Chen Yuan, Wang Chao, Xiao Yanyan, Hu Tian, Yang Xuerong, Mu Guohua, Lu Hao, Xu Junfei, Chen Chi
Department of Endocrinology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Obes Facts. 2025;18(2):139-148. doi: 10.1159/000542896. Epub 2024 Dec 3.
Fat distribution is a stronger predictor for cardiometabolic morbidity and mortality. We aimed to investigate the association of elevated iron stores, measured as serum ferritin levels, with total and regional body fat.
Data from 2,646 adults from the National Health and Nutrition Examination Survey 2017-2018 were analyzed. Dual-energy X-ray absorptiometry was used to measure overall and regional body fat. The fat mass index (FMI) was calculated by dividing the fat mass (kg) by the square of body height (m2). The leg fat mass to trunk fat mass ratio (LTR) was used to assess the relative distribution of leg fat compared to trunk fat.
Medians (IQR) of serum ferritin levels were 0.168 μg/mL (0.104-0.269) for men and 0.053 μg/mL (0.026-0.102) for women. After adjusting for sociodemographic, lifestyle, and metabolic factors, serum ferritin showed a significant positive association with total FMI (β = 2.662) and trunk FMI (β = 0.983), and a negative association with leg FMI (β = -0.324) and LTR (β = -0.160) in men. In women, serum ferritin showed a significant positive association with total FMI (β = 4.658), trunk FMI (β = 2.085), and negative association with LTR (β = -0.312). Significant positive trends were observed for serum ferritin with total and trunk FMI in men and women, using the lowest serum ferritin quartile as the reference group. Additionally, significant negative trends were observed for serum ferritin with leg FMI and LTR in men. The mediation analysis revealed that C-reactive protein mediated 16.4% and 22.6% of the potential effects of serum ferritin on trunk FMI in men and women, respectively.
Higher ferritin levels were associated with greater total and trunk fat but lower leg fat. Further prospective and mechanistic studies are warranted to confirm the study results.
脂肪分布是心血管代谢疾病发病率和死亡率更强的预测指标。我们旨在研究以血清铁蛋白水平衡量的铁储存升高与全身及局部体脂之间的关联。
分析了2017 - 2018年美国国家健康与营养检查调查中2646名成年人的数据。采用双能X线吸收法测量全身及局部体脂。脂肪质量指数（FMI）通过将脂肪质量（kg）除以身高的平方（m²）来计算。腿部脂肪质量与躯干脂肪质量比（LTR）用于评估腿部脂肪与躯干脂肪的相对分布。
男性血清铁蛋白水平的中位数（四分位间距）为0.168μg/mL（0.104 - 0.269），女性为0.053μg/mL（0.026 - 0.102）。在调整了社会人口统计学、生活方式和代谢因素后，血清铁蛋白在男性中与总FMI（β = 2.662）和躯干FMI（β = 0.983）呈显著正相关，与腿部FMI（β = -0.324）和LTR（β = -0.160）呈负相关。在女性中，血清铁蛋白与总FMI（β = 4.658）、躯干FMI（β = 2.085）呈显著正相关，与LTR（β = -0.312）呈负相关。以最低血清铁蛋白四分位数作为参照组，在男性和女性中均观察到血清铁蛋白与总FMI和躯干FMI呈显著正相关趋势。此外，在男性中观察到血清铁蛋白与腿部FMI和LTR呈显著负相关趋势。中介分析显示，C反应蛋白分别介导了血清铁蛋白对男性和女性躯干FMI潜在影响的16.4%和22.6%。
较高的铁蛋白水平与更多的全身及躯干脂肪但更少的腿部脂肪相关。需要进一步进行前瞻性和机制性研究来证实本研究结果。
