Serum ferritin and risk of myocardial infarction in the elderly: the Rotterdam Study
BACKGROUND: Elevated body iron stores have been suggested to be a risk factor for ischemic heart disease. OBJECTIVE: We examined whether elevated serum ferritin concentrations, other indicators of iron status, and dietary iron affected the incidence of myocardial infarction (MI) in an elderly population. DESIGN: A nested, case-control study of 60 patients who had their first MI and 112 age- and sex-matched control subjects embedded in the population-based cohort of the Rotterdam Study. RESULTS: The age- and sex-adjusted risk of MI for subjects with serum ferritin concentrations > or = 200 microg/L was 1.82 (95% CI: 0.90, 3.69; P = 0.096). The odds ratio (OR) was 1.26 (95% CI: 0.98, 1.64; P = 0.078) for the highest tertile of serum ferritin and was only slightly altered in a multivariate model. Risk of MI associated with the highest tertile of ferritin was most evident in current or former smokers (OR: 1.68; 95% CI: 1.17, 2.47; P for trend = 0.008) and in subjects with hypercholesterolemia (OR: 1.43; 95% CI: 0.99, 2.11; P for trend = 0.056) or diabetes (OR: 2.41; 95% CI: 1.12, 7.67; P for trend = 0.027). No association with risk of MI was observed for tertiles of serum iron, serum transferrin, or total dietary iron. For dietary heme iron, risk of MI was significantly increased in a multivariate model in which dietary energy, fat, saturated fat, and cholesterol were adjusted for (OR: 4.01; 95% CI: 1.17, 15.87; P for trend = 0.031). CONCLUSION: In the presence of other risk factors, serum ferritin may adversely affect ischemic heart disease risk in the elderly.
|Keywords||Aged, Case-Control Studies, Female, Ferritin/*blood, Geriatric Assessment, Health Status, Humans, Iron, Dietary/administration & dosage, Male, Myocardial Infarction/blood/epidemiology/*etiology, Myocardial Ischemia/etiology, Netherlands/epidemiology, Research Support, Non-U.S. Gov't, Risk Factors|
Klipstein-Grobusch, K., Koster, J.F., Grobbee, D.E., Lindemans, J., Boeing, H., Witteman, J.C.M., & Hofman, A.. (1999). Serum ferritin and risk of myocardial infarction in the elderly: the Rotterdam Study. The American Journal of Clinical Nutrition. Retrieved from http://hdl.handle.net/1765/9109