple risk factors, as compared with the lowest quartile, the odds ratios for high baPWV (>75th percentile) were 1.15 (0.84–1.56), 1.37 (0.97–1.73), and 1.46 (1.29–2.17) among men ( p for trend < 0.05) and 1.24 (0.87–1.79), 1.53 (1.09–2.16), and 1.80 (1.25–2.82) among women ( p for trend < 0.05), for the second, third, and fourth quartiles of ferritin, respectively. In conclusion, serum ferritin levels are independently associated with arterial stiffness in healthy Korean adults.
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Affiliation(s)
- Ji Yoon Ha
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Min Kyung Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Shinae Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Sun Nam
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
| | - Chul Woo Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Rae Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Suk Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
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Effects of long-term risedronate treatment on serum ferritin levels in postmenopausal women with osteoporosis. Menopause 2016; 23:55-9. [DOI: 10.1097/gme.0000000000000480] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Iron metabolism and regulation by neutrophil gelatinase-associated lipocalin in cardiomyopathy. Clin Sci (Lond) 2015; 129:851-62. [PMID: 26318828 DOI: 10.1042/cs20150075] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Neutrophil gelatinase-associated lipocalin (NGAL) has recently become established as an important contributor to the pathophysiology of cardiovascular disease. Accordingly, it is now viewed as an attractive candidate as a biomarker for various disease states, and in particular has recently become regarded as one of the best diagnostic biomarkers available for acute kidney injury. Nevertheless, the precise physiological effects of NGAL on the heart and the significance of their alterations during the development of heart failure are only now beginning to be characterized. Furthermore, the mechanisms via which NGAL mediates its effects are unclear because there is no conventional receptor signalling pathway. Instead, previous work suggests that regulation of iron metabolism could represent an important mechanism of NGAL action, with wide-ranging consequences spanning metabolic and cardiovascular diseases to host defence against bacterial infection. In the present review, we summarize rapidly emerging evidence for the role of NGAL in regulating heart failure. In particular, we focus on iron transport as a mechanism of NGAL action and discuss this in the context of the existing strong associations between iron overload and iron deficiency with cardiomyopathy.
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The impact of inflammatory factors associated with primary arteriovenous failure. Int J Artif Organs 2013; 36:710-6. [PMID: 23918269 DOI: 10.5301/ijao.5000235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2013] [Indexed: 01/06/2023]
Abstract
PURPOSE Very scarce data exist regarding the relationship between differential white blood cell (WBC) counts and primary arteriovenous fistula (AVF) failure. Thus, the current study aimed to investigate the specific relationship between primary AVF failure and differential WBC counts.
METHODS Sociodemographic, clinical, and laboratory parameters including automatically determined complete blood counts of the patients (from medical records and hospital charts) prior to AVF fistula surgery were recorded. Primary AVF failure was described as a complication of the AVF before the first successful cannulation for HD treatment.
RESULTS In total 94 patients (Male/Female: 49/45, Aged: 50.9 ± 15.0 years) were included. Ferritin, high sensitive C-reactive protein (hs-crp), total WBC count, neutrophil count, red cell distribution width (RDW) were higher in patients with primary AVF failure compared to patients without primary AVF failure. Logistic regression analysis showed that presence of diabetes (OR = 3.654, p = 0.035), RDW (OR = 0.449, p = 0.033) and ferritin (OR = 1.097, p = 0.021) were independently related with primary AVF failure.
CONCLUSIONS Neither total WBC counts nor WBC subtypes were related with primary AVF failure. Higher RDW and ferritin levels had a prognostic value for development of primary AVF failure.
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Sung KC, Kang SM, Cho EJ, Park JB, Wild SH, Byrne CD. Ferritin Is Independently Associated With the Presence of Coronary Artery Calcium in 12 033 Men. Arterioscler Thromb Vasc Biol 2012; 32:2525-30. [DOI: 10.1161/atvbaha.112.253088] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective—
Ferritin concentrations are often increased in patients with metabolic syndrome and type 2 diabetes mellitus, but few reports have examined the associations between ferritin and atherosclerosis. We investigated whether any relationship between ferritin and coronary artery calcium score (CACS) >0 (as a marker of atherosclerosis) was independent of potential confounders, such as iron-binding capacity (transferrin), low-grade inflammation, and cardiovascular risk factors.
