Iron status and cardiometabolic risk in children

Milton Fabian Suárez-Ortegón; Anna Prats-Puig; Judit Bassols; Gemma Carreras-Badosa; Stela McLachlan; Sarah H Wild; Abel López-Bermejo; José Manuel Fernández-Real

doi:10.1016/j.diabres.2023.110795

Iron status and cardiometabolic risk in children

Milton Fabian Suárez-Ortegón, Anna Prats-Puig, Judit Bassols, Gemma Carreras-Badosa, Stela McLachlan, Sarah H Wild, Abel López-Bermejo^*, José Manuel Fernández-Real^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract / Description of output

Aim: We aimed to evaluate associations between serum ferritin and transferrin and variables related to the metabolic syndrome (MetS) in children.
Methods: Cross-sectional and longitudinal study in prepubertal children(n=832) aged 3-14 years. A subset(n=203) were re-examined after a mean follow-up of 3.7±0.8 years[range 2-6]. Outcomes were MetS and MetS components scores, glycosylated haemoglobin (HbA1c), and their follow-up change.
Results: Children with low ferritin had increased HbA1c Z scores (ANCOVA,P=0.003). Ferritin was inversely associated with glycaemia [fully adjusted β (95% confidence interval): -2.35(-4.36 to -0.34)]. Transferrin was associated with diastolic blood pressure[β: 0.02(0.01-0.04)] and log-HOMA-IR [β:0.001(0.0005-0.002)]. MetS risk score worsened during follow-up in children with the lowest baseline ferritin levels. In contrast, at baseline ferritin was positively associated with all (except glycaemia) the MetS-related variables but adjustments for inflammatory, hepatic function, and body mass markers attenuated those associations(P>0.05).
Conclusions: Lower iron status was independently associated with glycaemic markers and MetS in children, whereas higher ferritin levels were related to other cardiometabolic risk markers under the influence of inflammation, hepatic injury and body mass. Research is required to study whether this mixed pattern is part of an early risk or would be explained by a normal transition during growth and development.

Original language	English
Article number	110795
Journal	Diabetes Research and Clinical Practice
Volume	202
Early online date	22 Jun 2023
DOIs	https://doi.org/10.1016/j.diabres.2023.110795
Publication status	Published - 1 Aug 2023

Keywords / Materials (for Non-textual outputs)

Transferrin
Ferritin
Metabolic syndrome
Insulin resistance
Glycosylated haemoglobin
Children

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Rev1_DRCP_Def_Manuscript_Iron-CMR-pediatricsAccepted author manuscript, 777 KBLicence: Creative Commons: Attribution (CC-BY)

Cite this

@article{bd8b95c0ec8a4d858283f469433834be,

title = "Iron status and cardiometabolic risk in children",

abstract = "Aim: We aimed to evaluate associations between serum ferritin and transferrin and variables related to the metabolic syndrome (MetS) in children.Methods: Cross-sectional and longitudinal study in prepubertal children(n=832) aged 3-14 years. A subset(n=203) were re-examined after a mean follow-up of 3.7±0.8 years[range 2-6]. Outcomes were MetS and MetS components scores, glycosylated haemoglobin (HbA1c), and their follow-up change.Results: Children with low ferritin had increased HbA1c Z scores (ANCOVA,P=0.003). Ferritin was inversely associated with glycaemia [fully adjusted β (95% confidence interval): -2.35(-4.36 to -0.34)]. Transferrin was associated with diastolic blood pressure[β: 0.02(0.01-0.04)] and log-HOMA-IR [β:0.001(0.0005-0.002)]. MetS risk score worsened during follow-up in children with the lowest baseline ferritin levels. In contrast, at baseline ferritin was positively associated with all (except glycaemia) the MetS-related variables but adjustments for inflammatory, hepatic function, and body mass markers attenuated those associations(P>0.05). Conclusions: Lower iron status was independently associated with glycaemic markers and MetS in children, whereas higher ferritin levels were related to other cardiometabolic risk markers under the influence of inflammation, hepatic injury and body mass. Research is required to study whether this mixed pattern is part of an early risk or would be explained by a normal transition during growth and development.",

keywords = "Transferrin, Ferritin, Metabolic syndrome, Insulin resistance, Glycosylated haemoglobin, Children",

author = "Su{\'a}rez-Orteg{\'o}n, {Milton Fabian} and Anna Prats-Puig and Judit Bassols and Gemma Carreras-Badosa and Stela McLachlan and Wild, {Sarah H} and Abel L{\'o}pez-Bermejo and Fern{\'a}ndez-Real, {Jos{\'e} Manuel}",

note = "Funding Information: G.C.-B. is an Investigator of the pFIS Fund for Scientific Research from Carlos III National Institute of Health, Madrid, Spain. J.B. is an Investigator of the Miguel Servet Fund from the National Institute of Health Carlos III, Madrid, Spain. A.L.-B. is an Investigator of the I3 Fund for Scientific Research, Ministry of Science and Innovation, Madrid, Spain. This work was supported by grant no. 10/00553 (to A.L.-B.) from the National Institute of Health Carlos III (Fund FIS for Health Research, Spain) a project funded in part by FEDER (Fondo Europeo de Desarrollo Regional). Funding Information: This work was supported by grant no. 10/00553 (to A.L.-B.) from the National Institute of Health Carlos III (Fund FIS for Health Research, Spain) a project funded in part by FEDER (Fondo Europeo de Desarrollo Regional). Publisher Copyright: {\textcopyright} 2023 Elsevier B.V.",

