From the Research Institute of Public Health and the Department of Public
Health and General Practice, University of Kuopio, and the Department of
Clinical Chemistry, Kuopio University Hospital (K.P.), Finland.
Correspondence to Professor Jukka T. Salonen, Research Institute of Public Health, University of Kuopio, Harjulantie 1B, 70210 Kuopio, Finland or PO Box 1627, 70211 Kuopio, Finland. E-mail salonen{at}reivi.uku.fi
Background—Epidemiological evidence
concerning the role of iron, a lipid peroxidation catalyst, in
coronary heart disease (CHD) is inconsistent. We
investigated the association of the concentration ratio of serum
transferrin receptor to serum ferritin (TfR/ferritin), a
state-of-the-art measurement of body iron stores, with the risk of
acute myocardial infarction (AMI) in a prospective nested case-control
study in men from eastern Finland.
Methods and Results—Transferrin receptor assays were carried out
for 99 men who had an AMI during an average 6.4 years of follow-up and
98 control men. Both the cases and the controls were nested from the
Kuopio Ischemic Heart Disease Risk Factor Study (KIHD) cohort
of 1931 men who had no clinical CHD at the baseline study. The controls
were matched for age, examination year, and residence. AMIs were
registered prospectively. Soluble transferrin receptors were measured
by immunoenzymometric assay and ferritin concentration by
radioimmunoassay from frozen baseline serum samples. The mean
TfR/ferritin ratio was 15.1 (SE, 2.0) among cases and 21.3 (SE, 2.2)
among controls (P=.035 for difference). In logistic
regression models adjusting for other strongest risk factors for AMI
and indicators of inflammation and alcohol intake, men in the lowest
and second lowest thirds of the TfR/ferritin ratio had a 2.9-fold (95%
CI, 1.3 to 6.6, P=.011) and 2.0-fold (0.9 to 4.2,
P=.081) risk of AMI compared with men in the highest
third (P=.010 for trend).
Conclusions—These data show an association between increased body
iron stores and excess risk of AMI, confirming previous epidemiological
findings.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Association Between Body Iron Stores and the Risk of Acute Myocardial Infarction in Men
Key Words: coronary disease • diabetes mellitus • ferritin • myocardial infarction • population
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