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Huang SY, Mayasari NR, Tung TH, Lin WL, Tseng SH, Chang CC, Huang HY, Chang JS. Weight loss induced by a hypocaloric diet with or without fish oil supplementation re-established iron and omega-3 fatty acid homeostasis in middle-aged women with obesity: A post-hoc analysis of a randomized controlled trial. Maturitas 2024; 184:107948. [PMID: 38447232 DOI: 10.1016/j.maturitas.2024.107948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 01/24/2024] [Accepted: 02/18/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE Middle-aged women with obesity are at increased risk of iron overload and iron disorder is known to disrupt n-3 polyunsaturated fatty acid homeostasis. We evaluated relationships between pretreatment hemoglobin and n-3 polyunsaturated fatty acid levels, and tested whether pretreatment hemoglobin contributed to inter-individual variability in weight loss with special focus on changes in body weight, iron and n-3 polyunsaturated fatty acid profiles. STUDY DESIGN 117 middle and older aged women with obesity and more than two metabolic abnormalities were randomized to a 12-week hypocaloric diet without or with fish oil supplementation. Blood iron biomarker and erythrocyte membrane phospholipid profiles were evaluated. MAIN OUTCOME The absolute change from baseline to week 12 in serum iron and erythrocyte n-3 polyunsaturated fatty acid levels according to pretreatment hemoglobin tertiles and fish oil supplementation. RESULTS A Pearson correlation analysis showed that pretreatment hemoglobin levels were negatively correlated with linoleic acid (r = -0.231), α-linoleic acid (r = -0.279), and n-3 polyunsaturated fatty acid (r = -0.217) (all p < 0.05). Dietary weight loss markedly enhanced erythrocyte membrane lipids of linoleic acid, α-linoleic acid, and n-6 and n-3 polyunsaturated fatty acid only in those women with the highest pretreatment hemoglobin levels (tertile 3) (all p < 0.05). Fish oil supplementation increased bioavailable iron in women with moderate pretreatment hemoglobin levels (tertile 2) (p < 0.05) and, to a lesser extent, prevented a reduction in circulating iron in those with the lowest hemoglobin levels (tertile 1). CONCLUSION Dietary weight loss is an effective treatment program to manage obesity-related iron and n-3 polyunsaturated fatty acid disorders, particularly for middle-aged women with obesity and iron overload.
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Affiliation(s)
- Shih-Yi Huang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan; Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan; TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Noor Rohmah Mayasari
- Department of Nutrition, Faculty of Sports and Health Sciences, Universitas Negeri Surabaya, Surabaya 60213, Indonesia
| | - Te-Hsuan Tung
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan.
| | - Wen-Ling Lin
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan
| | - Sung-Hui Tseng
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei 11031, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
| | - Chun-Chao Chang
- TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei 11031, Taiwan; Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
| | - Hui-Yu Huang
- Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan.
| | - Jung-Su Chang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan; Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan; TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan; Nutrition Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan; Chinese Taipei Society for the Study of Obesity (CTSSO), Taipei 11031, Taiwan.
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Liu WY, Lian LY, Zhang H, Chen SD, Jin XZ, Zhang N, Ye CH, Chen WY, Bee GGB, Wang FD, Miele L, Corradini E, Valenti L, Zheng MH. A Population-Based and Clinical Cohort Validation of the Novel Consensus Definition of Metabolic Hyperferritinemia. J Clin Endocrinol Metab 2024; 109:1540-1549. [PMID: 38124275 PMCID: PMC11099479 DOI: 10.1210/clinem/dgad749] [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: 09/28/2023] [Revised: 12/09/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023]
Abstract
CONTEXT There is limited data on the clinical significance of metabolic hyperferritinemia (MHF) based on the most recent consensus. OBJECTIVE We aimed to validate the clinical outcomes of MHF in the general population and patients with biopsy-proven metabolic dysfunction-associated fatty liver disease (MAFLD). METHODS The NHANES database and PERSONS cohort were included. MHF was defined as elevated serum ferritin with metabolic dysfunction (MD) and stratified into different grades according to ferritin (grade 1: 200 [females]/300 [males]-550 ng/mL; grade 2: 550-1000 ng/mL; grade 3: >1000 ng/mL). The clinical outcomes, including all-cause death, comorbidities, and liver histology, were compared between non-MHF and MHF in adjusted models. RESULTS In NHANES, compared with non-MHF with MD, MHF was related to higher risks of advanced fibrosis (P = .036), elevated albumin-creatinine ratio (UACR, P = .001), and sarcopenia (P = .013). Although the association between all grades of MHF and mortality was insignificant (P = .122), grades 2/3 was associated with increased mortality (P = .029). When comparing with non-MHF without MD, the harmful effects of MHF were more significant in mortality (P < .001), elevated UACR (P < .001), cardiovascular disease (P = .028), and sarcopenia (P < .001). In the PERSONS cohort, MHF was associated with more advanced grades of steatosis (P < .001), lobular inflammation (P < .001), advanced fibrosis (P = .017), and more severe hepatocellular iron deposition (P < .001). CONCLUSION Both in the general population and in at-risk individuals with MAFLD, MHF was related with poorer clinical outcomes.
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Affiliation(s)
- Wen-Yue Liu
- Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- Wenzhou Key Laboratory of Diabetes Research, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Li-You Lian
- MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- Institute of Hepatology, Wenzhou Medical University, Wenzhou 325000, China
- Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou 325000, China
| | - Huai Zhang
- Biostatistics and Medical Quality Management Office, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Sui-Dan Chen
- Department of Pathology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xin-Zhe Jin
- Department of Laboratory, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Ni Zhang
- MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- Institute of Hepatology, Wenzhou Medical University, Wenzhou 325000, China
- Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou 325000, China
| | - Chen-Hui Ye
- MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- Institute of Hepatology, Wenzhou Medical University, Wenzhou 325000, China
- Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou 325000, China
| | - Wen-Ying Chen
- MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- Institute of Hepatology, Wenzhou Medical University, Wenzhou 325000, China
- Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou 325000, China
| | - George Goh Boon Bee
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore 169608, Singapore
| | - Fu-Di Wang
- The Fourth Affiliated Hospital, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310000, China
- The First Affiliated Hospital, Basic Medical Sciences, School of Public Health, Hengyang Medical School, University of South China, Hengyang 421001, China
| | - Luca Miele
- Department of Internal Medicine Medical and Surgical Sciences, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica di Roma, Rome 00168, Italy
| | - Elena Corradini
- Department of Medical and Surgical Sciences, Università degli Studi di Modena e Reggio Emilia, Modena 41100, Italy
- Internal Medicine and Centre for Hemochromatosis and Hereditary Liver Diseases, Azienda Ospedaliero-Universitaria di Modena-Policlinico, Modena 41100, Italy
| | - Luca Valenti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan 20121, Italy
- Biological Resource Center and Precision Medicine Lab, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milan 20121, Italy
- Department of Transfusion Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milan 20121, Italy
| | - Ming-Hua Zheng
- MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- Institute of Hepatology, Wenzhou Medical University, Wenzhou 325000, China
- Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou 325000, China
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Männistö VT, Hakkarainen K, Jula A, Lundqvist A, Vihervaara T, Erlund I, Åberg F. Serum ferritin level is associated with liver fibrosis and incident liver-related outcomes independent of HFE genotype in the general population. Scand J Gastroenterol 2024; 59:592-599. [PMID: 38329447 DOI: 10.1080/00365521.2024.2314707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 01/31/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND & AIMS Hyperferritinemia reflects iron accumulation in the body and has been associated with metabolic disturbances and alcohol use, and is also a common finding in individuals diagnosed with liver disease. The major genetic regulator of iron metabolism is the HFE gene. METHODS The aim of this this study was to investigate the association between serum ferritin and liver fibrosis using the enhanced liver fibrosis (ELF) test, and the association between ferritin and liver-related outcomes in a Finnish population-based cohort of 6194 individuals (45% male, mean [± standard deviation] age, 52.9 ± 14.9 years; body mass index 26.9 ± 4.7 kg/m2). The effects of HFE variants on these associations were also evaluated. RESULTS Serum ferritin levels were significantly associated with liver fibrosis, as estimated by enhanced liver fibrosis (ELF) test in weighted linear regression analysis. Serum ferritin was significantly associated with both all liver-related outcomes (n = 92) and severe liver-related outcomes (n = 54) in weighted Cox regression analysis (hazard ratio [HR] per 1 SD, 1.11 [95% confidence interval (CI) 1.02-1.21]; p = 0.012 and HR 1.11 [95% CI 1.02-1.21]; p = 0.013, respectively). However, there was association neither between HFE risk variants and ELF test nor between HFE risk variants and liver-related outcomes. CONCLUSION Serum ferritin levels were associated with liver fibrosis and incident liver disease, independent of HFE genotype in the general population. Furthermore, data demonstrated that metabolic disturbances and alcohol use were major risk factors for hyperferritinemia.
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Affiliation(s)
- Ville T Männistö
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | | | - Antti Jula
- Finnish Institute for Health and Welfare, Finland
| | | | | | - Iris Erlund
- Finnish Institute for Health and Welfare, Finland
| | - Fredrik Åberg
- Transplantation and Liver Surgery Clinic, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Ortiz-Marrón H, Cabañas Pujadas G, Donoso Navarro E, Burreros García M, Herreros Álvaro MI, Mejía Fernández de Velasco AM, Cornejo Gutiérrez A, Galán I. Association between biomarkers of iron status and cardiometabolic risk in Spanish children aged 9-10 years. The ELOIN study. Eur J Pediatr 2023; 182:5649-5659. [PMID: 37819420 PMCID: PMC10746575 DOI: 10.1007/s00431-023-05244-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/15/2023] [Accepted: 09/27/2023] [Indexed: 10/13/2023]
Abstract
The relationship between iron metabolism and cardiometabolic risk factors has been scarcely studied in children, and the results are controversial. The objective of this study was to evaluate the association between iron parameters and lipid, glycemic and blood pressure alterations in the pediatric population. This was a cross-sectional study of 1954 children between 9 and 10 years of age in Madrid (Spain), participants in a longitudinal study of childhood obesity. Iron metabolism parameters, i.e., serum iron (Is), ferritin (Fs), transferrin (Tf) and transferrin saturation (STf) and lipid, glycemic and blood pressure profiles were evaluated. Odds ratios (ORs) were estimated using logistic regression models adjusted for sociodemographic characteristics, diet, physical activity, C-reactive protein and body mass index. Compared with the participants in the low Is and STf tertiles, those in the upper tertiles had a lower risk of low HDL-Chol (OR: 0.34; 95%CI: 0.17; 0.67) and OR: 0.44 (95%CI: 0.23; 0.84), respectively, and children in the upper Fs tertile had an OR of 2.07 (95%CI: 1.16; 3.68) for low HDL-Chol. Children in the highest Is and STf tertiles had a lower risk of prediabetes [OR: 0.63 (95%CI: 0.41; 0.97) and OR: 0.53 (95%CI: 0.34; 0.82)] and insulin resistance (IR) (OR: 0.37; 95%CI: 0.22; 0.64), and those in the upper Tf tertile had a higher risk of IR (OR: 1.90; 95%CI: 1.16; 3.12). An increased risk of hypertension was found only in children in the upper Fs tertile (OR: 1.46; 95%CI: 1.01; 2.13). CONCLUSIONS Biomarkers of iron metabolism are associated with cardiometabolic alterations in the pediatric population, with a variable direction and magnitude depending on the indicators used. WHAT IS KNOWN • Iron metabolism is related to important cardiometabolic alterations such as metabolic syndrome and its components. • Association between biomarkers of iron status and cardiometabolic risk have been less explored in children. WHAT IS NEW • Biomarkers of iron metabolism are associated with cardiometabolic alterations in the pediatric population. • Iron parameters in the pediatric population could be of great help to detect and prevent cardiometabolic abnormalities early.
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Affiliation(s)
- Honorato Ortiz-Marrón
- Cardiovascular Disease Surveillance Technical Unit, Directorate-General of Public Health. Ministry of Health of Community of Madrid, Madrid, Spain.
| | - Gloria Cabañas Pujadas
- Cardiovascular Disease Surveillance Technical Unit, Directorate-General of Public Health. Ministry of Health of Community of Madrid, Madrid, Spain
| | - Encarnación Donoso Navarro
- Clinical Analysis and Biochemistry Service, Puerta de Hierro University Hospital, Madrid, Majadahonda, Spain
| | - Mar Burreros García
- Health Center Collado Mediano. Collado Mediano, Ministry of Health of Community of Madrid, Madrid, Spain
| | | | | | - Ana Cornejo Gutiérrez
- Health Center Barcelona. Móstoles. Ministry of Health of Community of Madrid, Madrid, Spain
| | - Iñaki Galán
- National Centre for Epidemiology, Institute of Health Carlos III. Madrid, Madrid, Spain
- Department of Preventive Medicine and Public Health. Faculty of Medicine, Universidad Autónoma de Madrid (IdiPaz), Autonomous University of Madrid), Madrid, Spain
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Turkulainen E, Ihalainen J, Arvas M. Simulated effects of ferritin screening on C-reactive protein levels in recruited blood donors. Vox Sang 2023; 118:901-905. [PMID: 37622476 DOI: 10.1111/vox.13515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/28/2023] [Accepted: 08/05/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND AND OBJECTIVES Ferritin is commonly measured to evaluate iron stores in the body. Some countries have added or considered adding ferritin lower bounds to donor eligibility criteria. Ferritin is also elevated by inflammation. The main goal of this study is to estimate how different ferritin cut-offs would affect the proportion of donors with a C-reactive protein (CRP) level over 3 mg/L, which is the decision limit of the highest chronic cardiovascular risk. MATERIALS AND METHODS To simulate recruitment of new blood donors, we selected participants from two Finnish general population cohorts, namely FINRISK 1997 (n = 5369) and Health 2000 (n = 3278), that would likely fulfil the selection criteria of blood donation. We then calculated the proportion of individuals with high-sensitivity CRP values above 3 mg/L, over a range of ferritin values. RESULTS We found that for several ferritin cut-offs the proportion of potential donors with CRP > 3 mg/L would rise by a statistically significant amount. The trend was significant and similar for all subgroups but weaker for non-menstruating women as well as men. CONCLUSION Our results show that screening a population of potential blood donors with ferritin cut-offs raises the number of people with CRP > 3 mg/L within the blood donor population.
