Clinical InvestigationCoronary Artery DiseaseComparison of the serum ferritin and percentage of transferrin saturation as exposure markers of iron-driven oxidative stress–related disease outcomes
Section snippets
Methods
A detailed description of the NHANES III can be found elsewhere.17 Briefly, the NHANES III, conducted from 1988 to 1994, was a national probability sample designed to provide estimates of the health and nutritional status of the United States civilian and noninstitutionalized population aged 2 months or older. Of the 18 825 NHANES III participants aged 20 years or older, 7580 were excluded for one or more of the following reasons: 4038 had missing ferritin, %TS, or antioxidant values; 4769 had
Results
Table I shows the characteristics of the study participants by quintiles of serum ferritin or %TS. Subjects with high serum ferritin tended to be older, black, male, a current smoker, and obese. In addition, they consumed more alcohol and less dietary carotene. Subjects with high %TS showed tendencies similar to those with high ferritin concentration for sex, smoking, and alcohol consumption. However, subjects with high %TS tended to be younger, be white, be thinner, and consume more dietary
Discussion
Despite compelling evidence for the biologic plausibility of the iron hypothesis, epidemiologic studies on the association between iron and oxidative stress–related diseases have shown inconsistent results, especially for coronary heart disease.6, 7, 8, 9 A critical methodological question in evaluating this discrepancy is whether markers of body iron stores used in epidemiologic studies are appropriate as exposure markers for evaluating iron-driven oxidative stress–related pathology. A valid
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