Serum ferritin and risk of the metabolic syndrome in U.S. adults

Diabetes Care. 2004 Oct;27(10):2422-8. doi: 10.2337/diacare.27.10.2422.


Objective: We examined the relationship among iron stores, the metabolic syndrome, and insulin resistance.

Research design and methods: We conducted a cross-sectional study of 6,044 adults >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-to-HDL cholesterol ratio.

Results: After excluding individuals with likely hemochromatosis, mean serum ferritin values in premenopausal women, postmenopausal women, and men were 33.6, 93.4, and 139.9 microg/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 < 0.001), and men (27.3 vs. 13.8%, P < 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.

Conclusions: Elevated iron stores were positively associated with the prevalence of the metabolic syndrome and with insulin resistance.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Biomarkers / blood
  • Body Mass Index
  • Cross-Sectional Studies
  • Female
  • Ferritins / blood*
  • Ferritins / metabolism
  • Humans
  • Incidence
  • Insulin Resistance
  • Male
  • Metabolic Syndrome / diagnosis*
  • Metabolic Syndrome / epidemiology*
  • Middle Aged
  • Predictive Value of Tests
  • Probability
  • Prognosis
  • Risk Assessment
  • Severity of Illness Index
  • Sex Distribution
  • United States / epidemiology


  • Biomarkers
  • Ferritins