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Affiliation(s)
- Esa Turkulainen
- Research and Development, Finnish Red Cross Blood Service, Helsinki, Finland
| | - Jarkko Ihalainen
- Research and Development, Finnish Red Cross Blood Service, Helsinki, Finland
| | - Mikko Arvas
- Research and Development, Finnish Red Cross Blood Service, Helsinki, Finland
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Pühringer R, Muckenthaler M, Burtscher M. Association Between Ferritin Levels and Altitude-Dependent Cardiorespiratory Fitness in Mountain Guides. High Alt Med Biol 2023; 24:139-143. [PMID: 37134197 DOI: 10.1089/ham.2023.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
Pühringer, Reinhard, Martina Muckenthaler, and Martin Burtscher. Association between ferritin levels and altitude-dependent cardiorespiratory fitness in mountain guides. High Alt Med Biol. 24:139-143, 2023. Background: Higher ferritin levels may be associated with lower cardiorespiratory fitness (CRF; i.e., maximal oxygen uptake, VO2max) and may represent early markers of cardiovascular risk but may also support high-altitude acclimatization. To evaluate these potential associations, data recordings from a large sample of male mountain guides have been analyzed. Methods: A total of 154 data sets (including anthropometric data, VO2max, blood lipids, hemoglobin, ferritin, and transferrin levels) of regularly physically active and well-acclimatized mountain guides were available for analyses. Participants performed equal incremental cycle ergometer tests to exhaustion at low (600 m) and (∼1 week later) at moderate altitude (2,000 m). Results: Ferritin levels were positively correlated with levels of hemoglobin (r = 0.29, p < 0.01), total cholesterol (r = 0.18, p < 0.05), triglycerides (r = 0.23, p < 0.01), and low-density lipoprotein (r = 0.22, p < 0.01), and negatively with high-density lipoprotein levels (r = -0.16, p < 0.05) and also with baseline (taken at low altitude) VO2max values (r = -0.19, p < 0.05). In contrast, higher ferritin levels were associated with less VO2max decline from low-to-moderate altitude (r = 0.26, p < 0.01). Conclusion: Higher ferritin levels in male mountain guides are weakly associated with lower CRF and higher prevalence of cardiovascular risk factors but with slightly less reduction in VO2max when acutely exposed to moderate altitude. The clinical relevance of these observations needs further investigation.
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Affiliation(s)
- Reinhard Pühringer
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
- Austrian Society for Alpine- and High-Altitude Medicine, Innsbruck, Austria
| | - Martina Muckenthaler
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology, Immunology and Pulmonology, Centre for Translational Biomedical Iron Research, Molecular Medicine Partnership Unit (MMPU) Group Leader, University Hospital Heidelberg, Heidelberg, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Heidelberg/Mannheim, Heidelberg, Germany
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
- Austrian Society for Alpine- and High-Altitude Medicine, Innsbruck, Austria
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Zeng Z, Liu Y, Hu X, Li P, Wang L. Effects of high-heeled shoes on lower extremity biomechanics and balance in females: a systematic review and meta-analysis. BMC Public Health 2023; 23:726. [PMID: 37081521 PMCID: PMC10120101 DOI: 10.1186/s12889-023-15641-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 04/10/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND High-heeled shoes (HHS) are widely worn by women in daily life. Limited quantitative studies have been conducted to investigate the biomechanical performance between wearing HHS and wearing flat shoes or barefoot. This study aimed to compare spatiotemporal parameters, kinematics, kinetics and muscle function during walking and balance between wearing HHS and flat shoes or barefoot. METHODS According to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, PubMed Medline, Cochrane, EMBASE, CINAHL Complete and Web of Science databases were searched from the earliest record to December 2021. A modified quality index was applied to evaluate the risk of bias, and effect sizes with 95% confidence intervals were calculated as the standardized mean differences (SMD). Potential publication bias was evaluated graphically using funnel plot and the robustness of the overall results was assessed using sensitivity analyses. RESULTS Eighty-one studies (n = 1501 participants) were included in this study. The reduced area of support requires the body to establish a safer and more stable gait pattern by changing gait characteristics when walking in HHS compared with walking in flats shoes or barefoot. Walking in HHS has a slight effect on hip kinematics, with biomechanical changes and adaptations concentrated in the knee and foot-ankle complex. Females wearing HHS performed greater ground reaction forces earlier, accompanied by an anterior shift in plantar pressure compared with those wearing flat shoes/barefoot. Furthermore, large effect sizes indicate that wearing HHS resulted in poor static and dynamic balance. CONCLUSION Spatiotemporal, kinematic, kinetic and balance variables are affected by wearing HHS. The effect of specific heel heights on women's biomechanics would benefit from further research.
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Affiliation(s)
- Ziwei Zeng
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, China
| | - Yue Liu
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, China
| | - Xiaoyue Hu
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, China
| | - Pan Li
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, China
| | - Lin Wang
- Key Laboratory of Exercise and Health Sciences (Shanghai University of Sport), Ministry of Education, Shanghai, China.
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He X, Wang W, Zhu Z, Zang J, Liu T, Shi Y, Fu C. Percent Body Fat-Related Disparities of Serum Ferritin on the Risk of Lipid Metabolism Abnormalities in Children and Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16235. [PMID: 36498311 PMCID: PMC9740190 DOI: 10.3390/ijerph192316235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/24/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE This study examined the association between serum ferritin and dyslipidemia in children and adolescents with different degrees of obesity. METHOD In this multi-stage, stratified, randomized, sampling cross-section cohort study, demographic data were collected by questionnaire from 4320 children and adolescents (aged 6-17 years) in Shanghai, China. Anthropometric measures and percent body fat (PBF) were recorded. Serum lipid parameters were detected by an automatic biochemical method, and ferritin levels were measured by an automatic immunoassay. RESULTS Our results showed 70.6%, 13.9%, and 15.5% of participants had a healthy body fat, low fat, and overweight/obese, respectively. Increasing ferritin quartiles were independently associated with a greater hazard of dyslipidemia, especially in overweight/obese participants, and the OR (95% CI) was 3.01 (1.29-7.00), 3.58 (1.59-8.04), and 5.66 (2.57-12.46) across the ferritin quartiles after adjustment for confounders. Ferritin was only a predictive value for dyslipidemia in overweight/obese participants (AUC = 0.64) and was consistent in boys (AUC = 0.61) and girls (AUC = 0.68). The significant positive correlation between ferritin value and lipid abnormalities profiles (except for low HDL-C) mainly appeared in the overweight/obesity group. CONCLUSION The results showed that serum ferritin can be considered an independent risk factor for dyslipidemia in children and adolescents with obesity. HIGHLIGHTS Ferritin overload had a greater risk of dyslipidemia, especially in children and adolescents with overweight/obesity.
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Affiliation(s)
- Xin He
- Laboratory of Functional Medicine, Division of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Wenjing Wang
- Laboratory of Functional Medicine, Division of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Zhenni Zhu
- Department of Nutrition Hygiene, Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Jiajie Zang
- Department of Nutrition Hygiene, Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Tong Liu
- Laboratory of Functional Medicine, Division of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Yan Shi
- Laboratory of Functional Medicine, Division of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
| | - Chen Fu
- Laboratory of Functional Medicine, Division of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
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Xie CH, Chen LW, Lin CL, Hu CC, Chien CH. Serum Uric Acid but Not Ferritin Level Is Associated with Hepatic Fibrosis in Lean Subjects with Metabolic Dysfunction-Associated Fatty Liver Disease: A Community-Based Study. J Pers Med 2022; 12:jpm12122009. [PMID: 36556230 PMCID: PMC9782820 DOI: 10.3390/jpm12122009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 11/27/2022] [Accepted: 12/01/2022] [Indexed: 12/09/2022] Open
Abstract
Elevated serum ferritin and uric acid levels are common in patients with fatty liver disease. This study assessed the association between serum ferritin and uric acid levels and liver fibrosis in subjects with lean metabolic dysfunction-associated fatty liver disease (MAFLD). This cross-sectional study used data from a community screening examination for metabolic syndrome from December 2018 to September 2019 at Keelung Chang Gung Memorial Hospital. Subjects with lean MAFLD were defined as those with a body mass index (BMI) < 23 kg/m2 and hepatic steatosis according to the MAFLD criteria. A total of 182 lean subjects were included and were divided into lean MAFLD and lean healthy groups. Serum ferritin and uric acid concentrations were positively correlated with liver fibrosis, regardless of whether FIB-4, APRI, or NFS were used as references. Univariate logistic regression analysis showed that age and uric acid were associated with advanced liver fibrosis. After adjusting for potential confounders, only uric acid level was statistically significant in predicting the advanced liver fibrosis (OR = 6.907 (1.111−42.94), p = 0.038) in the lean MAFLD group. We found that an elevated serum uric acid level is an independent factor associated with advanced liver fibrosis in lean MAFLD subjects by noninvasive fibrosis scores.
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Affiliation(s)
- Cheng-Han Xie
- Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital and University, Keelung 204, Taiwan
| | - Li-Wei Chen
- Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital and University, Keelung 204, Taiwan
- Community Medicine Research Center, Chang-Gung Memorial Hospital and University, Keelung 204, Taiwan
- Correspondence: ; Tel.: +886-2-24313131 (ext. 6203); Fax: +886-2-24335342
| | - Chih-Lang Lin
- Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital and University, Keelung 204, Taiwan
- Community Medicine Research Center, Chang-Gung Memorial Hospital and University, Keelung 204, Taiwan
| | - Ching-Chih Hu
- Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital and University, Keelung 204, Taiwan
- Community Medicine Research Center, Chang-Gung Memorial Hospital and University, Keelung 204, Taiwan
| | - Cheng-Hung Chien
- Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital and University, Keelung 204, Taiwan
- Community Medicine Research Center, Chang-Gung Memorial Hospital and University, Keelung 204, Taiwan
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10
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Cho Y, Lee SY. Useful Biomarkers of Metabolic Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192215003. [PMID: 36429722 PMCID: PMC9690835 DOI: 10.3390/ijerph192215003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 11/13/2022] [Indexed: 05/30/2023]
Abstract
The Special Issue call for papers on "Metabolic syndrome and its association with biomarkers" was proposed to present research on various markers for pathophysiology and the early detection of metabolic syndrome (MetS) [...].
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Affiliation(s)
- Younghye Cho
- Department of Family Medicine and Biomedical Research Institute, Yangsan Hospital, Pusan National University, Yangsan 50612, Republic of Korea
| | - Sang Yeoup Lee
- Department of Family Medicine and Biomedical Research Institute, Yangsan Hospital, Pusan National University, Yangsan 50612, Republic of Korea
- Department of Medical Education, School of Medicine, Pusan National University, Yangsan 50612, Republic of Korea
- Integrated Research Institute for Natural Ingredients and Functional Foods, Yangsan 50612, Republic of Korea
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11
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Koivula T, Lempiäinen S, Laine S, Sjöros T, Vähä-Ypyä H, Garthwaite T, Löyttyniemi E, Sievänen H, Vasankari T, Knuuti J, Heinonen IHA. Cross-Sectional Associations of Body Adiposity, Sedentary Behavior, and Physical Activity with Hemoglobin and White Blood Cell Count. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114347. [PMID: 36361221 PMCID: PMC9657926 DOI: 10.3390/ijerph192114347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 05/06/2023]
Abstract
BACKGROUND This study examined whether hemoglobin (Hb) and white blood cell count (WBC) associate with body adiposity and other cardiometabolic risk factors, as well as accelerometer-measured sedentary behavior (SB) and physical activity (PA), when adjusted for body mass index (BMI). METHODS The cross-sectional analysis included 144 participants (42 men) with a mean age of 57.0 years and a mean BMI of 31.7 kg/m2. SB and standing time, breaks in sedentary time and PA were measured during four consecutive weeks with hip-worn accelerometers. A fasting blood sample was collected from each participant during the 4-week measurement period and analyzed using Sysmex XN and Cobas 8000 c702 analyzers. Associations of WBC, Hb and other red blood cell markers with cardiometabolic risk factors and physical activity were examined by Pearson's partial correlation coefficient test and with linear mixed regression models. RESULTS In sex- and age-adjusted correlation analyses both BMI and waist circumference correlated positively with Hb, WBC, red blood cell count (RBC), and hematocrit. Hb was also positively correlated with systolic blood pressure, insulin resistance scores, liver enzymes, LDL, and triglyceride levels. Sedentary time correlated positively with WBC, whereas standing time correlated negatively with WBC. Lying time correlated positively with WBC, RBC, hematocrit, and Hb. Regarding SB and PA measures, only the association between lying time and RBC remained significant after adjustment for the BMI. CONCLUSION We conclude that body adiposity, rather than components of SB or PA, associates with Hb levels and WBC, which cluster with general metabolic derangement.
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Affiliation(s)
- Tiia Koivula
- Turku PET Centre, University of Turku and Turku University Hospital, 20520 Turku, Finland
| | - Salla Lempiäinen
- Oncology Clinic, Turku University Hospital, 20520 Turku, Finland
| | - Saara Laine
- Turku PET Centre, University of Turku and Turku University Hospital, 20520 Turku, Finland
| | - Tanja Sjöros
- Turku PET Centre, University of Turku and Turku University Hospital, 20520 Turku, Finland
| | | | - Taru Garthwaite
- Turku PET Centre, University of Turku and Turku University Hospital, 20520 Turku, Finland
| | | | | | | | - Juhani Knuuti
- Turku PET Centre, University of Turku and Turku University Hospital, 20520 Turku, Finland
| | - Ilkka H. A. Heinonen
- Turku PET Centre, University of Turku and Turku University Hospital, 20520 Turku, Finland
- Rydberg Laboratory of Applied Sciences, University of Halmstad, 30118 Halmstad, Sweden
- Correspondence: ; Tel.: +358-2-3138145
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12
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Chung SJ, Lim HS, Lee MY, Lee YT, Yoon KJ, Park CH. Sex-Specific Associations between Serum Ferritin and Osteosarcopenic Obesity in Adults Aged over 50 Years. Nutrients 2022; 14:nu14194023. [PMID: 36235680 PMCID: PMC9570979 DOI: 10.3390/nu14194023] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
We investigated the sex-specific association between ferritin and adverse body composition in adults aged over 50 years in a population-based cohort. A total of 25,546 participants (16,912 women; 8634 men) were stratified into three groups by the tertiles of ferritin. The number of adverse body compositions was categorized as 0 (without osteopenia/osteoporosis, low muscle mass, or obesity), 1 (having one of the components), 2 (two), and 3 (all three; osteosarcopenic obesity). As ferritin tertile increased, the prevalence of one, two, or three simultaneous adverse body compositions increased, significant only in women (p < 0.0001), not in men (p = 0.125). Among women, the prevalence of osteosarcopenic obesity gradually increased from 1.7% in the lowest, to 2.2% in the middle, and 2.5% in the highest tertile. Using multivariate-adjusted analysis, women in the higher tertile had an increased likelihood of having multiple adverse body compositions compared with those in the lowest tertile. Women in the highest tertile had a 1.52 times increased risk of osteosarcopenic obesity than those in the lowest tertile. A high ferritin level was associated with an increased risk of having multiple adverse body compositions, especially for osteosarcopenic obesity in women aged >50 years, suggesting its potential use for detecting osteosarcopenic obesity.
