The relationship of serum ferritin with malondialdehyde concentration in patients with coronary artery disease: Ferritin and oxidative stress in CAD

Abstract

It has been suggested that the risk of coronary heart disease increased with increasing body iron stores. Free iron catalyzes the generation of free radicals and free radicals promote the oxidation of lipids. The aim of this study was to determine the association of serum ferritin levels with coronary artery disease (CAD) and to establish the relation of ferritin to the lipid peroxidation product malondialdehyde (MDA). The study included 188 patients. Thirty-eight patients (mean age: 55 ± 9 years) had angiographically normal coronary arteries and 150 patients (mean age: 54 ± 10 years) had significant stenosis at least in one coronary artery. Serum ferritin, total iron binding capacity (TIBC), MDA levels, lipoprotein variables and CAD risk factors were determined in all patients. Serum ferritin levels were significantly higher in patients with CAD compared with control groups (105 ± 65 ng/ml versus 83 ± 71 ng/ml) (p<0.01). TIBC was lower in patients with CAD (333 ± 62 μg/dl) versus 348 ± 48 μg/dl), (p<0.05). In patients with CAD, serum MDA levels were significantly higher when compared with control groups (8.1 ± 2 nmol/ml versus 5.9 ± 1.8 nmol/ml), (p<0.001). There were positive correlation between ferritin and MDA levels (r=0.20, p = 0.02) and negative correlation between TIBC and MDA levels (r=0.22, p = 0.001). These findings support the concept that iron, being an important transition metal, might contribute to atherogenesis, along with the classic risk factors. The results are also in agreement with the concept that iron overload would elevate the risk of CAD by promoting the lipid peroxidation.