Ferritin modifies the relationship between inflammation and arterial stiffness in hypertensive patients with different glucose tolerance.

Giorgio Sesti, Maria Perticone, Angela Sciacqua, Velia Cassano, Francesco Perticone, Ettore Ventura, Giovanni Tripepi, Graziella D'Arrigo, Stefanos Roumeliotis, Raffale Maio, Sofia Miceli, Francesco Andreozzi

Journal: Cardiovascular diabetology 2021;19(1):123

PMID: 32758229

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Abstract

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.

Address: Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy. [email protected].; Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy.; Institute of Clinical Physiology (IFC-CNR), Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, Reggio Calabria, Italy.; Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.; Department of Experimental and Clinical Medicine, University Magna Græcia of Catanzaro, Catanzaro, Italy.; Department of Clinical and Molecular Medicine, University of Rome-Sapienza, Rome, Italy.

DOI: 10.1186/s12933-020-01102-8

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MeSH Terms: Adult, Biomarkers, Blood Glucose, C-Reactive Protein, Carotid-Femoral Pulse Wave Velocity, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Female, Ferritins, Glucose Intolerance, Glucose Tolerance Test, Humans, Hypertension, Inflammation, Inflammation Mediators, Insulin Resistance, Male, Middle Aged, Vascular Stiffness