SERUM FERRITIN AND CERULOPLASMIN AS CORONARY RISK-FACTORS

Iron and copper catalyze lipid peroxidation in vitro, and recent epide miological data suggest that these metal ions might also be involved i n human coronary heart disease. We tested the hypothesis by investigat ing whether the storage proteins ferritin and ceruloplasmin were coron ary risk factors. A nested case-control study was set up in middle-age d dyslipidaemic participants of the Helsinki Heart Study: a placebo-co ntrolled coronary primary prevention trial with gemfibrozil. Of the 14 0 subjects with cardiac end-points (non-fatal myocardial infarction or cardiac death) 136 were matched with controls for geographical area a nd drug treatment (gemfibrozil-placebo). Frozen baseline serum samples were used in the analyses of ferritin and ceruloplasmin. Using logist ic regression analyses no increment in coronary risk was detected with increasing ferritin levels (P=0.8 for trend). Ceruloplasmin was highe r 349 +/- 86 vs 317 +/- 77 mg . l-1 (P<0.001) in cases than in control s and the risk in the highest tertile was two-fold (odds ratio 2.1; 95 % CI 1.1-4.2) compared to the lowest (P<0.005 for trend). The risk of high ceruloplasmin was influenced by lipoprotein cholesterol concentra tions, with an odds ratio of 2.4 (95% CI 1.3-4.4) in subjects with hig h low density lipoprotein cholesterol and of 11.3 (95% CI 2.5-52.2) in subjects with low high density lipoprotein cholesterol. It was conclu ded that ferritin was not associated with coronary heart disease in dy slipidaemic, middle-aged men, while there was a continuous and graded increment in coronary risk with elevating ceruloplasmin level.