Association Between High Serum Ferritin Levels and Carotid Atherosclerosis in the Study of Health in Pomerania (SHIP)
Abstract
Background and Purpose— Several studies have provided evidence for a relationship between body iron load and cardiovascular disease. We analyzed the association of serum ferritin levels with carotid atherosclerosis. Methods— We assessed intima-media thickness and plaque prevalence in the carotid arteries by high-resolution ultrasound among 2443 participants (1200 women; age, 45 to 79 years) in the Study of Health in Pomerania (SHIP), a population-based study in northeast Germany. Results— In multivariate analysis, serum ferritin levels were not independently associated with carotid intima-media thickness among women or men. In contrast, the relationship between serum ferritin levels and carotid plaque prevalence was significant among men (odds ratio per 1-SD increase of serum ferritin levels, 1.33; 95% confidence interval, 1.08 to 1.44) yet not among women (odds ratio, 1.29; 95% confidence interval, 0.98 to 1.75). However, both men and women showed a dose-response relation between serum ferritin levels and carotid atherosclerosis in which higher serum ferritin levels were associated with greater odds ratios for carotid plaque prevalence. Additionally, there was an interaction of serum ferritin levels with low-density lipoprotein (LDL) cholesterol ( P =0.039) among men in which the association of serum ferritin levels with carotid plaque prevalence became stronger with increasing LDL cholesterol levels. Conclusions— Our study identified a relationship between serum ferritin levels and carotid atherosclerosis that was potentiated by LDL cholesterol. This relationship adds support to the hypothesis of a link between iron and cardiovascular disease.
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Iron and oxidised lipids are both found in atherosclerotic lesions.
“Iron and oxidised lipids are both found in atherosclerotic lesions [141,765-777]”
Cites
The Pathogenesis of Atherosclerosis
Ross, R., & Glomset, J. A. (1976) · New England Journal of Medicine · doi:10.1056/nejm197608122950707 · Cited by 2,021 · see citing works
The pathogenesis of atherosclerosis
(1972) · American Heart Journal · doi:10.1016/0002-8703(72)90090-7 · Cited by 1,329 · see citing works
Salonen, J. T., Nyyssönen, K., Korpela, H., Tuomilehto, J., Seppänen, R., & Salonen, R. (1992) · Circulation · doi:10.1161/01.cir.86.3.803 · Cited by 1,284 · see citing works
IRON AND THE SEX DIFFERENCE IN HEART DISEASE RISK
Sullivan, J. (1981) · The Lancet · doi:10.1016/s0140-6736(81)92463-6 · Cited by 969 · see citing works
Ultrasonic Echolucent Carotid Plaques Predict Future Strokes
Grønholdt, M.-L. M., Nordestgaard, B. G., Schroeder, T. V., et al. (2001) · Circulation · doi:10.1161/hc2601.091704 · Cited by 578 · see citing works
Craven, T. E., Ryu, J. E., Espeland, M. A., Kahl, F. R., McKinney, W. M., Toole, J. F., McMahan, M. R., Thompson, C. J., HEISS, G. M., & Crouse, J. R. (1990) · Circulation · doi:10.1161/01.cir.82.4.1230 · Cited by 554 · see citing works
John, U., Hensel, E., L�demann, J., Piek, M., Sauer, S., Adam, C., Born, G., Alte, D., Greiser, E. M., Haertel, U., et al. (2001) · Sozial- und Präventivmedizin · doi:10.1007/bf01324255 · Cited by 547 · see citing works
