{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:51:16Z","timestamp":1793832676134,"version":"4.6.1"},"reference-count":27,"publisher":"American Diabetes Association","issue":"10","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2004,10,1]]},"abstract":"<jats:p>OBJECTIVE\u2014We examined the relationship among iron stores, the metabolic syndrome, and insulin resistance.<\/jats:p>\n               <jats:p>RESEARCH DESIGN AND METHODS\u2014We conducted a cross-sectional study of 6,044 adults &amp;gt;20 years of age who participated in the Third National Health and Nutrition Examination Survey. Metabolic syndrome was defined as the presence of at least three of the following: elevated blood pressure, low HDL cholesterol, elevated serum triglycerides, elevated plasma glucose, and abdominal obesity. Insulin resistance was estimated using homeostasis model assessment (for insulin resistance), fasting insulin, and triglyceride\u2013to\u2013HDL cholesterol ratio.<\/jats:p>\n               <jats:p>RESULTS\u2014After excluding individuals with likely hemochromatosis, mean serum ferritin values in premenopausal women, postmenopausal women, and men were 33.6, 93.4, and 139.9 \u03bcg\/l, respectively. Metabolic syndrome was more common in those with the highest compared with the lowest levels of serum ferritin in premenopausal women (14.9 vs. 6.4%, P = 0.002), postmenopausal women (47.5 vs. 28.2%, P &amp;lt; 0.001), and men (27.3 vs. 13.8%, P &amp;lt; 0.001). Insulin resistance also increased across quartiles of serum ferritin for men and postmenopausal women and persisted after adjustment for age, race\/ethnicity, C-reactive protein, smoking, alcohol intake, and BMI.<\/jats:p>\n               <jats:p>CONCLUSIONS\u2014Elevated iron stores were positively associated with the prevalence of the metabolic syndrome and with insulin resistance.<\/jats:p>","DOI":"10.2337\/diacare.27.10.2422","type":"journal-article","created":{"date-parts":[[2007,3,5]],"date-time":"2007-03-05T22:51:27Z","timestamp":1173135087000},"page":"2422-2428","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":357,"title":["Serum Ferritin and Risk of the Metabolic Syndrome in U.S. Adults"],"prefix":"10.2337","volume":"27","author":[{"given":"Megan","family":"Jehn","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne M.","family":"Clark","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"},{"name":"Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliseo","family":"Guallar","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","reference":[{"key":"2022031216023401000_R1","doi-asserted-by":"crossref","unstructured":"Salonen JT, Tuomainen TP, Nyyssonen K, Lakka HM, Punnonen K: Relation between iron stores and non-insulin dependent diabetes in men: case-control study. BMJ\u2008317: 727, 1998","DOI":"10.1136\/bmj.317.7160.727"},{"key":"2022031216023401000_R2","doi-asserted-by":"crossref","unstructured":"Jiang R, Manson JE, Meigs JB, Ma J, Rifai N, Hu FB: Body iron stores in relation to risk of type 2 diabetes in apparently healthy women. JAMA\u2008291:711\u2013717, 2004","DOI":"10.1001\/jama.291.6.711"},{"key":"2022031216023401000_R3","doi-asserted-by":"crossref","unstructured":"Piperno A, Trombini P, Gelosa M, Mauri V, Pecci V, Vergani A, Salvioni A, Mariani R, Mancia G: Increased serum ferritin is common in men with essential hypertension. J Hypertens\u200820:1513\u20131518, 2002","DOI":"10.1097\/00004872-200208000-00013"},{"key":"2022031216023401000_R4","doi-asserted-by":"crossref","unstructured":"Halle M, Konig D, Berg A, Keul J, Baumstark MW: Relationship of serum ferritin concentrations with metabolic cardiovascular risk factors in men without evidence for coronary artery disease. Atherosclerosis\u2008128:235\u2013240, 