title: Association of body iron status with the risk of premature acute myocardial infarction in a Pakistani population.
abstract: BACKGROUND
  Coronary artery disease is very common in Pakistani population. Some of the studies carried out on Western populations have shown a relationship between body iron status as determined by the ratio of concentrations of serum soluble transferrin receptor (sTfR) to ferritin and the risk of acute myocardial infarction (AMI). In order to investigate whether increased body iron status has any relationship with the risk of premature AMI in Pakistani population, a case-control study was carried out.
  
  
  RESULTS
  In this case-control study, 203 consecutive AMI patients [146 males and 57 females; age range 18-45 years] admitted to the National Institute for Cardiovascular Diseases, Karachi, were enrolled with informed consent. In addition, 205 healthy controls whose gender and age (within 3 years) matched the patients, and who had a similar socio-economic background were recruited. Fasting venous blood was obtained and assessed for plasma/serum folate, vitamin B12, homocysteine, total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol, sTfR and ferritin and blood lead. It was found that serum concentration of ferritin and blood lead levels were significantly higher in AMI patients compared to their age and gender-matched healthy controls (p value <0.05), while the concentrations of vitamin B12 and HDL-cholesterol were significantly lower in AMI patients compared to controls (p value <0.01). The ratio of sTfR to ferritin was significantly lower in AMI patients compared to controls [mean ± SD/median (IQR) values 84.7 ± 295/28.9 (38.4) vs 255 ± 836/49.4 (83.8), respectively; p value <0.001]. Compared with the highest quartile of sTfR/ferritin (low body iron status), the OR for the risk of AMI was 3.29(95% CI, 1.54-7.03) for the lowest quartile (quartile 1) when the model was adjusted for vitamin B12 and HDL-cholesterol (p value for trend <0.01).
  
  
  CONCLUSIONS
  This study shows a positive association between total body iron status and risk of premature AMI in a Pakistani population.
authors.affiliation: Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan. perwaiz.iqbal@aku.edu
authors.forename: Mohammad Perwaiz
authors.initials: MP
authors.lastname: Iqbal
authors.forename: Naseema
authors.initials: N
authors.lastname: Mehboobali
authors.forename: Asal Khan
authors.initials: AK
authors.lastname: Tareen
authors.forename: Mohsin
authors.initials: M
authors.lastname: Yakub
authors.forename: Saleem Perwaiz
authors.initials: SP
authors.lastname: Iqbal
authors.forename: Khalida
authors.initials: K
authors.lastname: Iqbal
authors.forename: Ghulam
authors.initials: G
authors.lastname: Haider
mesh_terms: D000328:Adult; D044466:Asian People; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D005260:Female; D005293:Ferritins / Q000097:blood; D005492:Folic Acid / Q000097:blood; D006801:Humans; D007501:Iron / Q000097:blood* / Q000378:metabolism*; D008297:Male; D009203:Myocardial Infarction / Q000097:blood* / Q000378:metabolism*; D010154:Pakistan; D011990:Receptors, Transferrin / Q000097:blood; D012306:Risk; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D011990:Receptors, Transferrin; D014280:Triglycerides; D005293:Ferritins; D005492:Folic Acid; D002784:Cholesterol; D007501:Iron; D014805:Vitamin B 12