Nutrition Research and Practice

The Korean Nutrition Society (한국영양학회)
권호 표지
DOI QR코드

DOI QR Code

Association of serum ferritin level and depression with respect to the body mass index in Korean male adults

  • Lee, Hea Shoon (Department of Nursing, Hannam University) ;
  • Park, Eunmi (Department of Food and Nutrition, School of Life Science and Nano-Technology, Hannam University)
  • Received : 2018.09.05
  • Accepted : 2019.02.12
  • Published : 2019.06.01
Download PDF
⟨ Previous Next ⟩

Abstract

BACKGROUD/OBJECTIVES: Obesity is globally a major public health issue. Evidence suggests that elevated ferritin levels are associated with obesity, dyslipidemia, insulin resistance, and metabolic syndrome. This study was undertaken to examine the relationship between the serum ferritin level and depression in Korean male adults with respect to classification of the prevailing obesity. SUBJECTS/METHODS: This was a case-control study; subjects were classified into obese group (${\geq}25.0kg/m^2$, 28 subjects) and normal group ($18.5-22.9kg/m^2$, 27 subjects). A survey was conducted to assess the depression levels as per the guidelines suggested by the Center program for Epidemiological Studies-Depression (CES-D). Blood was collected from each group for assessing biomarkers, and isolated plasma was evaluated for fasting glucose, insulin, quantitative insulin sensitivity check index, and ferritin levels. Data were analyzed, and groups were compared with respect to Body Mass Index (BMI), depression scale and biomarkers. RESULTS: The average depression score of the obesity group was 16.86, which was higher than the normal group (12.56). Subjects scoring more than 16 points comprised 53.6% of the population in the obese group, which was more than double that in the normal group, as assessed by the CES-D program. Furthermore, the serum ferritin level of the obesity group was 207.12 ng/mL, which was higher than that of the normal group (132.66 ng/mL). Lastly, the BMI appeared to be significantly correlated with both depression (r = 0.320, P = 0.017) and elevated ferritin levels (r = 0.352, P = 0.008). CONCLUSION: This study provides evidence of existing correlation between ferritin and depression with obesity.

