The Relationship between Cardiovascular Risk Factors and the Serum Ferritin Level in Relation to C-Reactive Protein in Korean

ABSTRACT

BACKGROUND AND OBJECTIVES: Iron is a key component in the production of oxidized low density lipoprotein (LDL), which increases cardiovascular disease through inflammation. However, there is little data to suggest that oxidative stress is positively correlated with C-reactive protein (CRP). The purpose of this study was to examine the influence of the serum ferritin level and cardiovascular risk factors on CRP in a Korean population. SUBJECTS AND METHODS: A total of 808 subjects (465 men, 343 women), who had undergone a medical check-up at the health promotion center at Kangbuk Samsung Hospital, between September 2002 and November 2002, were included in this study. Logistic regression models were computed using elevated or nonelevated hsCRP, as dependent variable, with cardiovascular risk factors, such as, serum ferritin, total, LDL and HDL cholesterols, controlling for potential confounders, including age, gender, body mass index (BMI), hypertension, diabetes and smoking. RESULTS: Significant positive correlations were found between hsCRP and age, BMI, triglyceride and the level of serum ferritin, with a negative correlation found between hsCRP and HDL cholesterol. In age, gender, BMI, hypertension, diabetes, a smoking-adjusted model, an elevated ferritin level were not significantly associated with elevated hsCRP in low LDL subjects (OR=1.68, 95% CI=0.81-3.48), but significant associations were observed in high LDL subjects (OR=11.21, 95% CI=1.14-110.27). And we observed the significant effect modification of the association of hsCRP with serum ferritin level by LDL-cholesterol (p=0.002). CONCLUSION: Our results suggest that increased LDL cholesterol and ferritin have an effect on the increment of hsCRP. Thus, iron-catalyzed oxidation of LDL cholesterol may be an important step of the development of the inflammatory process. Further prospective studies will need to be performed to establish the relationship between the decreasing of the serum ferritin level and CRP for the prevention of cardiovascular disease.