year = "2023",

month = aug,

day = "1",

doi = "10.1016/j.diabres.2023.110795",

language = "English",

volume = "202",

journal = "Diabetes Research and Clinical Practice",

issn = "0168-8227",

publisher = "Elsevier",

}

TY - JOUR

T1 - Iron status and cardiometabolic risk in children

AU - Suárez-Ortegón, Milton Fabian

AU - Prats-Puig, Anna

AU - Bassols, Judit

AU - Carreras-Badosa, Gemma

AU - McLachlan, Stela

AU - Wild, Sarah H

AU - López-Bermejo, Abel

AU - Fernández-Real, José Manuel

N1 - Funding Information: G.C.-B. is an Investigator of the pFIS Fund for Scientific Research from Carlos III National Institute of Health, Madrid, Spain. J.B. is an Investigator of the Miguel Servet Fund from the National Institute of Health Carlos III, Madrid, Spain. A.L.-B. is an Investigator of the I3 Fund for Scientific Research, Ministry of Science and Innovation, Madrid, Spain. This work was supported by grant no. 10/00553 (to A.L.-B.) from the National Institute of Health Carlos III (Fund FIS for Health Research, Spain) a project funded in part by FEDER (Fondo Europeo de Desarrollo Regional). Funding Information: This work was supported by grant no. 10/00553 (to A.L.-B.) from the National Institute of Health Carlos III (Fund FIS for Health Research, Spain) a project funded in part by FEDER (Fondo Europeo de Desarrollo Regional). Publisher Copyright: © 2023 Elsevier B.V.

PY - 2023/8/1

Y1 - 2023/8/1

N2 - Aim: We aimed to evaluate associations between serum ferritin and transferrin and variables related to the metabolic syndrome (MetS) in children.Methods: Cross-sectional and longitudinal study in prepubertal children(n=832) aged 3-14 years. A subset(n=203) were re-examined after a mean follow-up of 3.7±0.8 years[range 2-6]. Outcomes were MetS and MetS components scores, glycosylated haemoglobin (HbA1c), and their follow-up change.Results: Children with low ferritin had increased HbA1c Z scores (ANCOVA,P=0.003). Ferritin was inversely associated with glycaemia [fully adjusted β (95% confidence interval): -2.35(-4.36 to -0.34)]. Transferrin was associated with diastolic blood pressure[β: 0.02(0.01-0.04)] and log-HOMA-IR [β:0.001(0.0005-0.002)]. MetS risk score worsened during follow-up in children with the lowest baseline ferritin levels. In contrast, at baseline ferritin was positively associated with all (except glycaemia) the MetS-related variables but adjustments for inflammatory, hepatic function, and body mass markers attenuated those associations(P>0.05). Conclusions: Lower iron status was independently associated with glycaemic markers and MetS in children, whereas higher ferritin levels were related to other cardiometabolic risk markers under the influence of inflammation, hepatic injury and body mass. Research is required to study whether this mixed pattern is part of an early risk or would be explained by a normal transition during growth and development.

AB - Aim: We aimed to evaluate associations between serum ferritin and transferrin and variables related to the metabolic syndrome (MetS) in children.Methods: Cross-sectional and longitudinal study in prepubertal children(n=832) aged 3-14 years. A subset(n=203) were re-examined after a mean follow-up of 3.7±0.8 years[range 2-6]. Outcomes were MetS and MetS components scores, glycosylated haemoglobin (HbA1c), and their follow-up change.Results: Children with low ferritin had increased HbA1c Z scores (ANCOVA,P=0.003). Ferritin was inversely associated with glycaemia [fully adjusted β (95% confidence interval): -2.35(-4.36 to -0.34)]. Transferrin was associated with diastolic blood pressure[β: 0.02(0.01-0.04)] and log-HOMA-IR [β:0.001(0.0005-0.002)]. MetS risk score worsened during follow-up in children with the lowest baseline ferritin levels. In contrast, at baseline ferritin was positively associated with all (except glycaemia) the MetS-related variables but adjustments for inflammatory, hepatic function, and body mass markers attenuated those associations(P>0.05). Conclusions: Lower iron status was independently associated with glycaemic markers and MetS in children, whereas higher ferritin levels were related to other cardiometabolic risk markers under the influence of inflammation, hepatic injury and body mass. Research is required to study whether this mixed pattern is part of an early risk or would be explained by a normal transition during growth and development.

KW - Transferrin

KW - Ferritin

KW - Metabolic syndrome

KW - Insulin resistance

KW - Glycosylated haemoglobin

KW - Children

U2 - 10.1016/j.diabres.2023.110795

DO - 10.1016/j.diabres.2023.110795

M3 - Article

SN - 0168-8227

VL - 202

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

M1 - 110795

ER -

Iron status and cardiometabolic risk in children

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