Associations of iron status with apolipoproteins and lipid ratios: a cross-sectional study from the China Health and Nutrition Survey
Associations of iron status with apolipoproteins and lipid ratios: a cross-sectional study from the China Health and Nutrition Survey
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DOI：
10.1186/s12944-020-01312-9
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发表时间：
2020-06
影响因子：
4.5
通讯作者：
Bowen Zhou;Huihui Ren;Xinrong Zhou;G. Yuan
中科院分区：
文献类型：
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作者：
Bowen Zhou;Huihui Ren;Xinrong Zhou;G. Yuan
背景铁超载与多种心血管代谢紊乱有关，如血脂异常、代谢综合征、糖尿病等。铁状态和脂质代谢的紊乱可导致器官损伤，如动脉粥样硬化斑块的生长和不稳定。评估铁状态与载脂蛋白和脂质比值的相关性将为维持代谢稳态和阻碍疾病进展提供信息。因此，本研究的目的是建立铁状态与载脂蛋白和脂质ratio.MethodsA横断面研究的7540名成年参与者从中国健康与营养调查2009年进行的关系。Logistic回归分析用于研究铁状态指标与不利载脂蛋白谱患病率之间的关系。多变量线性回归模型被构建来评估血清铁蛋白和血脂参数之间的剂量-反应相关性。结果在调整混杂因素后，在两种性别中，铁蛋白的前四分位数中的受试者的载脂蛋白B升高的患病率最高（男性：比值比（OR）1.97，95%置信区间（CI）1.50-2.62;女性：OR 2.13，95% CI 1.53-2.97）和载脂蛋白B/载脂蛋白A1比值升高（男性：OR 2.00，95% CI 1.50-2.66;女性：OR 1.41，95% CI 1.04-1.92）。男性和女性的血红蛋白也与不利的载脂蛋白B和载脂蛋白B/载脂蛋白A1比值独立相关。然而，转铁蛋白（男性：OR 0.74，95%CI 0.56-0.99;女性：OR 0.73，95%CI 0.56-0.95）和可溶性转铁蛋白受体（男性：OR 0.75，95%CI 0.57-0.99;女性：OR 0.71，95%CI 0.55-0.91）与载脂蛋白A1降低呈负相关。此外，在控制了潜在的混杂因素后，铁蛋白浓度与男性的血脂比值（包括TG/HDL-C、non-HDL-C/HDL-C、TC/HDL-C、apoB/apoA 1和LDL-C/HDL-C比值）水平显著相关（β系数分别为0.147、0.061、0.043、0.038、0.032，均P < 0.001）（β系数分别为0.074，0.034，0.025，0.020，0.018，P均< 0.05）。血清铁蛋白浓度与血脂比值呈正相关。对可调铁状态和脂质代谢的管理具有临床意义。铁超载患者的动脉粥样硬化脂质谱值得特别的临床关注。
BackgroundIron overload has been found to be related with various cardiometabolic disorders, like dyslipidemia, metabolic syndrome, and diabetes. The disturbance of the iron status and lipid metabolism can contribute to organ damage such as atherosclerotic plaque growth and instability. An assessment on the associations of iron status with apolipoproteins and lipid ratios would be informative for maintenance of metabolic homeostasis and hinderance of disease progression. Hence, this study aims to establish the relationships of iron status with apolipoproteins and lipid ratios.MethodsA cross-sectional study of 7540 adult participants from the China Health and Nutrition Survey 2009 was conducted. Logistic regression analyses were used to investigate the relationships between indicators of iron status and the prevalence of unfavorable apolipoprotein profiles. Multivariate linear regression models were constructed to assess the dose-response correlations between serum ferritin and lipid parameters.ResultsAfter adjustment for confounding factors, in both sexes, the subjects in the top quartile of ferritin had the highest prevalence of an elevated apolipoprotein B (men: odds ratio (OR) 1.97, 95% confidence interval (CI) 1.50–2.62; women: OR 2.13, 95% CI 1.53–2.97) and an elevated apolipoprotein B/apolipoprotein A1 ratio (men: OR 2.00, 95% CI 1.50–2.66; women: OR 1.41, 95% CI 1.04–1.92) when compared with individuals in the lowest quartile. Hemoglobin were also independently associated with unfavorable apolipoprotein B and apolipoprotein B/apolipoprotein A1 ratio both in men and women. However, transferrin (men: OR 0.74, 95% CI 0.56–0.99; women: OR 0.73, 95% CI 0.56–0.95) and soluble transferrin receptor (men: OR 0.75, 95% CI 0.57–0.99; women: OR 0.71, 95% CI 0.55–0.91) were found to be negatively associated with a decreased apolipoprotein A1. Moreover, after controlling for potential confounders, the ferritin concentrations were significantly associated with the levels of lipid ratios including TG/HDL-C, non-HDL-C/HDL-C, TC/HDL-C, apoB/apoA1, and LDL-C/HDL-C ratio in men (β coefficient = 0.147, 0.061, 0.043, 0.038, 0.032, respectively, allPvalues < 0.001) and in women (β coefficient = 0.074, 0.034, 0.025, 0.020, 0.018, respectively, allPvalues < 0.05).ConclusionsThe indicators of iron status are significantly associated with unfavorable apolipoprotein profiles. Serum ferritin concentrations are positively correlated with the levels of lipid ratios. The management on the modifiable iron status and lipid metabolism has a clinical significance. The atherosclerotic lipid profiles of the patients with iron overload deserve special clinical concerns.