1997","DOI":"10.1016\/S0021-9150(96)05994-1"},{"key":"2022031216023401000_R5","doi-asserted-by":"crossref","unstructured":"Williams MJ, Poulton R, Williams S: Relationship of serum ferritin with cardiovascular risk factors and inflammation in young men and women. Atherosclerosis\u2008165:179\u2013184, 2002","DOI":"10.1016\/S0021-9150(02)00233-2"},{"key":"2022031216023401000_R6","doi-asserted-by":"crossref","unstructured":"Tuomainen TP, Nyyssonen K, Salonen R, Tervahauta A, Korpela H, Lakka T, Kaplan GA, Salonen JT: Body iron stores are associated with serum insulin and blood glucose concentrations: population study in 1,013 eastern Finnish men. Diabetes Care\u200820:426\u2013428, 1997","DOI":"10.2337\/diacare.20.3.426"},{"key":"2022031216023401000_R7","doi-asserted-by":"crossref","unstructured":"Gillum RF: Association of serum ferritin and indices of body fat distribution and obesity in Mexican American men: the Third National Health and Nutrition Examination Survey. Int J Obes Relat Metab Disord\u200825:639\u2013645, 2001","DOI":"10.1038\/sj.ijo.0801561"},{"key":"2022031216023401000_R8","doi-asserted-by":"crossref","unstructured":"Fernandez-Real JM, Ricart-Engel W, Arroyo E, Balanca R, Casamitjana-Abella R, Cabrero D, Fernandez-Castaner M, Soler J: Serum ferritin as a component of the insulin resistance syndrome. Diabetes Care\u200821:62\u201368, 1998","DOI":"10.2337\/diacare.21.1.62"},{"key":"2022031216023401000_R9","doi-asserted-by":"crossref","unstructured":"Ferrannini E: Insulin resistance, iron, and the liver. Lancet\u2008355:2181\u20132182, 2000","DOI":"10.1016\/S0140-6736(00)02397-7"},{"key":"2022031216023401000_R10","doi-asserted-by":"crossref","unstructured":"Niederau C, Berger M, Stremmel W, Starke A, Strohmeyer G, Ebert R, Siegel E, Creutzfeldt W: Hyperinsulinaemia in non-cirrhotic haemochromatosis: impaired hepatic insulin degradation? Diabetologia\u200826:441\u2013444, 1984","DOI":"10.1007\/BF00262217"},{"key":"2022031216023401000_R11","doi-asserted-by":"crossref","unstructured":"Ford ES, Cogswell ME: Diabetes and serum ferritin concentration among U.S. adults. Diabetes Care\u200822:1978\u20131983, 1999","DOI":"10.2337\/diacare.22.12.1978"},{"key":"2022031216023401000_R12","doi-asserted-by":"crossref","unstructured":"Wolff SP: Diabetes mellitus and free radicals: free radicals, transition metals and oxidative stress in the aetiology of diabetes mellitus and complications. Br Med Bull\u200849:642\u2013652, 1993","DOI":"10.1093\/oxfordjournals.bmb.a072637"},{"key":"2022031216023401000_R13","unstructured":"National Center for Health Statistics: Plan and Operation of the Third National Health and Nutrition Examination Survey. Vol. 11. Washington, DC, Vital Health Statistics, 1994, p. 1\u2013407"},{"key":"2022031216023401000_R14","doi-asserted-by":"crossref","unstructured":"Fairbanks VF: Laboratory testing for iron status. Hosp Pract (Off Ed)\u200826 (Suppl. 3):17\u201324, 1991","DOI":"10.1080\/21548331.1991.11704280"},{"key":"2022031216023401000_R15","unstructured":"National Center for Health Statistics: The Third National Health and Nutrition Examination Survey (NHANES III 1998\u20131994). References Manuals and Reports (CD-ROM). Hyattsville, MD, National Center for Health Statistics, 1996"},{"key":"2022031216023401000_R16","doi-asserted-by":"crossref","unstructured":"National Institutes of Health: Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Bethesda, MD, National Institutes of Health, 2001, (NIH publ. no. 01-3670)","DOI":"10.1001\/jama.285.19.2486"},{"key":"2022031216023401000_R17","doi-asserted-by":"crossref","unstructured":"Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC: Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia\u200828:412\u2013419, 