The relationship between serum ferritin levels, insulin resistance and dietary iron intake in individuals with cardiovascular disease

The aim of this study was to determine the relationship between dietary iron intake and serum ferritin levels, insulin resistance and nutritional status in patients with cardiovascular disease. The study was conducted between August and October 2019 in Gaziantep Dr. Ersin Arslan Training and Research Hospital, Department of Endocrinology and Metabolism. A total of 103 adults aged 20-64 years, were admitted to the study. Health information of the individuals who accepted to participate in the study were questioned with a questionnaire form and the anthropometric measurements of the individuals were taken and biochemical parameters were obtained from the patient files; in addition, 3-day food record and physical activity records were obtained from individuals. Serum ferritin values were sorted from small to large and divided into four groups of 25%. Serum ferritin <65.00 μg / L was divided into Q1, 65.01-154.60 μg / L was divided into Q2, 154.61-290.60 μg / L was divided into Q3, and > 290.60 μg/L was divided into Q4. Insulin resistance was calculated according to HOMA-IR, and insulin resistance was found to be 2.7 and above. The mean age of men was 52.9±10.15 years and the mean age of women was 51.6±11.71 years; mean age was 52.3±10.81 years. BMI classification of the individuals was examined according to WHO by gender, 20.3% of the males were in the normal BMI range, 49.2% were slightly obese and 15.3% were class I obese. It was found that 13.6% of the women were in the normal BMI range, 34.1% were slightly obese, 25.0% were class I obese and 20.5% were classs II obese. BMI (kg/m2) was highest in both sexes in Q1 above all quartiles (M: 29.57±4.35 kg/m2, F: 32.15±8.57 kg/m2) (p> 0.05). There was a statistically significant difference between ferritin quartiles and total cholesterol, HDL-C, non-HDL-C, LDL-C/HDL-C ratio and TG/HDL-C ratio (p <0.05). HDL-C, non-HDL-C and triglyceride levels were higher in Q1, higher values in LDL-C HDL-C ratio and TG/HDL-C ratio in Q4 above all quartile groups. There was a negative correlation between serum ferritin levels with total cholesterol and HDL-C in patients with insulin resistance (r=-0.384,p<0.05; r=-0.520,p<0.05). A statistically significant difference was found between ferritin quartiles and vitamin C and the difference was found between Q3 and Q4, lowest in Q4 (83.96±40.55 mg) (p <0.05). There was a positive correlation between serum ferritin and SFA and magnesium intake in patients with insulin resistance (r=0.248, p<0.05;r=0.247, p<0.05). There was no correlation between iron intake and serum ferritin levels (r=0.138, p>0.05). In conclusion, cardiovascular diseases and insulin resistance and iron metabolism were positively correlated with each other. The iron metabolism plays an important role in the oxidative process at the cellular level and triggers inflammation can be said as the underlying cause of the formation of these diseases. Serum ferritin and dietary iron intake are an important risk factor for cardiovascular diseases and insulin resistance, also dietary iron intake, dietary saturated fat intake and dietary mineral intake should be arranged within the framework of an adequate and balanced diet, considering the individuals daily reference values, and should be supported by lifestyle changes in the medical nutrition therapy for prevention of cardiometabolic diseases.