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Affiliation(s)
- Sung-Joon Chung
- Department of Physical and Rehabilitation Medicine, Kyunghee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, Korea
- Department of Medicine, Graduate School, Kyunghee University, Seoul 02447, Korea
| | - Han Sol Lim
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea
| | - Mi-Yeon Lee
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea
| | - Yong-Taek Lee
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea
| | - Kyung Jae Yoon
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul 06355, Korea
| | - Chul-Hyun Park
- Department of Physical and Rehabilitation Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea
- Correspondence: ; Tel.: +82-2-2001-2284
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13
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Srivastav SK, Mir IA, Bansal N, Singh PK, Kumari R, Deshmukh A. Serum Ferritin in Metabolic Syndrome-Mechanisms and Clinical Applications. PATHOPHYSIOLOGY 2022; 29:319-325. [PMID: 35736651 PMCID: PMC9231231 DOI: 10.3390/pathophysiology29020023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 11/17/2022] Open
Abstract
Metabolic syndrome (MS) is a cluster of conditions including central obesity, hypertriglyceridemia, low HDL cholesterol, hyperglycaemia, and hypertension with a prevalence rate of 20−25% of the world’s adult population. Metabolic syndrome is often characterized by insulin resistance, which some have suggested is a major supportive connection between physical inactivity and MS. Various studies suggest that moderately elevated iron and ferritin levels are associated with an increased prevalence of metabolic syndrome and are markers of insulin resistance. Increased body iron stores are associated with the development of glucose intolerance, type 2 diabetes mellitus, and insulin resistance syndrome (IRS). This is a hospital-based cross-sectional observational study, which was conducted in the department of internal medicine of a tertiary care hospital in northern India. The study was conducted from 1 January 2019 to 30 June 2020 and included 100 patients and 100 controls. All subjects in the age group of 35−65 years were enrolled and investigated as per the study design. Metabolic syndrome patients were diagnosed according to the modified National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP-III) with BMI > 23 kg/m2. All baseline investigations were undertaken, including serum ferritin levels. Insulin resistance (IR) was calculated using the homeostasis model assessment IR (HOMA-IR) formula. We found a positive association between an increase in serum ferritin with the prevalence of metabolic syndrome and its clinical parameter. The serum ferritin level was positively correlated with the level of insulin resistance and inversely correlated with the insulin level of the patients.
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Affiliation(s)
- Shrey Kumar Srivastav
- Department of Medicine, School of Medical Science and Research, Sharda University, Uttar Pradesh 201306, India; (S.K.S.); (N.B.); (R.K.); (A.D.)
| | - Irfan Ahmad Mir
- Department of Medicine, School of Medical Science and Research, Sharda University, Uttar Pradesh 201306, India; (S.K.S.); (N.B.); (R.K.); (A.D.)
- Correspondence:
| | - Naman Bansal
- Department of Medicine, School of Medical Science and Research, Sharda University, Uttar Pradesh 201306, India; (S.K.S.); (N.B.); (R.K.); (A.D.)
| | - Pankaj Kumar Singh
- Department of Emergency Medicine, School of Medical Science and Research, Sharda University, Uttar Pradesh 201306, India;
| | - Rashmi Kumari
- Department of Medicine, School of Medical Science and Research, Sharda University, Uttar Pradesh 201306, India; (S.K.S.); (N.B.); (R.K.); (A.D.)
| | - Ajoy Deshmukh
- Department of Medicine, School of Medical Science and Research, Sharda University, Uttar Pradesh 201306, India; (S.K.S.); (N.B.); (R.K.); (A.D.)
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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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Abulseoud OA, Yehia A, Egol CJ, Nettey VN, Aly M, Qu Y, Skolnik AB, Grill MF, Sen A, Schneekloth TD. Attenuated initial serum ferritin concentration in critically ill coronavirus disease 2019 geriatric patients with comorbid psychiatric conditions. Front Psychiatry 2022; 13:1035986. [PMID: 36440432 PMCID: PMC9681793 DOI: 10.3389/fpsyt.2022.1035986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 10/20/2022] [Indexed: 11/10/2022] Open
Abstract
We examined the effects of psychiatric comorbidity, sex, and ICU admission on serum ferritin concentration in 628 elderly patients (79.7 ± 8.5 years) with positive SARS-CoV-2 PCR test. Hospitalization was required in 96% of patients and 17% required ICU admission. Patients with COVID-19 and psychiatric comorbidities (n = 212) compared to patients without psychiatric comorbidities (n = 416) had significantly lower ferritin concentration (570.4 ± 900.1 vs. 744.1 ± 965, P = 0.029), a greater incidence of delirium (22.6 vs. 14.4%, P = 0.013) and higher mortality (35.3 vs. 27.6%, P = 0.015). Furthermore, we found significant effects for sex (P = 0.002) and ICU admission (P = 0.007). Among patients without comorbid psychiatric conditions, males had significantly higher ferritin compared to females (1,098.3 ± 78.4 vs. 651.5 ± 94.4, P < 0.001). ICU patients without comorbid psychiatric conditions had significantly higher serum ferritin compared to ICU patients with comorbid psychiatric conditions: (1,126.6 ± 110.7 vs. 668.6 ± 156.5, P < 0.001). Our results suggest that the presence of comorbid psychiatric conditions in elderly patients with COVID-19 is associated with higher rates of delirium and mortality and lower ferritin levels during severe illness. Whether high serum ferritin is protective during severe infection requires further investigation.
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Affiliation(s)
- Osama A Abulseoud
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ, United States.,Department of Neuroscience, Mayo Clinic Graduate School of Biomedical Sciences, Collaborative Research Building (CRB), Scottsdale, AZ, United States
| | - Asmaa Yehia
- Department of Medical Physiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Claudine J Egol
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - Victor N Nettey
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - Mohamed Aly
- Department of Cardiothoracic Surgery, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - Yihuai Qu
- Alix School of Medicine at Mayo Clinic, Phoenix, AZ, United States
| | - Aaron B Skolnik
- Department of Critical Care, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - Marie F Grill
- Department of Neurology, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - Ayan Sen
- Department of Critical Care, Mayo Clinic Arizona, Phoenix, AZ, United States
| | - Terry D Schneekloth
- Department of Psychiatry and Psychology, Mayo Clinic Arizona, Phoenix, AZ, United States
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Biomarkers in metabolic syndrome. Adv Clin Chem 2022; 111:101-156. [DOI: 10.1016/bs.acc.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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17
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Effects of Quality and Quantity of Protein Intake for Type 2 Diabetes Mellitus Prevention and Metabolic Control. Curr Nutr Rep 2021; 9:329-337. [PMID: 32572702 DOI: 10.1007/s13668-020-00324-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW The aim of this review is to evaluate the ideal protein quality and quantity and the dietary composition for the prevention and metabolic control of type 2 diabetes mellitus (T2DM). INTRODUCTION Although some reviews demonstrate the advantages of a diet with a higher protein intake, other reviews have observed that a diet high in carbohydrates, with low-glycaemic index carbohydrates and good fibre intake, is equally effective in improving insulin sensitivity. METHODS Over 2831 articles were screened, and 24 from the last 5 years were analysed and summarised for this review, using the protein, diabetes and insulin glucose metabolic keywords in Pubmed in June 2019. RESULTS Eleven studies demonstrate that a higher consumption of proteins has a positive effect on insulin sensitivity. A higher intake of animal protein seems to be related to an increased risk of T2DM. Four studies show that consumption of meat has a deleterious effect. Higher intake of plant protein and dairy products is associated with a modestly reduced risk. DISCUSSION Based on the results obtained, for the prevention of T2DM and all disorders related to metabolic syndrome, no ideal dietary composition has yet been found. The advantage of plant protein sources may be related to the foods' low-glycaemic index due to the high fibre content. However, the right protein quality (animal and plant) and the quantity for T2DM prevention and metabolic control are unclear and need to be investigated with further long-term studies.
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Hassannejad R, Sharrouf H, Haghighatdoost F, Kirk B, Amirabdollahian F. Diagnostic Power of Circulatory Metabolic Biomarkers as Metabolic Syndrome Risk Predictors in Community-Dwelling Older Adults in Northwest of England (A Feasibility Study). Nutrients 2021; 13:nu13072275. [PMID: 34209146 PMCID: PMC8308366 DOI: 10.3390/nu13072275] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Metabolic Syndrome (MetS) is a cluster of risk factors for diabetes and cardiovascular diseases with pathophysiology strongly linked to aging. A range of circulatory metabolic biomarkers such as inflammatory adipokines have been associated with MetS; however, the diagnostic power of these markers as MetS risk correlates in elderly has yet to be elucidated. This cross-sectional study investigated the diagnostic power of circulatory metabolic biomarkers as MetS risk correlates in older adults. Methods: Hundred community dwelling older adults (mean age: 68.7 years) were recruited in a study, where their blood pressure, body composition and Pulse Wave Velocity (PWV) were measured; and their fasting capillary and venous blood were collected. The components of the MetS; and the serum concentrations of Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF-α), Plasminogen Activator Inhibitor-I (PAI-I), Leptin, Adiponectin, Resistin, Cystatin-C, C-Reactive Protein (CRP), insulin and ferritin were measured within the laboratory, and the HOMA1-IR and Atherogenic Index of Plasma (AIP) were calculated. Results: Apart from other markers which were related with some cardiometabolic (CM) risk, after Bonferroni correction insulin had significant association with all components of Mets and AIP. These associations also remained significant in multivariate regression. The multivariate odds ratio (OR with 95% confidence interval (CI)) showed a statistically significant association between IL-6 (OR: 1.32 (1.06–1.64)), TNF-α (OR: 1.37 (1.02–1.84)), Resistin (OR: 1.27 (1.04–1.54)) and CRP (OR: 1.29 (1.09–1.54)) with MetS risk; however, these associations were not found when the model was adjusted for age, dietary intake and adiposity. In unadjusted models, insulin was consistently statistically associated with at least two CM risk factors (OR: 1.33 (1.16–1.53)) and MetS risk (OR: 1.24 (1.12–1.37)) and in adjusted models it was found to be associated with at least two CM risk factors and MetS risk (OR: 1.87 (1.24–2.83) and OR: 1.25 (1.09–1.43)) respectively. Area under curve (AUC) for receiver operating characteristics (ROC) demonstrated a good discriminatory diagnostics power of insulin with AUC: 0.775 (0.683–0.866) and 0.785 by cross validation and bootstrapping samples for at least two CM risk factors and AUC: 0.773 (0.653–0.893) and 0.783 by cross validation and bootstrapping samples for MetS risk. This was superior to all other AUC reported from the ROC analysis of other biomarkers. Area under precision-recall curve for insulin was also superior to all other markers (0.839 and 0.586 for at least two CM risk factors and MetS, respectively). Conclusion: Fasting serum insulin concentration was statistically linked with MetS and its risk, and this link is stronger than all other biomarkers. Our ROC analysis confirmed the discriminatory diagnostic power of insulin as CM and MetS risk correlate in older adults.
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Affiliation(s)
- Razieh Hassannejad
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran; (R.H.); (F.H.)
| | - Hamsa Sharrouf
- School of Health Sciences, Liverpool Hope University, Liverpool L16 9JD, UK; (H.S.); (B.K.)
| | - Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan 8158388994, Iran; (R.H.); (F.H.)
| | - Ben Kirk
- School of Health Sciences, Liverpool Hope University, Liverpool L16 9JD, UK; (H.S.); (B.K.)
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Furlong Road, St. Albans, Melbourne, VIC 3021, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Geroscience & Osteosarcopenia Research Program, The University of Melbourne and Western Health, St. Albans, Melbourne, VIC 3201, Australia
| | - Farzad Amirabdollahian
- School of Health Sciences, Liverpool Hope University, Liverpool L16 9JD, UK; (H.S.); (B.K.)
- Correspondence:
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Gavia-García G, Rosado-Pérez J, Arista-Ugalde TL, Aguiñiga-Sánchez I, Santiago-Osorio E, Mendoza-Núñez VM. Telomere Length and Oxidative Stress and Its Relation with Metabolic Syndrome Components in the Aging. BIOLOGY 2021; 10:biology10040253. [PMID: 33804844 PMCID: PMC8063797 DOI: 10.3390/biology10040253] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 12/20/2022]
Abstract
Simple Summary A link between telomere length and some age-related diseases has been identified, including metabolic syndrome. So far, there is no mechanism to explain the origin or cause of telomere shortening in this syndrome; however, oxidative stress is a constant factor. Therefore, we reviewed scientific evidence that supported the association between oxidative stress and telomere length dynamics, also examining how each of the metabolic syndrome components individually affects the length. In this regard, there is strong scientific evidence that an increase in the number of metabolic syndrome components is associated with a shorter telomere length, oxidative damage at the lipid and DNA level, and inflammation, as well as its other components, such as obesity, hyperglycemia, and hypertension, while for dyslipidemia, there is a little more discrepancy. The difficulty for the correct treatment of metabolic syndrome lies in its multifactorial nature. Hence, there is a need to carry out more studies on healthy lifestyles during aging to prevent and reduce oxidative damage and telomere wear during aging, and consequently the progression of chronic degenerative diseases, thus improving the living conditions of older people.
Abstract A great amount of scientific evidence supports that Oxidative Stress (OxS) can contribute to telomeric attrition and also plays an important role in the development of certain age-related diseases, among them the metabolic syndrome (MetS), which is characterised by clinical and biochemical alterations such as obesity, dyslipidaemia, arterial hypertension, hyperglycaemia, and insulin resistance, all of which are considered as risk factors for type 2 diabetes mellitus (T2DM) and cardiovascular diseases, which are associated in turn with an increase of OxS. In this sense, we review scientific evidence that supports the association between OxS with telomere length (TL) dynamics and the relationship with MetS components in aging. It was analysed whether each MetS component affects the telomere length separately or if they all affect it together. Likewise, this review provides a summary of the structure and function of telomeres and telomerase, the mechanisms of telomeric DNA repair, how telomere length may influence the fate of cells or be linked to inflammation and the development of age-related diseases, and finally, how the lifestyles can affect telomere length.
