{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T18:06:49Z","timestamp":1784657209588,"version":"3.55.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T00:00:00Z","timestamp":1657497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Iron deficiency or overload may contribute to complications associated with diseases, but the link between iron status and skeletal muscle disorder is poorly understood. This study aimed to investigate the relationship between serum iron status, reflected by serum ferritin concentration, and muscle mass in U.S. adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We utilized data from National Health and Nutrition Examination Survey (NHANES) 2015-2018 for analysis. Data on serum ferritin, appendicular skeletal muscle mass (ASM), body mass index (BMI) and confounding factors were extracted and analyzed. Multivariate linear regression analyses and smooth curve fittings were employed to investigate the association between serum ferritin and muscle mass. Subgroup analysis based on iron status, age, gender and race were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2,078 participants were included, and divided into iron deficiency (<jats:italic>n<\/jats:italic> = 225), normal iron status (<jats:italic>n<\/jats:italic> = 1,366), and iron overload (<jats:italic>n<\/jats:italic> = 487) groups. Participants with iron overload had significantly lower ASM and appendicular skeletal muscle index (ASMI) (ASM: 19.329 \u00b1 4.879, ASMI: 0.709 \u00b1 0.138) compared to those with iron deficiency (ASM: 22.660 \u00b1 6.789, ASMI: 0.803 \u00b1 0.206) and normal iron status (ASM: 22.235 \u00b1 6.167, ASMI: 0.807 \u00b1 0.201). The serum ferritin was negatively linked with muscle mass after adjusting for potential confounders (\u03b2 = \u22120.0001, 95% CI: \u22120.0001, \u22120.0000). When stratified by iron status, the trend test between them remained significant (P for trend: 0.008). Furthermore, subgroup analysis identified a stronger association in men (\u03b2 = \u22120.0001, 95% CI: \u22120.0002, \u22120.0001), age \u2265 40 years (\u03b2 = \u22120.0001, 95% CI: \u22120.0002, \u22120.0000), non-Hispanic black (\u03b2 = \u22120.0002, 95% CI: \u22120.0003, \u22120.0001) and other races (\u03b2 = \u22120.0002, 95% CI: \u22120.0003, \u22120.0000).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study revealed an inverse relationship between serum iron status and muscle mass in adults. This finding improves our understanding of the impact of serum iron status on muscle mass, and sheds new light on the prevention and treatment of muscle loss.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2022.941093","type":"journal-article","created":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T07:19:48Z","timestamp":1657523988000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":36,"title":["Association Between Serum Iron Status and Muscle Mass in Adults: Results From NHANES 2015\u20132018"],"prefix":"10.3389","volume":"9","author":[{"given":"Zhi","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenyang","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenge","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"6135319","DOI":"10.1155\/2016\/6135319","article-title":"Grape powder improves age-related decline in mitochondrial and kidney functions in fischer 344 rats","volume":"2016","author":"Pokkunuri","year":"2016","journal-title":"Oxid Med Cell Longev."},{"key":"B2","doi-asserted-by":"publisher","first-page":"2636","DOI":"10.1016\/S0140-6736(19)31138-9","article-title":"Sarcopenia","volume":"393","author":"Cruz-Jentoft","year":"2019","journal-title":"Lancet."},{"key":"B3","doi-asserted-by":"publisher","first-page":"308","DOI":"10.3390\/nu10030308","article-title":"Diet quality and sarcopenia in older adults: a systematic review","volume":"10","author":"Bloom","year":"2018","journal-title":"Nutrient"},{"key":"B4","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1093\/ageing\/afz046","article-title":"Sarcopenia: revised European consensus on definition and diagnosis","volume":"48","author":"Cruz-Jentoft","year":"2019","journal-title":"Age Ageing."