Erythropoietin, ferritin, haptoglobin, hemoglobin and transferrin receptor in metabolic syndrome: a case control study

Abstract

Background: Increased ferritin concentrations are associated with metabolic syndrome (MetS). The association between ferritin as well as hemoglobin level and individual MetS components is unclear. Erythropoietin levels in subjects with MetS have not been determined previously. The aim of this study was to compare serum erythropoietin, ferritin, haptoglobin, hemoglobin, and transferrin receptor (sTFR) levels between subjects with and without MetS and subjects with individual MetS components.

Methods: A population based cross-sectional study of 766 Caucasian, middle-aged subjects (341 men and 425 women) from five age groups born in Pieksämäki, Finland who were invited to a health check-up in 2004 with no exclusion criteria. Laboratory analyzes of blood samples collected in 2004 were done during year 2010. MetS was defined by National Cholesterol Education Program criteria.

Results: 159 (53%) men and 170 (40%) women of study population met MetS criteria. Hemoglobin and ferritin levels as well as erythropoietin and haptoglobin levels were higher in subjects with MetS (p < 0.001, p = 0.018). sTFR level did not differ significantly between subjects with or without MetS. Hemoglobin level was significantly higher in subjects with any of the MetS components (p < 0.001, p = 0.002). Ferritin level was significantly higher in subjects with abdominal obesity or high TG or elevated glucose or low high density cholesterol component (p < 0.001, p = 0.002, p = 0.02). Erythropoietin level was significantly higher in subjects with abdominal obesity component (p = 0.015) but did not differ significantly between subjects with or without other MetS components. Haptoglobin level was significantly higher in subjects with blood pressure or elevated glucose component o MetS (p = 0.028, p = 0.025).

Conclusion: Subjects with MetS have elevated hemoglobin, ferritin, erythropoietin and haptoglobin concentrations. Higher hemoglobin levels are related to all components of MetS. Higher ferritin levels associate with TG, abdominal obesity, elevated glucose or low high density cholesterol. Haptoglobin levels associate with blood pressure or elevated glucose. However, erythropoietin levels are related only with abdominal obesity. Higher serum erythropoietin concentrations may suggest underlying adipose tissue hypoxemia in MetS.

Figure 1

Eryhtropoietin mean values and individual MetS components. All values are standardized for age, sex, hs-CRP, smoking and physical activity. Abbreviations: BP, blood pressure; EPO, erythropoietin; HDL, high density lipoprotein cholesterol; TFR, transferrin receptor; TG, triglycerides. NCEP (National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults) criteria of MetS: Waist >102 cm(male) or >88 cm(female); FP-glucose ≥ 5.6 mmol/L; Systolic blood pressure ≥ 130 mmHg or diastolic ≥ 85 mmHg or antihypertensive medication; HDL–cholesterol < 1.03 mmol/l (men) or < 1.29 mmol/l (women) or medication for dyslipidemia; triglycerides >1.7 mmol/l or medication for dyslipidemia.

Figure 2

Ferritin mean values and individual MetS components. All values are standardized for age, sex, hs-CRP, smoking and physical activity. Abbreviations: BP, blood pressure; EPO, erythropoietin; HDL, high density lipoprotein cholesterol; TFR, transferrin receptor; TG, triglycerides. NCEP (National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults) criteria of MetS: Waist >102 cm(male) or >88 cm(female); FP-glucose ≥ 5.6 mmol/L; Systolic blood pressure ≥ 130 mmHg or diastolic ≥ 85 mmHg or antihypertensive medication; HDL–cholesterol < 1.03 mmol/l (men) or < 1.29 mmol/l (women) or medication for dyslipidemia; triglycerides >1.7 mmol/l or medication for dyslipidemia.

Figure 3

Haptoglobin mean values and individual MetS components. All values are standardized for age, sex, hs-CRP, smoking and physical activity. Abbreviations: BP, blood pressure; EPO, erythropoietin; HDL, high density lipoprotein cholesterol; TFR, transferrin receptor; TG, triglycerides. NCEP (National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults) criteria of MetS: Waist >102 cm(male) or >88 cm(female); FP-glucose ≥ 5.6 mmol/L; Systolic blood pressure ≥ 130 mmHg or diastolic ≥ 85 mmHg or antihypertensive medication; HDL–cholesterol < 1.03 mmol/l (men) or < 1.29 mmol/l (women) or medication for dyslipidemia; triglycerides >1.7 mmol/l or medication for dyslipidemia.

Figure 4

Transferrin receptor mean values and individual MetS components. All values are standardized for age, sex, hs-CRP, smoking and physical activity. Abbreviations: BP, blood pressure; EPO, erythropoietin; HDL, high density lipoprotein cholesterol; TFR, transferrin receptor; TG, triglycerides. NCEP (National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults) criteria of MetS: Waist >102 cm(male) or >88 cm(female); FP-glucose ≥ 5.6 mmol/L; Systolic blood pressure ≥ 130 mmHg or diastolic ≥ 85 mmHg or antihypertensive medication; HDL–cholesterol < 1.03 mmol/l (men) or < 1.29 mmol/l (women) or medication for dyslipidemia; triglycerides >1.7 mmol/l or medication for dyslipidemia.

Figure 5

Hemoglobin mean values and individual MetS components. All values are standardized for age, sex, hs-CRP, smoking and physical activity. Abbreviations: BP, blood pressure; EPO, erythropoietin; HDL, high density lipoprotein cholesterol; TFR, transferrin receptor; TG, triglycerides. NCEP (National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults) criteria of MetS: Waist >102 cm(male) or >88 cm(female); FP-glucose ≥ 5.6 mmol/L; Systolic blood pressure ≥ 130 mmHg or diastolic ≥ 85 mmHg or antihypertensive medication; HDL–cholesterol < 1.03 mmol/l (men) or < 1.29 mmol/l (women) or medication for dyslipidemia; triglycerides >1.7 mmol/l or medication for dyslipidemia.