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Affiliation(s)
- Graciela Gavia-García
- Research Unit on Gerontology, FES Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico; (G.G.-G.); (J.R.-P.); (T.L.A.-U.)
| | - Juana Rosado-Pérez
- Research Unit on Gerontology, FES Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico; (G.G.-G.); (J.R.-P.); (T.L.A.-U.)
| | - Taide Laurita Arista-Ugalde
- Research Unit on Gerontology, FES Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico; (G.G.-G.); (J.R.-P.); (T.L.A.-U.)
| | - Itzen Aguiñiga-Sánchez
- Hematopoiesis and Leukemia Laboratory, Research Unit on Cell Differentiation and Cancer, FES Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico; (I.A.-S.); (E.S.-O.)
| | - Edelmiro Santiago-Osorio
- Hematopoiesis and Leukemia Laboratory, Research Unit on Cell Differentiation and Cancer, FES Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico; (I.A.-S.); (E.S.-O.)
| | - Víctor Manuel Mendoza-Núñez
- Research Unit on Gerontology, FES Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico; (G.G.-G.); (J.R.-P.); (T.L.A.-U.)
- Correspondence: ; Tel.: +52-55-5623-0721; Fax: +52-55-5773-6330
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Majoni SW, Lawton PD, Rathnayake G, Barzi F, Hughes JT, Cass A. Narrative Review of Hyperferritinemia, Iron Deficiency, and the Challenges of Managing Anemia in Aboriginal and Torres Strait Islander Australians With CKD. Kidney Int Rep 2021; 6:501-512. [PMID: 33615076 PMCID: PMC7879094 DOI: 10.1016/j.ekir.2020.10.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/27/2020] [Indexed: 12/16/2022] Open
Abstract
Aboriginal and Torres Strait Islander Australians (Indigenous Australians) suffer some of the highest rates of chronic kidney disease (CKD) in the world. Among Indigenous Australians in remote areas of the Northern Territory, prevalence rates for renal replacement therapy (RRT) are up to 30 times higher than national prevalence. Anemia among patients with CKD is a common complication. Iron deficiency is one of the major causes. Iron deficiency is also one of the key causes of poor response to the mainstay of anemia therapy with erythropoiesis-stimulating agents (ESAs). Therefore, the effective management of anemia in people with CKD is largely dependent on effective identification and correction of iron deficiency. The current identification of iron deficiency in routine clinical practice is dependent on 2 surrogate markers of iron status: serum ferritin concentration and transferrin saturation (TSAT). However, questions exist regarding the use of serum ferritin concentration in people with CKD because it is an acute-phase reactant that can be raised in the context of acute and chronic inflammation. Serum ferritin concentration among Indigenous Australians receiving RRT is often markedly elevated and falls outside reference ranges within most national and international guidelines for iron therapy for people with CKD. This review explores published data on the challenges of managing anemia in Indigenous people with CKD and the need for future research on the efficacy and safety of treatment of anemia of CKD in patients with high ferritin and evidence iron deficiency.
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Affiliation(s)
- Sandawana William Majoni
- Department of Nephrology, Division of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
- Flinders University and Northern Territory Medical Program, Royal Darwin Hospital Campus, Darwin, Northern Territory, Australia
- Wellbeing and Preventable Chronic Diseases, Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia
| | - Paul D. Lawton
- Department of Nephrology, Division of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
- Wellbeing and Preventable Chronic Diseases, Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia
| | - Geetha Rathnayake
- Flinders University and Northern Territory Medical Program, Royal Darwin Hospital Campus, Darwin, Northern Territory, Australia
- Chemical Pathology–Territory Pathology, Department of Health, Northern Territory Government, Northern Territory, Australia
| | - Federica Barzi
- Wellbeing and Preventable Chronic Diseases, Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia
| | - Jaquelyne T. Hughes
- Department of Nephrology, Division of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
- Wellbeing and Preventable Chronic Diseases, Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia
| | - Alan Cass
- Wellbeing and Preventable Chronic Diseases, Menzies School of Health Research, Charles Darwin University, Northern Territory, Australia
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21
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Metabolic syndrome may be associated with a lower prevalence of iron deficiency in Ecuadorian women of reproductive age. J Nutr Sci 2021; 10:e4. [PMID: 33889387 PMCID: PMC8057425 DOI: 10.1017/jns.2020.55] [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: 08/27/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 11/06/2022] Open
Abstract
The present study aimed to assess the associations of the stages of Fe deficiency (Fe deficiency without anaemia (ID) and Fe-deficiency anaemia (IDA)) and anaemia with metabolic syndrome (MetS) in Ecuadorian women. A cross-sectional study was conducted in 5894 women aged 20–59 years, based on data from the 2012 Ecuadorian National Health and Nutrition Survey. The sample was stratified by age. A χ2 test was used to assess the possible associations of ID, IDA and anaemia with MetS. The prevalence ratio (PR) for each stage of Fe deficiency and anaemia was estimated considering women without MetS as a reference. The total prevalence of MetS, ID, IDA and anaemia was 32⋅3 % (se 0⋅6), 6⋅2 % (se 0⋅3), 7⋅1 % (se 0⋅3) and 5⋅0 % (se 0⋅3), respectively. In women aged 20–29, 30–39 and 40–49 years, MetS was associated with a lower prevalence of ID (PR (95 % CI; P-value)): 0⋅17 (0⋅06, 0⋅46; P < 0⋅001), 0⋅69 (0⋅48, 0⋅99; P = 0⋅044) and 0⋅44 (0⋅29, 0⋅67; P < 0⋅001), respectively. In women aged 50–59 years, MetS was associated with IDA and anaemia (PR (95 % CI; P-value)): 0⋅12 (0⋅02, 0⋅96; P = 0⋅026) and 0⋅22 (0⋅07, 0⋅64; P = 0⋅002), respectively. In conclusion, Ecuadorian women of reproductive age with MetS have a lower prevalence of ID compared with those without MetS. Furthermore, the MetS and IDA coexist at the population level. These findings require an analysis from a dietary pattern approach, which could provide key elements for developing public policies that simultaneously address all forms of malnutrition.
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R2 and R2* MRI assessment of liver iron content in an undifferentiated diagnostic population with hyperferritinaemia, and impact on clinical decision making. Eur J Radiol 2020; 135:109473. [PMID: 33373894 DOI: 10.1016/j.ejrad.2020.109473] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 12/02/2020] [Accepted: 12/07/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To confirm the linear correlation between Ferriscan® R2 (1/T2 Relaxomatry) and R2* (1/T2* Relaxometry) derived 3D Gradient echo (GRE) mDIXON-Quant sequence (Philips) with simultaneous production of a proton density fat fraction (PDFF) in undifferentiated patients with hyperferritinaemia, and to prospectively determine the clinical utility of this tool in these patients by recording the impact on clinical decision-making. MATERIALS AND METHODS Participants referred to a hospital haematology outpatient clinic for investigation and management of elevated serum ferritin (two serum ferritin levels > 500 μg/L 4 weeks apart) were included in the study. EXCLUSION CRITERIA contraindications to MRI; clinically relevant investigations for alternative causes of hyperferritinaemia pending; and terminal illness. Thirty-two participants were recruited: 27 men, 5 women. All MRIs performed at 1.5 T. For R2* quantification, 3D six echo GRE sequence (mDIXON-Quant) was acquired. R2 images were acquired over 20 min as dictated and reported by the licensee (Ferriscan®). Clinician interpretation and patient management based on R2* and liver iron content derived from R2 (LICR2) was recorded. Pearson's correlations, linear regression analyses, and ROC curves were calculated. P value <0.05 was considered significant. RESULTS A high degree of correlation between mean R2* and LICR2 was observed in this novel patient population (slope ± SE of 43.35 ± 1.88 s-1 permg/g; 95 % CI 39.5-47.2; P < 0.001; R2 = 0.87). Clinical decision making was amended in 14/32 (44 %) patients with hyperferritinaemia following the disclosure of R2* results to clinicians, compared with serum ferritin alone. Liver biopsy was avoided in one patient based on LICR2 and R2*. Unrecognised hepatic steatosis was diagnosed in one patient from the PDFF map. CONCLUSION We have confirmed the linear correlation between R2 and R2* in a real-world diagnostic population with hyperferritinaemia. Non-invasive assessment of liver iron content (LIC) by R2 and R2* MRI is a useful clinical tool and alters management in these patients.
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23
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Fallet E, Rayar M, Landrieux A, Camus C, Houssel-Debry P, Jezequel C, Legros L, Uguen T, Ropert-Bouchet M, Boudjema K, Guyader D, Bardou-Jacquet E. Iron metabolism imbalance at the time of listing increases overall and infectious mortality after liver transplantation. World J Gastroenterol 2020; 26:1938-1949. [PMID: 32390704 PMCID: PMC7201152 DOI: 10.3748/wjg.v26.i16.1938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/30/2020] [Accepted: 04/16/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Liver transplantation (LT) is the best treatment for patients with liver cancer or end stage cirrhosis, but it is still associated with a significant mortality. Therefore identifying factors associated with mortality could help improve patient management. The impact of iron metabolism, which could be a relevant therapeutic target, yield discrepant results in this setting. Previous studies suggest that increased serum ferritin is associated with higher mortality. Surprisingly iron deficiency which is a well described risk factor in critically ill patients has not been considered.
AIM To assess the impact of pre-transplant iron metabolism parameters on post-transplant survival.
METHODS From 2001 to 2011, 553 patients who underwent LT with iron metabolism parameters available at LT evaluation were included. Data were prospectively recorded at the time of evaluation and at the time of LT regarding donor and recipient. Serum ferritin (SF) and transferrin saturation (TS) were studied as continuous and categorical variable. Cox regression analysis was used to determine mortality risks factors. Follow-up data were obtained from the local and national database regarding causes of death.
RESULTS At the end of a 95-mo median follow-up, 196 patients were dead, 38 of them because of infections. In multivariate analysis, overall mortality was significantly associated with TS > 75% [HR: 1.73 (1.14; 2.63)], SF < 100 µg/L [HR: 1.62 (1.12; 2.35)], hepatocellular carcinoma [HR: 1.58 (1.15; 2.26)], estimated glomerular filtration rate (CKD EPI Cystatin C) [HR: 0.99 (0.98; 0.99)], and packed red blood cell transfusion [HR: 1.05 (1.03; 1.08)]. Kaplan Meier curves show that patients with low SF (< 100 µg/L) or high SF (> 400 µg/L) have lower survival rates at 36 mo than patients with normal SF (P = 0.008 and P = 0.016 respectively). Patients with TS higher than 75% had higher mortality at 12 mo (91.4% ± 1.4% vs 84.6% ± 3.1%, P = 0.039). TS > 75% was significantly associated with infection related death [HR: 3.06 (1.13; 8.23)].
CONCLUSION Our results show that iron metabolism imbalance (either deficiency or overload) is associated with post-transplant overall and infectious mortality. Impact of iron supplementation or depletion should be assessed in prospective study.
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Affiliation(s)
- Elodie Fallet
- Service des Maladies du Foie, CHU Rennes, University Rennes, Rennes 35033, France
| | - Michel Rayar
- Service de Chirurgie Hepatobilaire, CHU Rennes, University Rennes, Rennes 35033, France
| | - Amandine Landrieux
- Service des Maladies du Foie, CHU Rennes, University Rennes, Rennes 35033, France
| | - Christophe Camus
- Service de Réanimation médicale, CHU Rennes, University Rennes, Rennes 35033, France
| | - Pauline Houssel-Debry
- Service des Maladies du Foie, CHU Rennes, University Rennes, Rennes 35033, France
- Service de Chirurgie Hepatobilaire, CHU Rennes, University Rennes, Rennes 35033, France
| | - Caroline Jezequel
- Service des Maladies du Foie, CHU Rennes, University Rennes, Rennes 35033, France
| | - Ludivine Legros
- Service des Maladies du Foie, CHU Rennes, University Rennes, Rennes 35033, France
| | - Thomas Uguen
- Service des Maladies du Foie, CHU Rennes, University Rennes, Rennes 35033, France
| | | | - Karim Boudjema
- Service de Chirurgie Hepatobilaire, CHU Rennes, University Rennes, Rennes 35033, France
| | - Dominique Guyader
- Service des Maladies du Foie, CHU Rennes, University Rennes, Rennes 35033, France
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Mörwald K, Aigner E, Bergsten P, Brunner SM, Forslund A, Kullberg J, Ahlström H, Manell H, Roomp K, Schütz S, Zsoldos F, Renner W, Furthner D, Maruszczak K, Zandanell S, Weghuber D, Mangge H. Serum Ferritin Correlates With Liver Fat in Male Adolescents With Obesity. Front Endocrinol (Lausanne) 2020; 11:340. [PMID: 32625166 PMCID: PMC7314945 DOI: 10.3389/fendo.2020.00340] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 04/30/2020] [Indexed: 12/11/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) contributes essentially to the burden of obesity and can start in childhood. NAFLD can progress to cirrhosis and hepatocellular carcinoma. The early phase of NAFLD is crucial because during this time the disease is fully reversible. Pediatric NAFLD shows unique features of histology and pathophysiology compared to adults. Changes in serum iron parameters are common in adult NAFLD and have been termed dysmetabolic iron overload syndrome characterized by increased serum ferritin levels and normal transferrin saturation; however, the associations of serum ferritin, inflammation, and liver fat content have been incompletely investigated in children. As magnetic resonance imaging (MRI) is an excellent measure for the degree of liver steatosis, we applied this method herein to clarify the interaction between ferritin and fatty liver in male adolescents. For this study, one hundred fifty male pediatric patients with obesity and who are overweight were included. We studied a subgroup of male patients with (n = 44) and without (n = 18) NAFLD in whom we determined liver fat content, visceral adipose tissue, and subcutaneous adipose tissue extent with a 1.5T MRI (Philips NL). All patients underwent a standardized oral glucose tolerance test. We measured uric acid, triglycerides, HDL-, LDL-, total cholesterol, liver transaminases, high sensitive CRP (hsCRP), interleukin-6, HbA1c, and insulin. In univariate analysis, ferritin was associated with MRI liver fat, visceral adipose tissue content, hsCRP, AST, ALT, and GGT, while transferrin and soluble transferrin receptor were not associated with ferritin. Multivariate analysis identified hsCRP and liver fat content as independent predictors of serum ferritin in the pediatric male patients. Our data indicate that serum ferritin in male adolescents with obesity is mainly determined by liver fat content and inflammation but not by body iron status.