},{"key":"B5","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.jamda.2017.05.026","article-title":"Minerals and sarcopenia; the role of calcium, iron, magnesium, phosphorus, potassium, selenium, sodium, and zinc on muscle mass, muscle strength, and physical performance in older adults: a systematic review","volume":"19","author":"van Dronkelaar","year":"2018","journal-title":"J Am Med Dir Assoc"},{"key":"B6","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1016\/j.jamda.2014.06.014","article-title":"Low serum selenium level is associated with low muscle mass in the community-dwelling elderly","volume":"15","author":"Chen","year":"2014","journal-title":"J Am Med Dir Assoc."},{"key":"B7","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/j.clnu.2018.01.014","article-title":"Cross-sectional associations of dietary and circulating magnesium with skeletal muscle mass in the EPIC-Norfolk cohort","volume":"38","author":"Hayhoe","year":"2019","journal-title":"Clin Nutr."},{"key":"B8","doi-asserted-by":"publisher","first-page":"2696480","DOI":"10.1155\/2016\/2696480","article-title":"Effect of yi gong san decoction on iron homeostasis in a mouse model of acute inflammation","volume":"2016","author":"Zheng","year":"2016","journal-title":"Evid Based Complement Alternat Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"847","DOI":"10.3238\/arztebl.m2021.0290","article-title":"The evaluation of iron deficiency and iron overload","volume":"118","author":"Gattermann","year":"2021","journal-title":"Dtsch Arztebl Int."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1002\/jcsm.12927","article-title":"Iron deficiency is related to low functional outcome in patients at early rehabilitation after acute stroke","volume":"13","author":"Doehner","year":"2022","journal-title":"J Cachexia Sarcopenia Muscle."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e0178994","DOI":"10.1371\/journal.pone.0178994","article-title":"The association of ferritin with cardiovascular and all-cause mortality in community-dwellers: the English longitudinal study of ageing","volume":"12","author":"Kadoglou","year":"2017","journal-title":"PLoS ONE."},{"key":"B12","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.mito.2015.02.001","article-title":"Mitochondrial iron homeostasis and its dysfunctions in neurodegenerative disorders","volume":"21","author":"Mena","year":"2015","journal-title":"Mitochondrion."},{"key":"B13","doi-asserted-by":"publisher","first-page":"2403","DOI":"10.1007\/s00198-012-1982-1","article-title":"Iron homeostasis in osteoporosis and its clinical implications","volume":"23","author":"Li","year":"2012","journal-title":"Osteoporos Int."},{"key":"B14","doi-asserted-by":"publisher","first-page":"151","DOI":"10.7150\/ijbs.53126","article-title":"Ferroptosis in a sarcopenia model of senescence accelerated mouse prone 8 (SAMP8)","volume":"17","author":"Huang","year":"2021","journal-title":"Int J Biol Sci."},{"key":"B15","doi-asserted-by":"publisher","first-page":"720","DOI":"10.1113\/expphysiol.2008.046045","article-title":"Iron injections in mice increase skeletal muscle iron content, induce oxidative stress and reduce exercise performance","volume":"94","author":"Reardon","year":"2009","journal-title":"Exp Physiol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1186\/s12916-020-01771-y","article-title":"Relationship between serum B12 concentrations and mortality: experience in NHANES","volume":"18","author":"Wolffenbuttel","year":"2020","journal-title":"BMC Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1093\/gerona\/glu010","article-title":"The FNIH sarcopenia project: rationale, study description, conference recommendations, and final estimates","volume":"69","author":"Studenski","year":"2014","journal-title":"J Gerontol A Biol Sci Med Sci."},{"key":"B18","volume-title":"WHO Guideline on Use of Ferritin Concentrations to Assess Iron Status in Individuals and Populations","year":"2020"},{"key":"B19","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.jamda.2013.11.025","article-title":"Sarcopenia in Asia: consensus report of the Asian working group for sarcopenia","volume":"15","author":"Chen","year":"2014","journal-title":"J Am Med Dir Assoc."