Published Online
on January 15, 2004

A more recent version of this article appeared on February 1, 2004

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Submitted on October 27, 2003
Accepted on October 30, 2003

Association Between High Serum Ferritin Levels and Carotid Atherosclerosis in the Study of Health in Pomerania (SHIP)

Birger Wolff MD^*; Henry Völzke MD; Jan Lüdemann PhD; Daniel Robinson MD; Dirk Vogelgesang MD; Alexander Staudt MD; Christof Kessler MD; Johannes B. Dahm MD; Ulrich John PhD; and Stephan B. Felix MD

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.

^* To whom correspondence should be addressed. E-mail: birger.wolff{at}uni-greifswald.de.

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.

Key words: atherosclerosis • epidemiology • ferritin • iron • ultrasonography

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