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Affiliation(s)
- Katharina Mörwald
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Elmar Aigner
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- First Department of Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Peter Bergsten
- Department of Medical Cell Biology, University Uppsala, Uppsala, Sweden
| | - Susanne M Brunner
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Research Program for Receptor Biochemistry and Tumor Metabolism, Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Anders Forslund
- Department of Women's and Children's Health, University Uppsala, Uppsala, Sweden
| | - Joel Kullberg
- Department of Surgical Sciences, Radiology, University Uppsala, Uppsala, Sweden
| | - Hakan Ahlström
- Department of Surgical Sciences, Radiology, University Uppsala, Uppsala, Sweden
| | - Hannes Manell
- Department of Medical Cell Biology, University Uppsala, Uppsala, Sweden
| | - Kirsten Roomp
- Luxembourg Center for Systems Biomedicine, University Luxembourg, Luxembourg, Luxembourg
| | - Sebastian Schütz
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Fanni Zsoldos
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Wilfried Renner
- Luxembourg Center for Systems Biomedicine, University Luxembourg, Luxembourg, Luxembourg
| | - Dieter Furthner
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Department of Pediatrics and Adolescent Medicine, Salzkammergut-Klinikum, Vöcklabruck, Austria
| | - Katharina Maruszczak
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Stephan Zandanell
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- First Department of Medicine, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Daniel Weghuber
- Department of Pediatrics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
- Obesity Research Unit, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Harald Mangge
- Clinical Institute for Medical and Chemical Laboratory Diagnosis, Medical University Graz, Graz, Austria
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25
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Huang MC, Chang CI, Chang WT, Liao YL, Chung HF, Hsu CC, Shin SJ, Lin KD. Blood biomarkers of various dietary patterns correlated with metabolic indicators in Taiwanese type 2 diabetes. Food Nutr Res 2019; 63:3592. [PMID: 31807124 PMCID: PMC6878969 DOI: 10.29219/fnr.v63.3592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/29/2019] [Accepted: 08/15/2019] [Indexed: 12/28/2022] Open
Abstract
Background Metabolic alterations correlate with adverse outcomes in type 2 diabetes. Dietary modification serves as an integral part in its treatment. Objective We examined the relationships among dietary patterns, dietary biomarkers, and metabolic indicators in type 2 diabetes (n = 871). Design Diabetic patients (n = 871) who provided complete clinical and dietary data in both 2008 and 2009 were selected from a cohort participating in a diabetic control study in Taiwan. Dietary data were obtained using a short, semiquantitative food frequency questionnaires, and dietary pattern identified by factor analysis. Multiple linear regressions were used to analyze the association between dietary biomarkers (ferritin, folate, and erythrocyte n-3 polyunsaturated fatty acids [n-3 PUFAs]) and metabolic control upon adjusting for confounders. Results Three dietary patterns (high-fat meat, traditional Chinese food–snack, and fish–vegetable) were identified. Ferritin correlated positively with high-fat meat factor scores (P for trend <0.001). Erythrocyte n-3 PUFAs (eicosapentaenoic acid [EPA] + docosahexaenoic acid [DHA], n-3/n-6 PUFA ratio) correlated positively with fish–vegetable factor scores (all P for trends <0.001). Multiple linear regressions revealed a positive relationship between ferritin concentrations and fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), and triglycerides, but a negative relationship with high-density lipoprotein cholesterol (HDL-C). Erythrocyte n-3 PUFA, EPA+DHA, and n-3/n-6 PUFA ratio were negatively linked to FPG, HbA1c, and triglycerides (all P < 0.05) and positively with HDL-C (though n-3/n-6 ratio marginally correlated). Conclusions Ferritin and n-3 PUFA can serve as valid biomarkers for high-fat meat and fish–vegetable dietary patterns. Unlike ferritin, erythrocyte n-3 PUFA status was related to better glycemic and blood lipid profiles. Our results suggest that habitual consumption of diet pattern rich in fish and vegetables may contribute in part to a healthier metabolic profile in type 2 diabetes.
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Affiliation(s)
- Meng-Chuan Huang
- Department of Nutrition and Dietetics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Graduate Institute of Medicine and Department of Public Health and Environmental Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chiao-I Chang
- Graduate Institute of Medicine and Department of Public Health and Environmental Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Tsan Chang
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yen-Ling Liao
- Graduate Institute of Medicine and Department of Public Health and Environmental Medicine, School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsin-Fang Chung
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan , Taiwan
| | - Shyi-Jang Shin
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kun-Der Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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26
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Li FR, Zhang XR, Zhong WF, Li ZH, Gao X, Kraus VB, Lv YB, Zou MC, Chen GC, Chen PL, Zhang MY, Kur AKA, Shi XM, Wu XB, Mao C. Glycated Hemoglobin and All-Cause and Cause-Specific Mortality Among Adults With and Without Diabetes. J Clin Endocrinol Metab 2019; 104:3345-3354. [PMID: 30896760 PMCID: PMC7328059 DOI: 10.1210/jc.2018-02536] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 03/15/2019] [Indexed: 12/25/2022]
Abstract
CONTEXT The patterns of associations between glycated Hb (HbA1c) and mortality are still unclear. OBJECTIVE To explore the extent to which ranges of HbA1c levels are associated with the risk of mortality among participants with and without diabetes. DESIGN, SETTING, AND PATIENTS This was a nationwide, community-based prospective cohort study. Included were 15,869 participants (median age 64 years) of the Health and Retirement Study, with available HbA1c data and without a history of cancer. Cox proportional hazards regression models were used to estimate hazard ratios with 95% CIs for mortality. RESULTS A total of 2133 participants died during a median follow-up of 5.8 years. In participants with diabetes, those with an HbA1c level of 6.5% were at the lowest risk of all-cause mortality. When HbA1c level was <5.6% or >7.4%, the increased all-cause mortality risk became statistically significant as compared with an HbA1c level of 6.5%. As for participants without diabetes, those with an HbA1c level of 5.4% were at the lowest risk of all-cause mortality. When the HbA1c level was <5.0%, the increased all-cause mortality risk became statistically significant as compared with an HbA1c level of 5.4%. However, we did not observe a statistically significant elevated risk of all-cause mortality above an HbA1c level of 5.4%. CONCLUSIONS A U-shaped and reverse J-shaped association for all-cause mortality was found among participants with and without diabetes. The corresponding optimal ranges for overall survival are predicted to be 5.6% and 7.4% and 5.0% and 6.5%, respectively.
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Affiliation(s)
- Fu-Rong Li
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Xi-Ru Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Wen-Fang Zhong
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Zhi-Hao Li
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Xiang Gao
- Nutritional Epidemiology Laboratory, The Pennsylvania State University, Philadelphia, Pennsylvania
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Yue-Bin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Meng-Chen Zou
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Guo-Chong Chen
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Pei-Liang Chen
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Min-Yi Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Akech Kuol Akech Kur
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
| | - Xiao-Ming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xian-Bo Wu
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
- Correspondence and Reprint Requests: Chen Mao, PhD, or Xian-Bo Wu, PhD, Department of Epidemiology, School of Public Health, Southern Medical University, 510000 Guangzhou, Guangdong, China. E-mail: or
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University (Guangdong Provincial Key Laboratory of Tropical Disease Research), Guangzhou, China
- Correspondence and Reprint Requests: Chen Mao, PhD, or Xian-Bo Wu, PhD, Department of Epidemiology, School of Public Health, Southern Medical University, 510000 Guangzhou, Guangdong, China. E-mail: or
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27
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Liu JR, Liu Y, Yin FZ, Liu BW. Serum ferritin, an early marker of cardiovascular risk: a study in Chinese men of first-degree relatives with family history of type 2 diabetes. BMC Cardiovasc Disord 2019; 19:82. [PMID: 30943893 PMCID: PMC6448272 DOI: 10.1186/s12872-019-1068-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 03/26/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Ferritin is one of the key proteins that regulate iron homeostasis and is widely available clinical biomarker of iron status. This study aimed to discuss the influence of serum ferritin (SF) on cardiovascular risk factors in the first-degree relatives with family history of type 2 diabetes (FHD). METHODS This cross-sectional study included 232 men. Anthropometric measurements and blood samples were analyzed. The people were divided into four groups according to median SF (102.8 ng/ml) and people with or without FHD. Group A (FHD-and low SF), group B (FHD-and high SF), group C (FHD+ and low SF), and group D (FHD+ and high SF). RESULTS The subjects in different categories of SF concentrations showed significant differences in BMI (SF main effect: P = 0.010), WC (P = 0.030), SBP (P < 0.001), FPG (P < 0.001), PPG-2 h (P < 0.001), FINS (P < 0.001), and HOMA-IR (P = 0.015; all: 2-way ANOVA). There was a significant difference in SBP (FHD main effect: P = 0.003), DBP (P = 0.006), and FINS (P = 0.013, all: 2-way ANOVA) between the groups with or without FHD. The interaction term between SF and FHD was significant for SBP (P = 0.011), DBP (P = 0.012), and PPG-2 h (P = 0.022). Logistic analysis showed that accumulation of CVD risk factors, which were ≥ 2 items and ≥ 3 items in group D were 7.546 and 3.343 times higher compared with group A (P < 0.05). CONCLUSIONS The increased SF levels increased the risk of cardiovascular risk factors and the occurrence of insulin resistance in first-degree relatives with FHD.
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Affiliation(s)
- Jun-Ru Liu
- Department of Endocrinology, Qinhuangdao First Hospital, No.258 Wenhua Road, Qinhuangdao, 066000, Hebei Province, China
| | - Yang Liu
- Department of General Surgery, Qinhuangdao First Hospital, No.258 Wenhua Road, Qinhuangdao, 066000, Hebei Province, China
| | - Fu-Zai Yin
- Department of Endocrinology, Qinhuangdao First Hospital, No.258 Wenhua Road, Qinhuangdao, 066000, Hebei Province, China
| | - Bo-Wei Liu
- Department of Endocrinology, Qinhuangdao First Hospital, No.258 Wenhua Road, Qinhuangdao, 066000, Hebei Province, China.
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Suárez-Ortegón MF, Echeverri I, Prats-Puig A, Bassols J, Carreras-Badosa G, López-Bermejo A, Fernández-Real JM. Iron Status and Metabolically Unhealthy Obesity in Prepubertal Children. Obesity (Silver Spring) 2019; 27:636-644. [PMID: 30821086 DOI: 10.1002/oby.22425] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/10/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE This study aimed to evaluate the association of metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) with iron status markers in prepubertal children. METHODS Three hundred twelve prepubertal children with overweight and obesity from a pediatric general Spanish population were evaluated. MHO and MUO were defined as obesity with the absence or presence of metabolic syndrome components. Phenotypes of metabolically healthy overweight including obesity (MHOV) and metabolically unhealthy overweight including obesity (MUOV) were also studied and defined using the same criteria. Serum ferritin, transferrin, and blood hemoglobin levels were evaluated. RESULTS Prevalence rates of MHOV and MHO were 35% (n = 111/312) and 27.1% (n = 42/155), respectively. Ferritin and hemoglobin levels were higher in children with MUOV versus MHOV (P < 0.05). MUO was positively associated with ferritin (beta [95% CI] = 0.43 [0.05 to 0.81]) and hemoglobin levels (0.43 [0.05 to 0.81]). These associations remained significant independently of age, sex, C-reactive protein, physical activity, and BMI/waist z scores in bivariate linear regression models. In multivariable models, transaminase levels attenuated the association of MUO with ferritin and hemoglobin levels (P > 0.05). CONCLUSIONS MUOV and MUO are associated with higher ferritin and hemoglobin levels in prepubertal children affected by overweight and obesity. Increased circulating ferritin in MUO might be influenced by liver injury.
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Affiliation(s)
- Milton Fabian Suárez-Ortegón
- Basic and Clinic Sciences Group-Department of Basic Sciences of Health, Pontificia Universidad Javeriana, Cali, Colombia
- Nutrition Group, University of Valle, Cali, Colombia
| | | | - Anna Prats-Puig
- Pediatrics Research Group, Girona Institute for Biomedical Research, Girona, Spain
- Department of Pediatrics, Dr Josep Trueta Hospital, Girona, Spain
- Department of Physical Therapy, University School of Health and Sports, University of Girona, Girona, Spain
| | - Judit Bassols
- Pediatrics Research Group, Girona Institute for Biomedical Research, Girona, Spain
- Department of Pediatrics, Dr Josep Trueta Hospital, Girona, Spain
| | - Gemma Carreras-Badosa
- Pediatrics Research Group, Girona Institute for Biomedical Research, Girona, Spain
- Department of Pediatrics, Dr Josep Trueta Hospital, Girona, Spain
| | - Abel López-Bermejo
- Pediatrics Research Group, Girona Institute for Biomedical Research, Girona, Spain
- Department of Pediatrics, Dr Josep Trueta Hospital, Girona, Spain
- TransLab Research Group, Department of Medical Sciences, Faculty of Medicine, University of Girona, Girona, Spain
| | - Jose Manuel Fernández-Real
- Department of Diabetes, Endocrinology and Nutrition, Department of Medical Sciences, Faculty of Medicine, Girona Institute for Biomedical Research, Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition and National Institute of Health Carlos III, Girona, Spain
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Suárez-Ortegón MF, Blanco E, McLachlan S, Fernandez-Real JM, Burrows R, Wild SH, Lozoff B, Gahagan S. Ferritin levels throughout childhood and metabolic syndrome in adolescent stage. Nutr Metab Cardiovasc Dis 2019; 29:268-278. [PMID: 30648600 PMCID: PMC6758555 DOI: 10.1016/j.numecd.2018.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 10/10/2018] [Accepted: 11/26/2018] [Indexed: 12/12/2022]
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.