},{"key":"B20","doi-asserted-by":"publisher","first-page":"5671","DOI":"10.1111\/jcmm.16581","article-title":"The detrimental effect of iron on OA chondrocytes: Importance of pro-inflammatory cytokines induced iron influx and oxidative stress","volume":"25","author":"Jing","year":"2021","journal-title":"J Cell Mol Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"177","DOI":"10.3390\/cancers11020177","article-title":"A novel combination cancer therapy with iron chelator targeting cancer stem cells via suppressing stemness","volume":"11","author":"Katsura","year":"2019","journal-title":"Cancers."},{"key":"B22","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1007\/s12011-018-1332-z","article-title":"Is iron accumulation a possible risk factor for sarcopenia?","volume":"186","author":"Zhao","year":"2018","journal-title":"Biol Trace Elem Res."},{"key":"B23","doi-asserted-by":"publisher","first-page":"165","DOI":"10.3389\/fnins.2019.00165","article-title":"Iron metabolism of the skeletal muscle and neurodegeneration","volume":"13","author":"Halon-Golabek","year":"2019","journal-title":"Front Neurosci."},{"key":"B24","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1002\/mus.20808","article-title":"Iron load and redox stress in skeletal muscle of aged rats","volume":"36","author":"Altun","year":"2007","journal-title":"Muscle Nerve."},{"key":"B25","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1113\/expphysiol.2007.039453","article-title":"Plantaris muscle of aged rats demonstrates iron accumulation and altered expression of iron regulation proteins","volume":"93","author":"Jung","year":"2008","journal-title":"Exp Physiol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"e2865","DOI":"10.1371\/journal.pone.0002865","article-title":"Iron accumulation with age, oxidative stress and functional decline","volume":"3","author":"Xu","year":"2008","journal-title":"PLoS ONE."},{"key":"B27","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1001\/jama.299.3.308","article-title":"Serum micronutrient concentrations and decline in physical function among older persons","volume":"299","author":"Bartali","year":"2008","journal-title":"JAMA."},{"key":"B28","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1007\/s12603-014-0004-8","article-title":"Sexually dimorphic patterns of nutritional intake and eating behaviors in community-dwelling older adults with normal and slow gait speed","volume":"18","author":"Waters","year":"2014","journal-title":"J Nutr Health Aging."},{"key":"B29","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1053\/j.jrn.2016.01.011","article-title":"Association of increased serum ferritin with impaired muscle strength\/quality in hemodialysis patients","volume":"26","author":"Nakagawa","year":"2016","journal-title":"J Renal Nutr."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1249","DOI":"10.1007\/s40520-016-0701-8","article-title":"Sarcopenia and sarcopenic obesity in comparison: prevalence, metabolic profile, and key differences. a cross-sectional study in Italian hospitalized elderly","volume":"29","author":"Perna","year":"2017","journal-title":"Aging Clin Exp Res."},{"key":"B31","doi-asserted-by":"publisher","first-page":"524948","DOI":"10.1155\/2015\/524948","article-title":"Novel insights on nutrient management of sarcopenia in elderly","volume":"2015","author":"Rondanelli","year":"2015","journal-title":"Biomed Res Int."},{"key":"B32","doi-asserted-by":"publisher","first-page":"526.e529","DOI":"10.1016\/j.amjmed.2005.10.049","article-title":"Inflammatory markers and loss of muscle mass (sarcopenia) and strength","volume":"119","author":"Schaap","year":"2006","journal-title":"Am J Med"},{"key":"B33","doi-asserted-by":"publisher","first-page":"3519","DOI":"10.3390\/nu13103519","article-title":"Metabolic syndrome and sarcopenia","volume":"13","author":"Nishikawa","year":"2021","journal-title":"Nutrients."}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2022.941093\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,11]],"date-time":"2022-07-11T07:19:52Z","timestamp":1657523992000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2022.941093\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,11]]},"references-count":33,"alternative-id":["10.3389\/fnut.2022.941093"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2022.941093","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,11]]},"article-number":"941093"}}