| Abstract |
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. |