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Affiliation(s)
- M F Suárez-Ortegón
- Basic and Clinic Sciences Group-Department of Basic Sciences of Health, Pontificia Universidad Javeriana, Cali, Colombia; Nutrition Group, Universidad del Valle, Cali, Colombia.
| | - E Blanco
- Division of Child Development and Community Health, University of California, San Diego, La Jolla, CA, USA
| | - S McLachlan
- Basic and Clinic Sciences Group-Department of Basic Sciences of Health, Pontificia Universidad Javeriana, Cali, Colombia
| | - J M Fernandez-Real
- Department of Diabetes, Endocrinology and Nutrition, Institut d'Investigació Biomèdica de Girona (IdIBGi), CIBEROBN (CB06/03/010) and Instituto de Salud Carlos III (ISCIII), Girona, Spain
| | - R Burrows
- University of Chile, Santiago, Chile
| | - S H Wild
- Basic and Clinic Sciences Group-Department of Basic Sciences of Health, Pontificia Universidad Javeriana, Cali, Colombia
| | - B Lozoff
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - S Gahagan
- Division of Child Development and Community Health, University of California, San Diego, La Jolla, CA, USA
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Batsaikhan B, Gantumur G, Huang CI, Yeh ML, Huang CF, Lin ZY, Chen SC, Huang JF, Yu ML, Chuang WL, Lee JC, Dai CY. Elevated serum ferritin level associated with hepatic steatosis and fibrosis in hepatitis C virus-infected patients. J Chin Med Assoc 2019; 82:99-104. [PMID: 30839498 DOI: 10.1097/jcma.0000000000000009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Serum ferritin is an indicator of iron accumulation in a human body, and it is frequently elevated in patients with systemic inflammatory state in chronic hepatitis C (CHC). Iron accumulation is associated with hepatic fibrosis, steatosis, and unfavorable outcome in CHC patients. We studied the status of elevated serum ferritin level and its association with the liver fibrosis or steatosis in Taiwanese CHC patients. METHODS Seven hundred and thirty-eight Taiwanese CHC patients were consecutively included in this study. Laboratory analysis, four indexes of fibrosis (FIB4), histological assessment of fibrosis, and steatosis were assessed by appropriate elevation of serum ferritin level. RESULTS Three hundred and one patients (40.8%) had elevated serum ferritin level (sex-specific threshold >1.5 × upper limit of normal). Serum iron level (odds ratio [OR], 1.02; 95% CI, 1.01%-1.03%, p < 0.001), female gender (OR, 1.49; 95% CI, 1.07%-2.08%, p = 0.018), serum gamma-glutamyl transferase level (OR, 1.007; 95% CI, 1.003%-1.01%, p < 0.001), steatosis grade (OR, 1.56; 95% CI, 1.13%-2.16%, p = 0.006), and FIB4 ≥3.25 (OR, 1.63; 95% CI, 1.18%-2.27%, p = 0.003) indexes were associated with high serum ferritin level by multivariate logistic regression analysis. Patients with steatosis (>5%) were associated with older age (OR, 1.01; 95% CI, 1.00%-1.03%, p = 0.015), body mass index (OR, 1.10; 95% CI, 1.05%-1.15%, p < 0.001), and elevated serum ferritin level (OR, 1.001; 95% CI, 1.00%-1.001%, p = 0.024) by multivariate logistic regression analysis. Serum ferritin level also associated with high FIB4 (≥3.25) (OR, 1.001; 95% CI, 1.001%-1.002%, p = 0.010) when multivariate model adjusted together with advanced liver fibrosis by biopsy. CONCLUSION Elevated serum ferritin level was noted in 40.8% of Taiwanese CHC patients, and the serum ferritin level was associated with liver steatosis and high FIB4.
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Affiliation(s)
- Batbold Batsaikhan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- Department of Internal Medicine, Institute of Medical Sciences, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Gantsetseg Gantumur
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Ching-I Huang
- Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Ming-Lun Yeh
- Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Chung-Feng Huang
- Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- Department of Biotechnology, College of Life Science, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Zu-Yau Lin
- Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Shinn-Cherng Chen
- Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Jee-Fu Huang
- Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Ming-Lung Yu
- Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Wan-Long Chuang
- Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Jin-Ching Lee
- Department of Biotechnology, College of Life Science, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Chia-Yen Dai
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- Hepatobiliary Section, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
- Health Management Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
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Hu X, Yang Y, Su J, Yao C. Meta-analysis of the relationship between amyotrophic lateral sclerosis and susceptibility to serum ferritin level elevation. ACTA ACUST UNITED AC 2018; 21:120-5. [PMID: 27094521 PMCID: PMC5107265 DOI: 10.17712/nsj.2016.2.20150482] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective: To study the possible relationship between amyotrophic lateral sclerosis (ALS) patients and their susceptibility to serum ferritin level elevation. Methods: We searched the PubMed, Springer, Medline, and OVID databases for any-language original research articles relating to serum ferritin levels in ALS patients published between June 2005 and June 2015. The search term used with ‘amyotrophic lateral sclerosis’, ‘ferritins’, ‘ferritin’, ‘iron’, ‘iron stores, ‘iron status, ‘iron intake’, and ‘iron consumption’. The meta-analysis software RevMan 5.0 was used for the heterogeneity test, and to test for the overall effect. Results: Six case-control studies met our inclusion criteria including data from a total of 1813 participants. The mean difference of serum ferritin levels comparing ALS to healthy controls was 69.05 (95% confidence interval: 52.56-85.54; p<0.00001); heterogeneity: p=0.03; I2=50%. The findings indicate homology in the sensitivity analysis. Funnel plot assessment indicated publication bias. Conclusion: Our results suggest that ALS is positively associated with susceptibility to the elevation of serum ferritin levels; however, further evidence is required to support this.
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Affiliation(s)
- Xiaohui Hu
- Department of Neurology, Jingzhou Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jingzhou, China
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Fernández-Cao JC, Doepking C. Role of ethnicity and environment on lifestyle and cardiometabolic profile in the Native American Mapuche population: Protocol for a systematic review and meta-analysis. Medicine (Baltimore) 2018; 97:e13354. [PMID: 30508925 PMCID: PMC6283115 DOI: 10.1097/md.0000000000013354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Cardiometabolic risk factors contribute to increase the incidence of some of the most widespread noncommunicable diseases today. The propensity to present an elevated cardiometabolic risk appears to especially affect non-Caucasians ethnic groups, such as the Native American Mapuche population. In addition, urbanization process has also a great impact on lifestyle and cardiometabolic profile. Therefore, a systematic review and meta-analysis will be conducted to summarize the relevant evidence regarding lifestyle and cardiometabolic profile in Mapuche population, and to assess the role of the ethnicity and the urbanization process on the lifestyle and cardiometabolic profile in Mapuche people with respect to European descendants. METHODS A comprehensive search until 2019 will be performed using PubMed/MEDLINE, SciELO, Web of Science and Scopus. Observational studies, carried out in general population of Mapuche ethnicity living in rural and urban areas, with data of lifestyle and/or cardiometabolic profile, will be selected. A qualitative summary, as well as meta-analyzes when possible, will be done to present the information. Random effects meta-analyzes will be performed using the generic inverse variance method. Pooled effect size will be expressed as mean difference with 95% confidence intervals. Heterogeneity will be assessed using the Cochran Q-statistic and the I statistic. Stratified analyzes, meta-regressions, and sensitivity analyzes will be performed to evaluate potential sources of heterogeneity. In addition, random effects meta-regressions and stratified analyzes will also be used to examine the impact of covariates on the effect size estimated. Publication bias will be investigated using Egger and Begg test, and risk of bias will be assessed using the Research Triangle Institute Item Bank (RTI-IB). Finally, the quality of evidence will be evaluated through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. RESULTS The results of meta-analyzes will provide important information about differences in lifestyle and cardiometabolic profile between Mapuche people and European descendants, as well as between Mapuche people living in urban and rural areas. CONCLUSION This systematic review and meta-analysis will be helpful to obtain a more reliable understanding of lifestyle and cardiometabolic profile in Mapuche population compared to European descendants, and the impact of the transition from rural to urban areas in this ethnic group.
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Wu H, Liang Y, Jiang X, Wei X, Liu Y, Liu W, Guo Y, Tang W. Meta-analysis of intravoxel incoherent motion magnetic resonance imaging in differentiating focal lesions of the liver. Medicine (Baltimore) 2018; 97:e12071. [PMID: 30142864 PMCID: PMC6112959 DOI: 10.1097/md.0000000000012071] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Accurate detection and characterization of focal liver lesions, including differentiation between malignant and benign lesions, are particularly important. The objective of this meta-analysis was to evaluate the parameters of intravoxel incoherent motion (IVIM), including apparent diffusion coefficient (ADC), pure molecular diffusion coefficient (D), perfusion-related diffusion coefficient (D*), and perfusion fraction (f) in differentiating focal liver lesions. METHODS IVIM method employed for focal liver lesion and the quality assessment of diagnostic studies were evaluated. Standardized mean differences and 95% confidence intervals were calculated. The heterogeneity was quantified with the I statistic. RESULTS The difference between groups was analyzed according to the I values from 6 different studies using fixed effects or random effects models. Significant differences in ADC (P < .001) and D (P < .001) were observed between benign and malignant lesions. Moreover, significant differences in ADC (P < .001), D (P < .001), and f (P = .01) were found between hemangioma and hepatocellular carcinoma (HCC). In addition, no significant difference was observed between the metastases and HCC. CONCLUSIONS D and ADC values were useful for the differentiation between benignity and malignancy; higher values of ADC, D, and f were observed in hemangioma compared to HCC. Nevertheless, IVIM did not result as the optimal approach for differentiation between the metastases and HCC.
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Affiliation(s)
- Hongzhen Wu
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong
- Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yingying Liang
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong
| | - Xinqing Jiang
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong
- Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xinhua Wei
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong
| | - Yu Liu
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong
| | - Weifeng Liu
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong
| | - Yuan Guo
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong
| | - Wenjie Tang
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong
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Mateo-Gallego R, Lacalle L, Pérez-Calahorra S, Marco-Benedí V, Recasens V, Padrón N, Lamiquiz-Moneo I, Baila-Rueda L, Jarauta E, Calmarza P, Cenarro A, Civeira F. Efficacy of repeated phlebotomies in hypertriglyceridemia and iron overload: A prospective, randomized, controlled trial. J Clin Lipidol 2018; 12:1190-1198. [PMID: 30049591 DOI: 10.1016/j.jacl.2018.06.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 06/21/2018] [Accepted: 06/27/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND High ferritin concentration is associated with hypertriglyceridemia, although it is not elucidated if iron overload has a causal role. OBJECTIVE To evaluate the efficacy of repeated phlebotomies in patients with iron overload and hypertriglyceridemia. METHODS Twelve weeks, 1:1 randomized, parallel-groups trial conducted at a University Hospital Lipid Clinic, including 86 subjects aged 18-70 years with serum ferritin >300 ng/mL in men or >200 ng/mL in women and triglycerides >200 mg/dL. Participants underwent: (1) three phlebotomies (every 3 weeks) and lipid-lowering dietary counseling or (2) lipid-lowering dietary counseling. The main outcome measured was the mean difference in percent change in triglyceride concentration between groups after the intervention. The mean differences in percent change of other clinical and biochemical variables (including cytokines and proinflammatory markers) after the intervention were also evaluated. RESULTS Subjects who received phlebotomies showed a significant improvement in iron metabolism. The mean percent change in triglycerides between groups was -4.68 [-20.8, 11.4]%, P = .721. Retinol-binding protein 4 decreased by 9.98 ± 21.7% after phlebotomies, with a mean percent change between groups of -14.2 [-25.8, -2.73]%, P = .017, and correlated to gamma glutamyl transferase, alanine aminotransferase and aspartate aminotransferase change. Subjects with a large reduction in hepcidin showed a large improvement in liver enzymes and proinflammatory markers. CONCLUSIONS A lipid-lowering diet plus a substantial reduction in iron deposits with repeated phlebotomies in subjects with hyperferritinemia and hypertriglyceridemia did not reduce triglyceride concentration in comparison with a lipid-lowering diet. Iron depletion for lipid management in these patients is not supported.
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Affiliation(s)
- Rocío Mateo-Gallego
- Lipid Unit, Hospital Universitario Miguel Servet, IIS Aragon, CIBERCV, Zaragoza, Spain; Universidad de Zaragoza, Zaragoza, Spain
| | - Laura Lacalle
- Hematology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Sofía Pérez-Calahorra
- Lipid Unit, Hospital Universitario Miguel Servet, IIS Aragon, CIBERCV, Zaragoza, Spain
| | - Victoria Marco-Benedí
- Lipid Unit, Hospital Universitario Miguel Servet, IIS Aragon, CIBERCV, Zaragoza, Spain
| | - Valle Recasens
- Universidad de Zaragoza, Zaragoza, Spain; Hematology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Noelia Padrón
- Hematology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Itziar Lamiquiz-Moneo
- Lipid Unit, Hospital Universitario Miguel Servet, IIS Aragon, CIBERCV, Zaragoza, Spain
| | - Lucía Baila-Rueda
- Lipid Unit, Hospital Universitario Miguel Servet, IIS Aragon, CIBERCV, Zaragoza, Spain
| | - Estíbaliz Jarauta
- Lipid Unit, Hospital Universitario Miguel Servet, IIS Aragon, CIBERCV, Zaragoza, Spain
| | - Pilar Calmarza
- Biochemistry Department, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Ana Cenarro
- Lipid Unit, Hospital Universitario Miguel Servet, IIS Aragon, CIBERCV, Zaragoza, Spain
| | - Fernando Civeira
- Lipid Unit, Hospital Universitario Miguel Servet, IIS Aragon, CIBERCV, Zaragoza, Spain; Universidad de Zaragoza, Zaragoza, Spain.
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Suárez-Ortegón MF, Ensaldo-Carrasco E, Shi T, McLachlan S, Fernández-Real JM, Wild SH. Ferritin, metabolic syndrome and its components: A systematic review and meta-analysis. Atherosclerosis 2018; 275:97-106. [PMID: 29886355 DOI: 10.1016/j.atherosclerosis.2018.05.043] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/03/2018] [Accepted: 05/22/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND AIMS Mechanisms for the association between iron stores and risk factors for diabetes and cardiovascular disease, such as metabolic syndrome (MetS) and its components, are still not clear. We evaluated the associations between ferritin levels, MetS and its individual components, and potential role of confounding, in a meta-analysis. METHODS We searched articles in MEDLINE and EMBASE until February 14th, 2018. There were two approaches: meta-analysis of 1) cross-sectional and longitudinal studies and 2) only cross-sectional studies. Meta-regressions were conducted to identify sources of heterogeneity in the associations of ferritin with MetS and its individual components. RESULTS Information from 26 studies (5 prospective) was systematically reviewed and 21 studies were meta-analysed. The pooled OR for MetS by increased ferritin was 1.78 (95%CI: 1.60-1.97) in the meta-analysis 1, and 1.70 (95%CI: 1.49-1.95) in the meta-analysis 2. The pooled association was weaker in studies adjusted for hepatic injury markers (meta-regression coefficient (95% CI): -0.34 (-0.60,-0.09) p = 0.008) and body mass index (BMI) (meta-regression coefficient (95% CI): -0.27 (-0.53,-0.01) p = 0.039). Among MetS components, the pooled association with increased ferritin was strongest with high triglycerides [OR (95%CI): 1.96 (1.65-2.32)] and high glucose levels [OR 95%CI: 1.60 (1.40-1.82)]. Higher cut-off points used to define high ferritin concentrations were more strongly associated with high triglycerides [meta-regression coefficient (95% CI): 0.22 (0.03, 0.041), p = 0.023]. CONCLUSIONS High triglycerides and glucose are the components more strongly associated with ferritin. Hepatic injury and BMI appear to influence the ferritin-MetS association, and a threshold effect of high ferritin concentration on the ferritin-high triglycerides association was observed.
