BODY IRON STORES AND PRESENCE OF CAROTID ATHEROSCLEROSIS - RESULTS FROM THE BRUNECK STUDY

We hypothesized that the formation of foam cells and fatty streaks req uires a postsecretory oxidative modification of lipoproteins that targ ets them for rapid uptake by macrophages. Lipid peroxidation may in pa rt depend on the concentration of tissue iron, one of the major oxidan ts in vivo. We analyzed the relation between sonographically assessed carotid atherosclerosis and body iron stores in a population sample of 847 men and women aged 40 to 79 years. In a logistic regression analy sis adjusting for age, sex, and all major vascular risk markers, ferri tin emerged as one of the strongest indicators of carotid artery disea se in both sexes (40 to 59 years; odds ratio, 1.54 per 100 mu g/L; P < .001). The predictive significance of ferritin was found to be synerg istic with that of hypercholesterolemia. Variations in body iron store s between sexes may partly explain evident sex differences in the expr ession of carotid atherosclerosis. In the elderly (greater than or equ al to 60 years) the predictive significance of ferritin was found to d ecrease parallel to that of apolipoprotein B. The current study sugges ts a possible role of body iron in early atherogenesis.