Body Iron Stores and Metabolic Syndrome in Adults Free of Cardiometabolic Disease From Southwestern Colombia

Evidence linking serum ferritin (SF) with metabolic syndrome (MetS) remains inconsistent by sex. Data from Latin American populations are lacking, and adults free of cardiometabolic disease remain understudied. We examined whether SF was independently associated with MetS (harmonized definition) in adults from Cali, Colombia. In this cross-sectional study of 245 adults (123 women) without type 2 diabetes or cardiovascular disease, SF was the exposure, and outcomes included categorical MetS, a continuous MetS z-score, individual MetS components, and total and LDL cholesterol (LDL-C). Sex-stratified logistic and linear regressions were performed, unadjusted and progressively adjusted for age, lifestyle factors, C-reactive protein, and BMI. MetS prevalence was 24.6% in men and 12.2% in women; overweight/obesity prevalence was 64.1% (men 68.9%, women 59.3%). In men, each 1-SD increase in SF was associated with a higher MetS z-score across models (β [95% CI] 0.82 [0.39–1.26]; p < 0.001), whereas the association with categorical MetS was attenuated after adjustment for C-reactive protein and BMI. In women, SF was not independently associated with MetS. By components, higher SF related to higher fasting glucose and triglycerides in men, and to lower HDL-C in both sexes. SF was associated with LDL-C only in women. In men, SF increased with the number of MetS components, including one or two versus none (p = 0.043). In conclusion, in this Latin American sample free of cardiometabolic disease, SF was positively associated with MetS score in men, but not in women, among whom SF was consistently linked to LDL-C.