Keywords

References

  1. Staerk L, Sherer JA, Ko D, Benjamin EJ, Helm RH. Atrial fibrillation: epidemiology, pathophysiology, and clinical outcomes. Circ Res 2017;120:1501-17. https://doi.org/10.1161/CIRCRESAHA.117.309732
  2. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999-2004. JAMA 2006;295:1549-55. https://doi.org/10.1001/jama.295.13.1549
  3. Bjerkeset O, Romundstad P, Evans J, Gunnell D. Association of adult body mass index and height with anxiety, depression, and suicide in the general population: the HUNT study. Am J Epidemiol 2008;167:193-202. https://doi.org/10.1093/aje/kwm280
  4. Rebolledo-Solleiro D, Roldan-Roldan G, Diaz D, Velasco M, Larque C, Rico-Rosillo G, Vega-Robledo GB, Zambrano E, Hiriart M, Perez de la Mora M. Increased anxiety-like behavior is associated with the metabolic syndrome in non-stressed rats. PLoS One 2017;12:e0176554. https://doi.org/10.1371/journal.pone.0176554
  5. Carnethon MR, Biggs ML, Barzilay JI, Smith NL, Vaccarino V, Bertoni AG, Arnold A, Siscovick D. Longitudinal association between depressive symptoms and incident type 2 diabetes mellitus in older adults: the cardiovascular health study. Arch Intern Med 2007;167:802-7. https://doi.org/10.1001/archinte.167.8.802
  6. Avsar G, Ham R, Tannous WK. Modelling gender differences in the economic and social influences of obesity in Australian young people. Int J Environ Res Public Health 2017;14:E257. https://doi.org/10.3390/ijerph14030257
  7. Zhao G, Ford ES, Dhingra S, Li C, Strine TW, Mokdad AH. Depression and anxiety among US adults: associations with body mass index. Int J Obes 2009;33:257-66. https://doi.org/10.1038/ijo.2008.268
  8. Khan A, Khan WM, Ayub M, Humayun M, Haroon M. Ferritin is a marker of inflammation rather than iron deficiency in overweight and obese people. J Obes 2016;2016:1937320.
  9. Wang H, Jiang X, Wu J, Zhang L, Huang J, Zhang Y, Zou X, Liang B. Iron overload coordinately promotes ferritin expression and fat accumulation in Caenorhabditis elegans. Genetics 2016;203:241-53. https://doi.org/10.1534/genetics.116.186742
  10. Iwasaki T, Nakajima A, Yoneda M, Yamada Y, Mukasa K, Fujita K, Fujisawa N, Wada K, Terauchi Y. Serum ferritin is associated with visceral fat area and subcutaneous fat area. Diabetes Care 2005;28:2486-91. https://doi.org/10.2337/diacare.28.10.2486
  11. Wu H, Qi Q, Yu Z, Sun L, Li H, Lin X. Opposite associations of trunk and leg fat depots with plasma ferritin levels in middle-aged and older Chinese men and women. PLoS One 2010;5:e13316. https://doi.org/10.1371/journal.pone.0013316
  12. Oshaug A, Bugge KH, Bjonnes CH, Borch-Iohnsen B, Neslein IL. Associations between serum ferritin and cardiovascular risk factors in healthy young men. A cross sectional study. Eur J Clin Nutr 1995;49:430-8.
  13. Gillum RF. Association of serum ferritin and indices of body fat distribution and obesity in Mexican American men--the Third National Health and Nutrition Examination Survey. Int J Obes Relat Metab Disord 2001;25:639-45. https://doi.org/10.1038/sj.ijo.0801561
  14. Jehn M, Clark JM, Guallar E. Serum ferritin and risk of the metabolic syndrome in U.S. adults. Diabetes Care 2004;27:2422-8. https://doi.org/10.2337/diacare.27.10.2422
  15. Illouz F, Roulier V, Rod A, Gallois Y, Pelle CP, Aube C, Rohmer V, Ritz P, Ducluzeau PH. Distribution of adipose tissue: quantification and relationship with hepatic steatosis and vascular profiles of type 2 diabetic patients with metabolic syndrome. Diabetes Metab 2008;34:68-74. https://doi.org/10.1016/j.diabet.2007.10.007
  16. Sun L, Franco OH, Hu FB, Cai L, Yu Z, Li H, Ye X, Qi Q, Wang J, Pan A, Liu Y, Lin X. Ferritin concentrations, metabolic syndrome, and type 2 diabetes in middle-aged and elderly chinese. J Clin Endocrinol Metab 2008;93:4690-6. https://doi.org/10.1210/jc.2008-1159
  17. Cho YS, Kang JH, Kim SA, Shim KW, Lee HS. Association of serum ferritin and abdominal obesity and insulin resistance. Korean J Obes 2005;14:76-81.
  18. Choi KM, Lee KW, Kim HY, Seo JA, Kim SG, Kim NH, Choi DS, Baik SH. Association among serum ferritin, alanine aminotransferase levels, and metabolic syndrome in Korean postmenopausal women. Metabolism 2005;54:1510-4. https://doi.org/10.1016/j.metabol.2005.05.018
  19. Ryu SY, Kim KS, Park J, Kang MG, Han MA. Serum ferritin and risk of the metabolic syndrome in some Korean rural residents. J Prev Med Public Health 2008;41:115-20. https://doi.org/10.3961/jpmph.2008.41.2.115
  20. Cohen J. Statistical power analysis for the behavioral science. 2nd ed. Hillsdale (NJ): Lawrence Erlbaum Associates; 1988.
  21. Shin HY, Kang HT. Recent trends in the prevalence of underweight, overweight, and obesity in Korean adults: the Korean National Health and Nutrition Examination Survey from 1998 to 2014. J Epidemiol 2017;27:413-9. https://doi.org/10.1016/j.je.2016.08.014
  22. Chon KK, Rhee MK. Preliminary development of Korean version of CES-D. Korean J Clin Psychol 1992;11:65-76.
  23. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977;1:385-401. https://doi.org/10.1177/014662167700100306
  24. Boyed JH, Weissman MM, Thompson WD, Myers JK. Screening for depression in a community sample. Understanding the discrepancies between depression symptom and diagnostic scales. Arch Gen Psychiatry 1982;39:1195-200. https://doi.org/10.1001/archpsyc.1982.04290100059010
  25. Kim HK, Lim JH, Kwon ER, Park YJ, Kim NE, Noh WY, Seol KH, Jung MC, Kim YJ. Serum ferritin and risk of the metabolic syndrome in Korean adults. Korean J Obes 2010;19:48-55.
  26. Park SK, Ryoo JH, Kim MG, Shin JY. Association of serum ferritin and the development of metabolic syndrome in middle-aged Korean men: a 5-year follow-up study. Diabetes Care 2012;35:2521-6. https://doi.org/10.2337/dc12-0543
  27. Park SK, Choi WJ, Oh CM, Kim J, Shin H, Ryoo JH. Association between serum ferritin levels and the incidence of obesity in Korean men: a prospective cohort study. Endocr J 2014;61:215-24. https://doi.org/10.1507/endocrj.EJ13-0173
  28. Su Q, Gu Y, Yu B, Yu F, He H, Zhang Q, Meng G, Wu H, Du H, Liu L, Shi H, Xia Y, Guo X, Liu X, Li C, Bao X, Liu F, Fang L, Yang H, Sun S, Wang X, Zhou M, Jia Q, Zhao H, Song K, Niu K. Association between serum ferritin concentrations and depressive symptoms among Chinese adults: a population study from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIHealth) cohort study. PLoS One 2016;11:e0162682. https://doi.org/10.1371/journal.pone.0162682
  29. Greenberg AS, Obin MS. Obesity and the role of adipose tissue in inflammation and metabolism. Am J Clin Nutr 2006;83:461S-5S. https://doi.org/10.1093/ajcn/83.2.461S
  30. Zafon C, Lecube A, Simo R. Iron in obesity. An ancient micronutrient for a modern disease. Obes Rev 2010;11:322-8. https://doi.org/10.1111/j.1467-789X.2009.00638.x
  31. Huang TL, Lee CT. Low serum albumin and high ferritin levels in chronic hemodialysis patients with major depression. Psychiatry Res 2007;152:277-80. https://doi.org/10.1016/j.psychres.2005.07.038
  32. Baune BT, Neuhauser H, Ellert U, Berger K. The role of the inflammatory markers ferritin, transferrin and fibrinogen in the relationship between major depression and cardiovascular disorders - the German health interview and examination survey. Acta Psychiatr Scand 2010;121:135-42. https://doi.org/10.1111/j.1600-0447.2009.01435.x
  33. Veltman EM, Lamers F, Comijs HC, de Waal MW, Stek ML, van der Mast RC, Rhebergen D. Depressive subtypes in an elderly cohort identified using latent class analysis. J Affect Disord 2017;218:123-30. https://doi.org/10.1016/j.jad.2017.04.059