Ferritin is independently associated with the presence of coronary artery calcium in 12 033 men

Ki Chul Sung, Seok Min Kang, Eun Joo Cho, Jeong Bae Park, Sarah H. Wild, Christopher D. Byrne

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OBJECTIVE-: Ferritin concentrations are often increased in patients with metabolic syndrome and type 2 diabetes mellitus, but few reports have examined the associations between ferritin and atherosclerosis. We investigated whether any relationship between ferritin and coronary artery calcium score (CACS) >0 (as a marker of atherosclerosis) was independent of potential confounders, such as iron-binding capacity (transferrin), low-grade inflammation, and cardiovascular risk factors. METHODS AND RESULTS-: Data were analyzed from a South Korean occupational cohort of 12 033 men who underwent a cardiac computed tomography estimation of CACS and measurements of multiple cardiovascular risk factors. One-thousand three-hundred-fifteen of 12 033 (11.2%) subjects had a CACS >0. For people with a CACS >0, median (interquartile range) ferritin concentration was 196.8 (136.3-291.9) compared with 182.2 (128.1-253.6) in people with a CACS=0; P<0.001. In the highest ferritin quartile, 14.7% (442/3008) of subjects had a CACS >0 compared with 9.7% (292/3010) in the lowest quartile (P<0.0001). With increasing ferritin quartiles, there were also higher proportions of people with diabetes mellitus (P<0.0001), hypertension (P<0.0001), coronary heart disease (P=0.003), and a Framingham Risk Score >10% (P<0.0001). In logistic regression modeling with CACS >0 as the outcome, ferritin but not transferrin was independently associated with CACS >0 (odds ratio for highest quartile versus lowest quartile, 1.66 [95% CI, 1.3-1.98]; P=0.0001). CONCLUSION-: Increased ferritin concentrations are associated with the presence of a marker of early coronary artery atherosclerosis, independently of traditional cardiovascular risk factors including Framingham risk score, transferrin, preexisting vascular disease, diabetes mellitus, metabolic syndrome factors, and low-grade inflammation.

Original languageEnglish
Pages (from-to)2525-2530
Number of pages6
JournalArteriosclerosis, thrombosis, and vascular biology
Issue number10
Publication statusPublished - 2012 Nov

Bibliographical note

Funding Information:
We are very grateful for discussions with A.P. Balachandran who pointed out a difficulty with an earlier version of the paper. We also thank him for informing us of ref. [13]. A.S. wishes to thank the members of the Institute of Theoretical Physics, G6teborg, for their hospitality during a stay in which the present work was completed. P.S. and B.-S.S. are supported by the Swedish Research Council under contract numbers 7310-125 and 8244-103, respectively. A.S. is supported by the U.S. Department of Energy under grant no. DE-FG05-84ER40141.

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine


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