Research Article: The association of serum 25-hydroxyvitamin D concentrations with elevated serum ferritin levels in normal weight, overweight and obese Canadians

Date Published: March 7, 2019

Publisher: Public Library of Science

Author(s): Lalani L. Munasinghe, John P. Ekwaru, Marco F. Mastroeni, Silmara S. B. S. Mastroeni, Paul J. Veugelers, Pal Bela Szecsi.

http://doi.org/10.1371/journal.pone.0213260

Abstract

In light of the growing body of literature suggesting a beneficial effect of vitamin D on inflammatory response, we hypothesized that vitamin D affects serum ferritin (SF), a biomarker of inflammation. The objective of the present study is to examine the association of serum 25-hydroxyvitamin D [25(OH)D] with elevated SF concentrations indicative of inflammation as no earlier study has done so. Data from 5550 Canadian adults who participated in the 2012/2013 and the 2014/2015 Canadian Health Measures Surveys were analysed. We observed that 9.4% of Canadian adults have elevated SF concentrations and that 35.6% were vitamin D insufficient. Among Canadians with under/normal body weights, those with serum 25(OH)D ≥ 75 nmol/L relative to those with serum 25(OH)D < 50 nmol/L, were substantially less at risk for elevated SF concentrations (OR = 0.24; 95% CI = 0.06, 0.89; p = 0.034). We did not observe this association for overweight and obese Canadians. Canadians of older age, non-white ethnicity, males, those with income above $100,000, those who consumed alcohol, and those with high total cholesterol concentrations and elevated blood pressures were more likely to have elevated SF concentrations. Serum 25(OH)D ≥ 75 nmol/L is likely to provoke anti-inflammatory benefits, but intervention studies that achieve high 25(OH)D concentrations and with long follow up are needed to establish the role of vitamin D on SF.

Partial Text

Serum ferritin (SF) reflects the total body iron storage and is the established nutritional marker of iron status [1–4]. SF is also an acute-phase reactant that elevates in systemic response to inflammation [5–11] and has therefore been identified as a marker of inflammation [6, 12, 13]. In the presence of inflammation, elevated SF may conceal poor iron status [2, 5, 9, 14]. SF has also been identified as a predictor of diabetes [15–18], metabolic syndrome [10, 19] and cardiovascular events [20–22]. The prevention and management of elevated SF is therefore a strategy in the prevention of these conditions [10, 18, 22].

Participant characteristics (n = 5550) are shown in Table 1. The median SF concentration was 86.0 μg/L (IQR = 39.0, 169.0) and the median serum 25(OH)D concentration was 59.3 nmol/L (IQR = 43.1, 75.2). Of all Canadian adults 9.4% had elevated SF concentrations and 35.6% had insufficient vitamin D levels, i.e. serum 25(OH)D <50 nmol/L [54]. We revealed that 9.4% of Canadian adults have elevated SF levels. Under/normal weight adults, compared to overweight and obese adults, had lower SF concentrations and were less likely to experience adverse elevated SF levels. Under/normal weight adults with serum 25(OH)D concentrations ≥75 nmol/L were 0.24 times as likely to have elevated SF compared to under/normal weight adults with serum 25(OH)D concentrations ≤ 50 nmol/L. Serum 25(OH)D concentrations were not associated with elevated SF among overweight and obese individuals. Older age, non-white ethnicity, males, those who had annual income above $100,000, those who consumed alcohol, and those with high total cholesterol concentrations and elevated blood pressures were more likely to have elevated SF concentrations.   Source: http://doi.org/10.1371/journal.pone.0213260

 

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