Key result
Serum ferritin explains ~15% of PWV variation and amplifies inflammation-driven arterial stiffness.
Why the study?
Ferritin is associated with chronic inflammatory conditions like hypertension and type 2 diabetes mellitus, but whether it associates with arterial stiffness and modifies the relationship between inflammation and arterial stiffness across different glucose tolerance states remained unknown.
Cross-Sectional (n=462)
No
Effect estimate: beta 0.37
p-value: p=<0.001
Ferritin is an independent risk factor for arterial stiffness and modifies the relationship between inflammation and arterial stiffness in newly diagnosed hypertensive patients.
Ferritin may refine vascular risk stratification in new hypertension; leaves open causal inference and intervention trials.
BACKGROUND: Ferritin, a crucial element for iron homeostasis, is associated with chronic diseases characterized by subclinical inflammation such as essential arterial hypertension and type 2 diabetes mellitus (T2DM), showing a prognostic value in different clinical settings. We investigated whether ferritin is associated with arterial stiffness (AS), an early indicator of atherosclerosis, and if it could act as effect modifier on the relationship between inflammation and AS in hypertensive patients with different glucose tolerance. METHODS: We enrolled 462 newly diagnosed untreated hypertensive (HT) patients. All subjects underwent an oral glucose tolerance test. Insulin sensitivity was assessed by MATSUDA index and ferritin levels were estimated by immunoradiometric assay. AS was defined by carotid-femoral pulse wave velocity (PWV). RESULTS: Out of 462 patients, 271 showed normal glucose tolerance (HT/NGT), 146 impaired glucose tolerance (HT/IGT) and 45 were diabetic (HT/T2DM). Iron levels significantly decreased and transferrin and ferritin significantly increased from the first to the third group. PWV values were significantly higher in HT/IGT and HT/T2DM patients. PWV was related directly with ferritin, high sensitivity C reactive protein (hs-CRP), transferrin, and inversely with MATSUDA index. Ferritin resulted the strongest determinant of PWV explaining a 14.9% of its variation; moreover it was a strong modifier of the relationship between hs-CRP and PWV. The estimated augmentation in PWV portended by a fixed increase in hs-CRP, was higher across increasing values of ferritin. CONCLUSION: Ferritin represents an independent risk factor of arterial stiffness in our study population and a strong effect modifier on the relationship between inflammation and PWV. However, further studies are needed to fully elucidate the potential role of this biomarker in human atherosclerosis.
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Sciacqua et al. (2020) conducted a cross-sectional in Essential arterial hypertension (n=462). Serum ferritin was evaluated on Carotid-femoral pulse wave velocity (PWV) (beta 0.37, p=<0.001). Serum ferritin was the strongest determinant of pulse wave velocity, explaining 14.9% of its variation, and significantly amplified the effect of inflammation on arterial stiffness.
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