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Affiliation(s)
- Milton Fabian Suárez-Ortegón
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom; Nutrition Group, Universidad del Valle, Cali, Colombia.
| | - Eduardo Ensaldo-Carrasco
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Ting Shi
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Stela McLachlan
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - José Manuel Fernández-Real
- Department of Diabetes, Endocrinology and Nutrition, Institut d'Investigació Biomèdica de Girona, CIBEROBN (CB06/03/010) and Instituto de Salud Carlos III (ISCIII), Girona, Spain.
| | - Sarah H Wild
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, Scotland, United Kingdom
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Corante N, Anza-Ramírez C, Figueroa-Mujíca R, Macarlupú JL, Vizcardo-Galindo G, Bilo G, Parati G, Gamboa JL, León-Velarde F, Villafuerte FC. Excessive Erythrocytosis and Cardiovascular Risk in Andean Highlanders. High Alt Med Biol 2018; 19:221-231. [PMID: 29782186 PMCID: PMC6157350 DOI: 10.1089/ham.2017.0123] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Corante, Noemí, Cecilia Anza-Ramírez, Rómulo Figueroa-Mujíca, José Luis Macarlupú, Gustavo Vizcardo-Galindo, Grzegorz Bilo, Gianfranco Parati, Jorge L. Gamboa, Fabiola León-Velarde, and Francisco C. Villafuerte. Excessive erythrocytosis and cardiovascular risk in Andean highlanders. High Alt Med Biol. 19:221–231, 2018.—Cardiovascular diseases are the main cause of death worldwide. Life under high-altitude (HA) hypoxic conditions is believed to provide highlanders with a natural protection against cardiovascular and metabolic diseases compared with sea-level inhabitants. However, some HA dwellers become intolerant to chronic hypoxia and develop a progressive incapacitating syndrome known as chronic mountain sickness (CMS), characterized by excessive erythrocytosis (EE; Hb ≥21 g/dL in men, Hb ≥19 g/dL in women). Evidence from HA studies suggests that, in addition to CMS typical signs and symptoms, these highlanders may also suffer from metabolic and cardiovascular disorders. Thus, we hypothesize that this syndrome is also associated to the loss of the cardiometabolic protection observed in healthy highlanders (HH), and therefore to a higher cardiovascular risk (CVR). The aim of the present work was to evaluate the association between EE and CVR calculated using the Framingham General CVR Score and between EE and CVR factors in male highlanders. This cross-sectional study included 342 males from Cerro de Pasco, Peru at 4340 m (HH = 209, CMS = 133). Associations were assessed by multiple logistic regressions adjusted for potential confounders (BMI, pulse oxygen saturation and age). The adjusted models show that the odds of high CVR (>20%) in highlanders with EE was 3.63 times the odds in HH (CI 95%:1.22–10.78; p = 0.020), and that EE is associated to hypertension, elevated fasting serum glucose, insulin resistance, and elevated fasting serum triglycerides. Our results suggest that individuals who suffer from EE are at increased risk of developing cardiovascular events compared with their healthy counterparts.
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Affiliation(s)
- Noemí Corante
- 1 Laboratorio de Fisiología Comparada, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia. Lima , Perú
| | - Cecilia Anza-Ramírez
- 1 Laboratorio de Fisiología Comparada, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia. Lima , Perú
| | - Rómulo Figueroa-Mujíca
- 1 Laboratorio de Fisiología Comparada, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia. Lima , Perú
| | - José Luis Macarlupú
- 1 Laboratorio de Fisiología Comparada, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia. Lima , Perú
| | - Gustavo Vizcardo-Galindo
- 1 Laboratorio de Fisiología Comparada, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia. Lima , Perú
| | - Grzegorz Bilo
- 2 Department of Medicine and Surgery, University of Milano-Bicocca , Milano, Italy .,3 Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano , Milano, Italy
| | - Gianfranco Parati
- 2 Department of Medicine and Surgery, University of Milano-Bicocca , Milano, Italy .,3 Department of Cardiovascular, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano , Milano, Italy
| | - Jorge L Gamboa
- 4 Division of Clinical Pharmacology, Vanderbilt University Medical Center , Nashville, Tennessee
| | - Fabiola León-Velarde
- 1 Laboratorio de Fisiología Comparada, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia. Lima , Perú
| | - Francisco C Villafuerte
- 1 Laboratorio de Fisiología Comparada, Departamento de Ciencias Biológicas y Fisiológicas, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia. Lima , Perú
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Abstract
With a third of all food production lost via leaky supply chains or spoilage, food loss is a key contributor to global food insecurity. Demand for resource-intensive animal-based food further limits food availability. In this paper, we show that plant-based replacements for each of the major animal categories in the United States (beef, pork, dairy, poultry, and eggs) can produce twofold to 20-fold more nutritionally similar food per unit cropland. Replacing all animal-based items with plant-based replacement diets can add enough food to feed 350 million additional people, more than the expected benefits of eliminating all supply chain food loss. Food loss is widely recognized as undermining food security and environmental sustainability. However, consumption of resource-intensive food items instead of more efficient, equally nutritious alternatives can also be considered as an effective food loss. Here we define and quantify these opportunity food losses as the food loss associated with consuming resource-intensive animal-based items instead of plant-based alternatives which are nutritionally comparable, e.g., in terms of protein content. We consider replacements that minimize cropland use for each of the main US animal-based food categories. We find that although the characteristic conventional retail-to-consumer food losses are ≈30% for plant and animal products, the opportunity food losses of beef, pork, dairy, poultry, and eggs are 96%, 90%, 75%, 50%, and 40%, respectively. This arises because plant-based replacement diets can produce 20-fold and twofold more nutritionally similar food per cropland than beef and eggs, the most and least resource-intensive animal categories, respectively. Although conventional and opportunity food losses are both targets for improvement, the high opportunity food losses highlight the large potential savings beyond conventionally defined food losses. Concurrently replacing all animal-based items in the US diet with plant-based alternatives will add enough food to feed, in full, 350 million additional people, well above the expected benefits of eliminating all supply chain food waste. These results highlight the importance of dietary shifts to improving food availability and security.
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Randell EW, Twells LK, Gregory DM, Lester KK, Daneshtalab N, Dillon C, Pace D, Smith C, Boone D. Pre-operative and post-operative changes in CRP and other biomarkers sensitive to inflammatory status in patients with severe obesity undergoing laparoscopic sleeve gastrectomy. Clin Biochem 2018; 52:13-19. [DOI: 10.1016/j.clinbiochem.2017.10.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 10/15/2017] [Indexed: 01/09/2023]
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Shabanzadeh DM, Skaaby T, Sørensen LT, Eugen-Olsen J, Jørgensen T. Metabolic biomarkers and gallstone disease - a population-based study. Scand J Gastroenterol 2017; 52:1270-1277. [PMID: 28799434 DOI: 10.1080/00365521.2017.1365166] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The objectives for this study were to examine the associations between metabolic biomarkers of obesity including insulin resistance, vascular dysfunction, systemic inflammation, genetic susceptibility and ultrasound proven gallstone disease or cholecystectomy in a population-based cross-sectional study. MATERIAL AND METHODS A total of 2650 participants were included, of whom 422 had gallstone disease. Associations between selected metabolic biomarkers and gallstone disease were estimated by multivariable logistic regression models and expressed as odds ratio (OR) and 95% confidence interval (CI). RESULTS Gallstone disease was associated with fasting glucose (OR 1.14, 95% CI [1.05;1.24]), fasting insulin (OR 1.03, 95% CI [1.01;1.05]), homeostasis model assessment insulin resistance (OR 1.18, 95% CI [1.02;1.36]), the metabolic syndrome (OR 1.51, 95% CI [1.16;1.96]), white blood cell count (OR 1.07, 95% CI [1.00;1.15]) and C-reactive protein (OR 1.03, 95% CI [1.01;1.05]). A tendency towards an association for soluble urokinase plasminogen activator receptor was also found (OR 1.08, 95% CI [0.99;1.18]). The MC4R(rs17782313) (OR 1.27, 95% CI [1.02;1.58]), MAP2K5(rs2241423) (OR 1.80, 95% CI [1.04;3.41]), NRXN3(rs10146997) (OR 1.26, 95% CI [1.01;1.57]), HHEX(rs1111875) (OR 1.29, 95% CI [1.03;1.62]), FAIM2(rs7138803) (OR 0.66, 95% CI [0.48;0.91]), and apolipoprotein E4 allele (OR 0.76, 95% CI [0.59;0.98]) were associated with gallstone disease. Urinary albumin was not associated with gallstone disease. The association between BMI and gallstone disease was explained by insulin resistance. CONCLUSIONS Biomarkers of insulin resistance, systemic inflammation and genetic obesity or type 2 diabetes risk alleles seem to be associated with gallstone disease. Future studies should explore temporal associations and genetic associations in other populations in order to clarify targets for prevention or intervention.
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Affiliation(s)
- Daniel Mønsted Shabanzadeh
- a Digestive Disease Center , Bispebjerg University Hospital , Copenhagen , Denmark.,b Research Centre for Prevention and Health , Centre for Health, Capital Region of Denmark, Copenhagen , Denmark
| | - Tea Skaaby
- b Research Centre for Prevention and Health , Centre for Health, Capital Region of Denmark, Copenhagen , Denmark
| | - Lars Tue Sørensen
- a Digestive Disease Center , Bispebjerg University Hospital , Copenhagen , Denmark.,c Institute for Clinical Medicine, Faculty of Health and Medical Sciences , University of Copenhagen, Copenhagen , Denmark
| | - Jesper Eugen-Olsen
- d Clinical Research Centre , Copenhagen University Hospital Hvidovre , Hvidovre , Denmark
| | - Torben Jørgensen
- b Research Centre for Prevention and Health , Centre for Health, Capital Region of Denmark, Copenhagen , Denmark.,e Department of Public Health, Faculty of Health and Medical Sciences , University of Copenhagen, Copenhagen , Denmark.,f The Faculty of Medicine , Aalborg University, Aalborg , Denmark
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Robberecht H, Bruyne TD, Hermans N. Biomarkers of the metabolic syndrome: Influence of minerals, oligo- and trace elements. J Trace Elem Med Biol 2017; 43:23-28. [PMID: 28277234 DOI: 10.1016/j.jtemb.2016.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 10/11/2016] [Accepted: 10/18/2016] [Indexed: 01/18/2023]
Abstract
Influences of minerals, oligo- and trace elements on the concentration of biomarkers of the metabolic syndrome (MetS) are reviewed. Since food is a complex mixture of caloric compounds and essential non-caloric food components with multiple interactions and varying bioavailability, it is hard to separate or identify the effect of one single component in a total meal or diet. Moreover the diet contains various non-nutritive biologically active components, which may add some beneficial characteristics. Therefore, conclusions on the effect of components on various biomarkers of MetS are sometimes quite contradictory. Reasons therefore are mentioned. Literature data should be studied in detail to conclude whether a component is related to a reduction of MetS-related symptoms or whether its influence is merely affecting a biomarker.
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Affiliation(s)
- Harry Robberecht
- University of Antwerp, Department of Pharmaceutical Sciences, Laboratory of Nutrition and Functional Foods, NatuRA (Natural Products and Food-Research and Analysis), Universiteitsplein 1, B-2610, Wilrijk, Belgium.
| | - Tess De Bruyne
- University of Antwerp, Department of Pharmaceutical Sciences, Laboratory of Nutrition and Functional Foods, NatuRA (Natural Products and Food-Research and Analysis), Universiteitsplein 1, B-2610, Wilrijk, Belgium
| | - Nina Hermans
- University of Antwerp, Department of Pharmaceutical Sciences, Laboratory of Nutrition and Functional Foods, NatuRA (Natural Products and Food-Research and Analysis), Universiteitsplein 1, B-2610, Wilrijk, Belgium
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Akter S, Nanri A, Kuwahara K, Matsushita Y, Nakagawa T, Konishi M, Honda T, Yamamoto S, Hayashi T, Noda M, Mizoue T. Circulating ferritin concentrations and risk of type 2 diabetes in Japanese individuals. J Diabetes Investig 2017; 8:462-470. [PMID: 28060459 PMCID: PMC5497053 DOI: 10.1111/jdi.12617] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/16/2016] [Accepted: 01/01/2017] [Indexed: 12/13/2022] Open
Abstract
AIMS/INTRODUCTION Higher iron storage has been linked to an increased risk of type 2 diabetes, but little is known about the mediator of this association. Here, we prospectively investigated the association between circulating ferritin, a marker of iron storage, and the incidence of type 2 diabetes among Japanese individuals. MATERIALS AND METHODS The participants were 4,754 employees who attended a comprehensive health check-up in 2008-2009 and donated blood for the study. During 5 years of follow up, diabetes was identified based on plasma glucose, glycated hemoglobin and self-report. Two controls matched to each case on sex, age and date of check-up were randomly chosen using density sampling, giving 327 cases and 641 controls with ferritin measurement. Cox proportional hazards regression was used to estimate the hazard ratio while adjusting for a series of potential confounders or mediators. RESULTS Elevated serum ferritin levels were associated with a significantly increased risk of type 2 diabetes, with the hazard ratio adjusted for known risk factors in the highest vs lowest quartile of 1.42 (95% confidence interval: 1.03-1.96). This association was unchanged after adjustment for C-reactive protein and adiponectin, but attenuated after adjustment for liver enzyme and insulin resistance (hazard ratio 1.04). The ferritin-diabetes association was confined to non-obese participants. CONCLUSIONS These results suggest that elevated iron storage is associated with increased risk of type 2 diabetes in normal weight individuals, and that this association is partly mediated through liver dysfunction and resulting insulin resistance.
