Ferritin and transferrin as markers of the metabolic syndrome
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Both ferritin and transferrin are prospectively associated with hyperinsulinaemia and abnormal glucose homeostasis. Transferrin is also a determinant of serum lipolytic activity in humans. To study the relations between iron stocks (ferritin) and the iron transport protein (transferrin) with the metabolic syndrome, 469 men and 475 pre- or post-menopausal women from the French D.E.S.I.R. cohort were followed-up for 6 years. At baseline, higher concentrations of both ferritin and transferrin were associated with the metabolic syndrome as defined by the IDF and the NCEP ATP III original and revised definition criteria. At the 6-year follow-up, change in the presence of the metabolic syndrome was associated with higher baseline log(ferritin) and transferrin levels in all three groups. Although part of the correlation between transferrin and fasting insulin, waist-hip ratio, and BMI could result from hepatocyte upregulation of transferrin by insulin, higher transferrinaemia level was an independent predictor of the development of insulin resistance. Among metabolic syndrome components, hypertriglyceridaemia at 6 years was the component most strongly associated with baseline ferritin and transferrin levels. When ferritin and transferrin were both above the group-specific top tertile, the odds of incident metabolic syndrome (IDF criteria) at 6 years was more than four-fold higher as compared with subjects presenting parameters below these thresholds.
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