1985","DOI":"10.1007\/BF00280883"},{"key":"2022031216023401000_R18","doi-asserted-by":"crossref","unstructured":"Gabay C, Kushner I: Acute-phase proteins and other systemic responses to inflammation. N Engl J Med\u2008340:448\u2013454, 1999","DOI":"10.1056\/NEJM199902113400607"},{"key":"2022031216023401000_R19","doi-asserted-by":"crossref","unstructured":"Pinhas-Hamiel O, Newfield RS, Koren I, Agmon A, Lilos P, Phillip M: Greater prevalence of iron deficiency in overweight and obese children and adolescents. Int J Obes Relat Metab Disord\u200827:416\u2013418, 2003","DOI":"10.1038\/sj.ijo.0802224"},{"key":"2022031216023401000_R20","doi-asserted-by":"crossref","unstructured":"Witte DL, Crosby WH, Edwards CQ, Fairbanks VF, Mitros FA: Practice guideline development task force of the College of American Pathologists: hereditary hemochromatosis. Clin Chim Acta\u2008245:139\u2013200, 1996","DOI":"10.1016\/0009-8981(95)06212-2"},{"key":"2022031216023401000_R21","doi-asserted-by":"crossref","unstructured":"Haap M, Fritsche A, Mensing H, Haring H, Stumvoll M: Association of high serum ferritin concentration with glucose intolerance and insulin resistance in healthy people. Ann Intern Med\u2008139:869\u2013870, 2003","DOI":"10.7326\/0003-4819-139-10-200311180-00029"},{"key":"2022031216023401000_R22","doi-asserted-by":"crossref","unstructured":"Fernandez-Real JM, Penarroja G, Castro A, Garcia-Bragado F, Hernandez-Aguado I, Ricart W: Blood letting in high-ferritin type 2 diabetes: effects on insulin sensitivity and \u03b2-cell function. Diabetes\u200851:1000\u20131004, 2002","DOI":"10.2337\/diabetes.51.4.1000"},{"key":"2022031216023401000_R23","doi-asserted-by":"crossref","unstructured":"Lao TT, Chan PL, Tam KF: Gestational diabetes mellitus in the last trimester: a feature of maternal iron excess? Diabet Med\u200818:218\u2013223, 2001","DOI":"10.1046\/j.1464-5491.2001.00453.x"},{"key":"2022031216023401000_R24","doi-asserted-by":"crossref","unstructured":"Cario H, Holl RW, Debatin KM, Kohne E: Disproportionately elevated fasting proinsulin levels in normoglycemic patients with thalassemia major are correlated to the degree of iron overload. Horm Res\u200859:73\u201378, 2003","DOI":"10.1159\/000068572"},{"key":"2022031216023401000_R25","doi-asserted-by":"crossref","unstructured":"Wilson JG, Lindquist JH, Grambow SC, Crook ED, Maher JF: Potential role of increased iron stores in diabetes. Am J Med Sci\u2008325:332\u2013339, 2003","DOI":"10.1097\/00000441-200306000-00004"},{"key":"2022031216023401000_R26","doi-asserted-by":"crossref","unstructured":"Zacharski L, Ornstein D, Woloshin S, Schwartz L: Association of age, sex, and race with body iron stores in adults: analysis of NHANES III data. Am Heart J\u2008140:98\u2013104, 2000","DOI":"10.1067\/mhj.2000.106646"},{"key":"2022031216023401000_R27","doi-asserted-by":"crossref","unstructured":"McCarty MF: Hyperinsulinemia may boost both hematocrit and iron absorption by up-regulating activity of hypoxia-inducible factor-1\u03b1. Med Hypotheses\u200861:567\u2013573, 2003","DOI":"10.1016\/S0306-9877(03)00231-7"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/27\/10\/2422\/561805\/zdc01004002422.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/27\/10\/2422\/561805\/zdc01004002422.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,12]],"date-time":"2022-03-12T16:19:16Z","timestamp":1647101956000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/27\/10\/2422\/23240\/Serum-Ferritin-and-Risk-of-the-Metabolic-Syndrome"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,10,1]]},"references-count":27,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2004,10,1]]}},"URL":"https:\/\/doi.org\/10.2337\/diacare.27.10.2422","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,10,1]]}}}