Self-citationBody Iron Stores and the Risk of Carotid Atherosclerosis: Prospective Results From the Bruneck Study
Kiechl, S., Willeit, J., Egger, G., Poewe, W., & Oberhollenzer, F. (1997) · Circulation · doi:10.1161/01.cir.96.10.3300 · Cited by 390 · see citing works
Drüeke, T. B., Witko‐Sarsat, V., Massy, Z. A., Descamps‐Latscha, B., Guérin, A. P., Marchais, S. J., Gausson, V., & London, G. M. (2002) · Circulation · doi:10.1161/01.cir.0000035250.66458.67 · Cited by 375 · see citing works
Iron Chelation Improves Endothelial Function in Patients With Coronary Artery Disease
Duffy, S. J., Biegelsen, E. S., Holbrook, M., Russell, J. D., Gokce, N., Keaney, J. F., & Vita, J. A. (2001) · Circulation · doi:10.1161/01.cir.103.23.2799 · Cited by 271 · see citing works
Body Iron Stores and the Risk of Coronary Heart Disease
Sempos, C. T., Looker, A. C., Gillum, R. F., & Makuc, D. M. (1994) · New England Journal of Medicine · doi:10.1056/nejm199404213301604 · Cited by 251 · see citing works
Coronary Heart Disease and Iron Status: Meta-Analyses of Prospective Studies
Danesh, J., & Appleby, P. (1999) · Circulation · doi:10.1161/01.cir.99.7.852 · Cited by 226 · see citing works
Blood Donations and Risk of Coronary Heart Disease in Men
Ascherio, A., Rimm, E. B., Giovannucci, E. L., Willett, W. C., & Stampfer, M. J. (2001) · Circulation · doi:10.1161/01.cir.103.1.52 · Cited by 193 · see citing works
Kallikazaros, I. E., Tsioufis, C. P., Sideris, S. K., Stefanadis, C., & TOUTOUZAS, P. K. (1999) · Stroke · doi:10.1161/01.str.30.5.1002 · Cited by 188 · see citing works
Iron Overload Augments the Development of Atherosclerotic Lesions in Rabbits
Araujo, J. A., Romano, E. L., Brito, B. E., Parthe, V., Romano, M., Bracho, M. P., Montaño, R. F., & Cardier, J. E. (1995) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.15.8.1172 · Cited by 180 · see citing works
Iron-Deficient Diet Reduces Atherosclerotic Lesions in ApoE-Deficient Mice
Lee, T.-S., Shiao, M.-S., Pan, C.-C., & Chau, L.-Y. (1999) · Circulation · doi:10.1161/01.cir.99.9.1222 · Cited by 179 · see citing works
Low iron-binding capacity as a risk factor for myocardial infarction.
Magnússon, M. K., Sigfússon, N., Sigvaldason, H., Jóhannesson, G. M., Magnússon, S. H., & Thorgeirsson, G. (1994) · Circulation · doi:10.1161/01.cir.89.1.102 · Cited by 179 · see citing works
Gaenzer, H., Marschang, P., Sturm, W., Neumayr, G., Vogel, W., Patsch, J. R., & Weiß, G. (2002) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(02)02611-6 · Cited by 147 · see citing works
Serum Iron and Risk of Fatal Acute Myocardial Infarction
MORRISON, H. I., Semenciw, R. M., Mao, Y., & Wigle, D. T. (1994) · Epidemiology · doi:10.1097/00001648-199403000-00015 · Cited by 146 · see citing works
Distinct Risk Profiles of Early and Advanced Atherosclerosis
Willeit, J., Kiechl, S. J., Oberhollenzer, F., Rungger, G., Egger, G., Bonora, E., Mitterer, M., & Muggeo, M. (2000) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.20.2.529 · Cited by 136 · see citing works
Iron-Dependent Human Platelet Activation and Hydroxyl Radical Formation
Praticò, D., Pasin, M., Barry, Ó. P., Ghiselli, A., Sabatino, G., Iuliano, L., FitzGerald, G. A., & Violi, F. (1999) · Circulation · doi:10.1161/01.cir.99.24.3118 · Cited by 129 · see citing works
Iron stores are not associated with acute myocardial infarction.