Methods and Results—
Data were analyzed from a South Korean occupational cohort of 12 033 men who underwent a cardiac computed tomography estimation of CACS and measurements of multiple cardiovascular risk factors. One-thousand three- hundred-fifteen of 12 033 (11.2%) subjects had a CACS >0. For people with a CACS >0, median (interquartile range) ferritin concentration was 196.8 (136.3–291.9) compared with 182.2 (128.1–253.6) in people with a CACS=0;
P
<0.001. In the highest ferritin quartile, 14.7% (442/3008) of subjects had a CACS >0 compared with 9.7% (292/3010) in the lowest quartile (
P
<0.0001). With increasing ferritin quartiles, there were also higher proportions of people with diabetes mellitus (
P
<0.0001), hypertension (
P
<0.0001), coronary heart disease (
P
=0.003), and a Framingham Risk Score >10% (
P
<0.0001). In logistic regression modeling with CACS >0 as the outcome, ferritin but not transferrin was independently associated with CACS >0 (odds ratio for highest quartile versus lowest quartile, 1.66 [95% CI, 1.3–1.98];
P
=0.0001).
Conclusion—
Increased ferritin concentrations are associated with the presence of a marker of early coronary artery atherosclerosis, independently of traditional cardiovascular risk factors including Framingham risk score, transferrin, preexisting vascular disease, diabetes mellitus, metabolic syndrome factors, and low-grade inflammation.
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Affiliation(s)
- Ki-Chul Sung
- From the Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (K.-C.S.); Cardiology Division, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Seoul, Republic of Korea (S.-M.K.); Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, St Paul’s Hospital, Seoul, Republic of Korea (E.-J.C.); Division of Medicine/Cardiology, Cheil
| | - Seok-Min Kang
- From the Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (K.-C.S.); Cardiology Division, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Seoul, Republic of Korea (S.-M.K.); Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, St Paul’s Hospital, Seoul, Republic of Korea (E.-J.C.); Division of Medicine/Cardiology, Cheil
| | - Eun-Joo Cho
- From the Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (K.-C.S.); Cardiology Division, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Seoul, Republic of Korea (S.-M.K.); Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, St Paul’s Hospital, Seoul, Republic of Korea (E.-J.C.); Division of Medicine/Cardiology, Cheil
| | - Jeong Bae Park
- From the Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (K.-C.S.); Cardiology Division, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Seoul, Republic of Korea (S.-M.K.); Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, St Paul’s Hospital, Seoul, Republic of Korea (E.-J.C.); Division of Medicine/Cardiology, Cheil
| | - Sarah H. Wild
- From the Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (K.-C.S.); Cardiology Division, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Seoul, Republic of Korea (S.-M.K.); Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, St Paul’s Hospital, Seoul, Republic of Korea (E.-J.C.); Division of Medicine/Cardiology, Cheil
| | - Christopher D. Byrne
- From the Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (K.-C.S.); Cardiology Division, Severance Cardiovascular Hospital and Cardiovascular Research Institute, Seoul, Republic of Korea (S.-M.K.); Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, St Paul’s Hospital, Seoul, Republic of Korea (E.-J.C.); Division of Medicine/Cardiology, Cheil
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Li S, Lin L, Mo Z, Qin X, Lv H, Gao Y, Tan A, Yang X, Huang S, Chen Z. Reference values for serum ferritin in Chinese Han ethnic males: Results from a Chinese male population survey. Clin Biochem 2011; 44:1325-8. [DOI: 10.1016/j.clinbiochem.2011.08.1137] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Revised: 08/10/2011] [Accepted: 08/18/2011] [Indexed: 02/06/2023]
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