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Affiliation(s)
- Shamima Akter
- Department of Epidemiology and Prevention, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akiko Nanri
- Department of Epidemiology and Prevention, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Keisuke Kuwahara
- Department of Epidemiology and Prevention, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.,Teikyo University Graduate School of Public Health, Tokyo, Japan
| | - Yumi Matsushita
- Department of Clinical Research Coordination, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tohru Nakagawa
- Hitachi Health Care Center, Hitachi, Ltd., Ibaraki, Japan
| | - Maki Konishi
- Department of Epidemiology and Prevention, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Toru Honda
- Hitachi Health Care Center, Hitachi, Ltd., Ibaraki, Japan
| | | | | | - Mitsuhiko Noda
- Department of Diabetes Research, Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan.,Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
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Wilson MS, Thompson EW. Venesection is an effective non-pharmacological treatment for patients with high serum ferritin type 2 diabetes. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY CASE REPORTS 2017. [DOI: 10.1016/j.jecr.2016.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Jaruvongvanich V, Riangwiwat T, Sanguankeo A, Upala S. Outcome of phlebotomy for treating nonalcoholic fatty liver disease: A systematic review and meta-analysis. Saudi J Gastroenterol 2016; 22:407-414. [PMID: 27976635 PMCID: PMC5184740 DOI: 10.4103/1319-3767.195551] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND/AIMS No medications have been approved for managing nonalcoholic fatty liver disease (NAFLD). Lifestyle intervention is the mainstay for its treatment. Hyperferritinemia, which appears to be associated with the severity of liver injury and insulin resistance, is frequently observed in patients with NAFLD. PATIENTS AND METHODS We conducted a systematic review and meta-analysis of the outcomes of four interventional trials regarding the effect of phlebotomy in patients with NAFLD versus the outcomes of NAFLD patients who did not undergo phlebotomy. Primary outcome was the pooled mean difference (MD) of the homeostasis model assessment of insulin resistance (HOMA-IR). The secondary outcomes were the changes in liver enzymes and the lipid profile. RESULTS Four interventional studies involving 438 participants were included in the meta-analysis. HOMA-IR was lower in patients who underwent phlebotomy, with an MD of 0.84 [95% confidence interval (CI) 0.01 to 1.67, I2 = 72%]. Phlebotomy also significantly reduced the alanine aminotransferase (MD = 10.05, 95% CI 7.19-12.92, I2 = 34%) and triglyceride (MD = 9.89, 95% CI 4.96-14.83, I2 = 22%) levels and increased the high-density cholesterol level (MD = 3.48, 95% CI 2.03-4.92, I2 = 18%). CONCLUSION Phlebotomy decreased insulin resistance and liver transaminase levels in patients with NAFLD. In addition, it improved their lipid profile.
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Affiliation(s)
- Veeravich Jaruvongvanich
- Department of Internal Medicine, University of Hawaii, Honolulu, HI, USA,Department of Internal Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Tanawan Riangwiwat
- Department of Internal Medicine, University of Hawaii, Honolulu, HI, USA
| | - Anawin Sanguankeo
- Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, NY, USA,Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sikarin Upala
- Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, NY, USA,Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand,Address for correspondence: Dr. Sikarin Upala, Bassett Medical Center, 1 Atwell Road, Cooperstown, NY, USA 13326. E-mail:
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Soluble transferrin receptor levels are positively associated with insulin resistance but not with the metabolic syndrome or its individual components. Br J Nutr 2016; 116:1165-1174. [PMID: 27605239 DOI: 10.1017/s0007114516002968] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The metabolic syndrome (MetS) is known to be associated with elevated serum ferritin levels. The possible association with other Fe markers has been less well studied. We aimed to investigate the cross-sectional association of soluble transferrin receptor (sTfR) and ferritin levels with the MetS components, insulin resistance and glycosylated Hb (HbA1C). The sample consisted of 725 adults, aged 19-93 years (284 men, 151 premenopausal and 290 postmenopausal women), from the Croatian island of Vis. Serum sTfR and ferritin levels were measured by immunoturbidimetry and electrochemiluminescence assays, respectively. The MetS was defined using modified international consensus criteria. Logistic and linear regression analyses were conducted to investigate the associations adjusting for age, fibrinogen, smoking status, alcohol consumption and BMI. Prevalence of the MetS was 48·7 %. Standardised values of ferritin were positively associated with all of the MetS components (except high blood pressure and waist circumference) in men (P0·05). sTfR levels could be spuriously elevated in subjects with insulin resistance and without association with the MetS or its components. We conclude that different markers of Fe metabolism are not consistently associated with cardiometabolic risk.
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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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Cigerli O, Parildar H, Dogruk Unal A, Tarcin O, Kut A, Eroglu H, Guvener N. VITAMIN DEFICIENCY AND INSULIN RESISTANCE IN NONDIABETIC OBESE PATIENTS. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2016; 12:319-327. [PMID: 31149107 PMCID: PMC6535262 DOI: 10.4183/aeb.2016.319] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Obese people may have nutritional deficiencies, although they are exposed to excessive food intake. We aim to assess relationship of vitamin D, B12, and folic acid levels and dietary vitamin intake and insulin resistance in obese people. DESIGN This case-control study was performed at the obesity outpatient clinics between March 2014 and April 2015. SUBJECTS AND METHODS We included 304 non-diabetic obese subjects in patient group and 150 normal weight individuals in control group. Patients were questioned in detail about their food intake. RESULTS Mean age of obese patients was 37.3±10.1 years, the mean duration of obesity was 7.9±5.4 years, and the percentage of female patients was 65.8%. Mean vitamin D, B12, and folic acid levels were significantly lower in patients than in controls. Vitamin D deficiency (<20 ng/mL) in 69.7%, vitamin B12 deficiency (<200 pg/mL) in 13.5%, and folic acid deficiency (<4 ng/mL) was found in 14.2% of the patients. BMI negatively correlated with vitamin D, B12, and folic acid levels. B12 levels negatively correlated with duration of obesity. Insulin resistance was found in 55.9% of patients and HOMA-IR levels negatively correlated with vitamin D and B12 levels. While dietary vitamin D and folic acid intakes were inadequate in all of patients, only 28.3% of patients had inadequate vitamin B12 intake. There was no relation between vitamin levels and dietary vitamin intakes. CONCLUSIONS The study reveals that vitamin D, B12, and folic acid levels were low and poor vitamin D and B12 status were associated with insulin resistance in nondiabetic obese patients.
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Affiliation(s)
- O. Cigerli
- Baskent University Istanbul Hospital - Department of Family Medicine - Istanbul, Turkey
| | - H. Parildar
- Baskent University Istanbul Hospital - Department of Family Medicine - Istanbul, Turkey
| | - A. Dogruk Unal
- Baskent University Istanbul Hospital - Endocrinology and Metabolic Diseases - Istanbul, Turkey
| | - O. Tarcin
- Baskent University Istanbul Hospital - Endocrinology and Metabolic Diseases - Istanbul, Turkey
| | - A. Kut
- Baskent University Istanbul Hospital - Department of Family Medicine - Istanbul, Turkey
| | - H. Eroglu
- Baskent University Istanbul Hospital - Department of Biochemistry, Istanbul, Turkey
| | - N. Guvener
- Baskent University Istanbul Hospital - Endocrinology and Metabolic Diseases - Istanbul, Turkey
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Extremely High Ferritinemia Associated with Haemophagocytic Lympho Histiocytosis (HLH). Indian J Clin Biochem 2016; 32:117-120. [PMID: 28149024 DOI: 10.1007/s12291-016-0559-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 02/10/2016] [Indexed: 10/22/2022]
Abstract
Hyperferritinemia (>10,000 ng/ml) is an important hallmark used as an indicator of infection triggered macrophage activation syndrome leading to hemophagocytic lympho histiocytosis (HLH). Measurement of serum ferritin can be used in diagnosis as well as disease monitoring indicator and prognosis related to HLH, cAPS, sepsis, neoplasm and inflammatory conditions. It is a major contributor to manage critically ill patients as predicting and monitoring indicator. It can be used as acute phase response in conditions of MAS, AOSD, cAPS etc. A case study in our hospital showed extremely high ferritin values along with low hemoglobin, elevated LDH and triglycerides with positive MRSA in sputum culture and macrophage proliferation and hemophagocytosis in the bone marrow examination. Patient showed definite inverse relation with steroid therapy and serum ferritin levels.
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Eftekharzadeh A, Khamseh ME, Farshchi A, Malek M. The Association Between Subclinical Hypothyroidism and Metabolic Syndrome as Defined by the ATP III Criteria. Metab Syndr Relat Disord 2016; 14:137-44. [PMID: 26824297 DOI: 10.1089/met.2015.0065] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The association between subclinical hypothyroidism (SCH) and metabolic syndrome (MetS) is a matter of debate. In this study, we aimed to examine the risk of MetS in SCH through a systematic review and meta-analysis. A systematic search of published literature up to September 2015 was conducted. General population studies were included if they had considered SCH as the independent variable. After data extraction, a meta-analysis was run to assess the odds ratio (OR) of MetS and its components between subclinical hypothyroid and euthyroid groups. Only studies employing Adult Treatment Panel III (ATP III) criteria for MetS were included in the meta-analysis. In the SCH group, female gender was more prevalent [OR = 1.65, 95% confidence interval (95% CI) 1.29-2.13]. Meta-analysis showed no significant difference in MetS prevalence between SCH and euthyroid individuals (OR = 1.13, 95% CI 0.95-1.34). However, the prevalence of central obesity (OR = 1.43, 95% CI 1.04-1.96) was significantly higher in the SCH group. On the other hand, hypertriglyceridemia was more prevalent in the female-only SCH subgroup. In conclusion, although we found some MetS components to be more prevalent in SCH, the prevalence of MetS as defined by ATP III criteria was not increased in SCH. Considerable heterogeneity observed may have influenced the results on MetS components.
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Affiliation(s)
- Anita Eftekharzadeh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences , Tehran, Iran
| | - Mohammad Ebrahim Khamseh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences , Tehran, Iran
| | - Amir Farshchi
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences , Tehran, Iran
| | - Mojtaba Malek
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences , Tehran, Iran
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Barton JC, Barton JC, Adams PC, Acton RT. Risk Factors for Insulin Resistance, Metabolic Syndrome, and Diabetes in 248 HFE C282Y Homozygotes Identified by Population Screening in the HEIRS Study. Metab Syndr Relat Disord 2016; 14:94-101. [PMID: 26771691 DOI: 10.1089/met.2015.0123] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND We sought to identify risk factors for insulin resistance, metabolic syndrome (MetS), and diabetes mellitus in 248 non-Hispanic white HFE C282Y homozygotes identified by population screening. METHODS We analyzed observations obtained prospectively in a postscreening examination: age; sex; body mass index (BMI); systolic/diastolic blood pressure; metacarpophalangeal (MP) joint hypertrophy; hepatomegaly; complete blood counts; alanine/aspartate aminotransferase levels; elevated C-reactive protein (>0.5 mg/dL); transferrin saturation; serum ferritin; homeostasis model assessment-insulin resistance (HOMA-IR); and MetS. RESULTS Twenty-six participants (10.5%) had diabetes diagnoses. A significant trend across HOMA-IR quartiles was observed only for blood neutrophils. Logistic regression on HOMA-IR fourth quartile revealed positive associations: age (P = 0.0002); male sex (P = 0.0022); and BMI (P < 0.0001). HOMA-IR fourth quartile predicted MetS (P < 0.0001). Logistic regression on diabetes revealed positive associations: age (P = 0.0012); male sex (P = 0.0068); MP joint hypertrophy (P = 0.0167); neutrophils (P = 0.0342); and MetS (P = 0.0298). Serum ferritin did not predict HOMA-IR fourth quartile, MetS, or diabetes. CONCLUSIONS In screening C282Y homozygotes, age, male sex, and BMI predicted HOMA-IR fourth quartile. HOMA-IR fourth quartile alone predicted MetS. Diabetes was associated with greater age, male sex, MP joint hypertrophy, greater blood neutrophil counts, and MetS.
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Affiliation(s)
- James C Barton
- 1 Southern Iron Disorders Center , Birmingham, Alabama.,2 Department of Medicine, University of Alabama at Birmingham , Birmingham, Alabama
| | | | - Paul C Adams
- 3 Department of Medicine, University of Western Ontario , London, Ontario, Canada
| | - Ronald T Acton
- 1 Southern Iron Disorders Center , Birmingham, Alabama.,4 Department of Microbiology, University of Alabama at Birmingham , Alabama
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Zhou FL, Gao Y, Tian L, Yan FF, Chen T, Zhong L, Tian HM. Serum ferritin is associated with carotid atherosclerotic plaques but not intima-media Thickness in patients with abnormal glucose metabolism. Clin Chim Acta 2015; 450:190-5. [PMID: 26319885 DOI: 10.1016/j.cca.2015.08.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 08/06/2015] [Accepted: 08/25/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND We investigated the association between serum ferritin and carotid artery lesions in populations with abnormal glucose metabolism. METHODS We included 70 participants with abnormal glucose metabolism and 170 participants with normal glucose metabolism and measured their baseline serum ferritin levels. During follow-up carotid intima-media thickness and carotid plaque were evaluated. RESULTS Serum ferritin levels were higher in the participants with abnormal glucose metabolism (p<0.01). We further divided the patients with abnormal glucose metabolism into subgroups with and without intima-media proliferation, and found that ferritin was excluded from the final equation in the logistic regression. Furthermore, age, waist circumference, ferritin, 2h-PG, and total cholesterol were significantly different between the subgroups with and without carotid plaque. When the above data were included in a logistic regression model, the p values obtained for age, ferritin, and 2h-PG were 0.004, 0.032, and 0.011, respectively. CONCLUSIONS In the Chinese population, serum ferritin levels are significantly increased in patients with abnormal glucose metabolism. The carotid intima-media thickness showed no independent relationship with serum ferritin in patients with abnormal glucose metabolism. However, high serum ferritin is an important risk factor for carotid atherosclerosis in these patients.
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Affiliation(s)
- F L Zhou
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
| | - Y Gao
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
| | - L Tian
- Laboratory of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
| | - F F Yan
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
| | - T Chen
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China
| | - L Zhong
- First People's Hospital of Longquanyi District, Chengdu 610041, Sichuan, People's Republic of China
| | - H M Tian
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, People's Republic of China.
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