Baer, D., Tekawa, I. S., & Hurley, L. B. (1994) · Circulation · doi:10.1161/01.cir.89.6.2915 · Cited by 103 · see citing works
Luedemann, J., Schminke, U., Berger, K., Piek, M., Willich, S. N., Döring, A., John, U., & Kessler, C. (2002) · Stroke · doi:10.1161/01.str.0000038422.57919.7f · Cited by 99 · see citing works
Self-citationNo Association between Serum Ferritin and Asymptomatic Carotid Atherosclerosis
Moore, M., Folsom, A. R., Barnes, R. W., & Eckfeldt, J. H. (1995) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a117493 · Cited by 98 · see citing works
Iron overload diminishes atherosclerosis in apoE-deficient mice
Kirk, E. A., Heinecke, J. W., & LeBoeuf, R. C. (2001) · Journal of Clinical Investigation · doi:10.1172/jci7664 · Cited by 80 · see citing works
Yuan, X., Brunk, U. T., & OLSSON, A. G. (1995) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.15.9.1345 · Cited by 79 · see citing works
Gillum, R. F., Sempos, C. T., Makuc, D. M., Looker, A. C., Chien, C.-Y., & Ingram, D. D. (1996) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a008855 · Cited by 67 · see citing works
Iron released from transferrin at acidic pH can catalyse the oxidation of low density lipoprotein
Lamb, D. J., & Leake, D. S. (1994) · FEBS Letters · doi:10.1016/0014-5793(94)00903-1 · Cited by 64 · see citing works
Rossi, E., McQuillan, B., Hung, J., Thompson, P. L., Kuek, C. M., & Beilby, J. P. (2000) · Stroke · doi:10.1161/01.str.31.12.3015 · Cited by 49 · see citing works
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Kell, D. B., & Pretorius, E. (2014) · Metallomics · doi:10.1039/c3mt00347g · Cited by 667 · see citing works
Kell, D. B. (2009) · BMC Medical Genomics · doi:10.1186/1755-8794-2-2 · Cited by 554 · see citing works
Kell, D. B. (2010) · Archives of Toxicology · doi:10.1007/s00204-010-0577-x · Cited by 361 · see citing works
Iron Status Is Associated with Carotid Atherosclerotic Plaques in Middle-Aged Adults
Ahluwalia, N., Genoux, A., Ferrieres, J., Perret, B., Carayol, M., Drouet, L., & Ruidavets, J.-B. (2010) · The Journal of Nutrition · doi:10.3945/jn.109.110353 · Cited by 69 · see citing works
Erythropoietin Depletes Iron Stores: Antioxidant Neuroprotection for Ischemic Stroke?
Bailey, D. M., Robach, P., Thomsen, J. J., & Lundby, C. (2006) · Stroke · doi:10.1161/01.str.0000239787.92203.16 · Cited by 19 · see citing works
Ferritina sérica e coronariopatia obstrutiva: correlação angiográfica
Godoy, M. F. D., Takakura, I. T., Machado, R. D., Grassi, L. V., & Nogueira, P. R. (2007) · Arquivos Brasileiros de Cardiologia · doi:10.1590/s0066-782x2007000400011 · Cited by 15 · see citing works
Sena, A., Pedrosa, R., Ferret-Sena, V, Cascais, M., Roque, R., Araújo, C., & Couderc, R. (2008) · Multiple Sclerosis Journal · doi:10.1177/1352458508089687 · Cited by 12 · see citing works
- Authors
- Wolff, B., Völzke, H., Lüdemann, J., Robinson, D., Vogelgesang, D., Staudt, A., Kessler, C., Dahm, J. B., John, U., & Felix, S. B.
- Affiliations
- Universitätsmedizin Greifswald (DE)
- From Klinik für Innere Medizin B (B.W., D.R., D.V., A.S., J.B.D., S.B.F.), Institut für Epidemiologie und Sozialmedizin (H.V., U.J.), Institut für Klinische Chemie (J.L.), and Klinik für Neurologie (C.K.), Universität Greifswald, Greifswald, Germany.
- Venue
- Stroke
- Published
- 2004-02
- Volume
- 35
- Issue
- 2
- Pages
- 453-457
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W2131601303
- Cited by
- 108
- References
- 29
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 5 · 2019: 2 · 2018: 1 · 2017: 3 · 2016: 3 · 2015: 6 · 2014: 9 · 2013: 3 · 2012: 6
- FWCI
- 5.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Bundesministerium für Bildung und Forschung
- Topics
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cerebrovascular and Carotid Artery Diseases
- Keywords
- serum ferritin, carotid atherosclerosis, carotid intima-media thickness, iron overload, LDL cholesterol, sex differences, dose-response relationship, cardiovascular disease, Study of Health in Pomerania
- MeSH terms
- Aged, Carotid Arteries, Carotid Artery Diseases, Cross-Sectional Studies, Female, Ferritins, Germany, Health Surveys, Humans, Cholesterol, LDL, Male, Middle Aged, Risk Factors, Sex Factors, Ultrasonography, Prevalence, Multivariate Analysis, Odds Ratio, Tunica Intima, Tunica Media, Sex Distribution
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