Dysregulated Iron Metabolism-Associated Dietary Pattern Predicts an Altered Body Composition and Metabolic Syndrome

Abstract

Diet plays an important role in the development of obesity and may contribute to dysregulated iron metabolism (DIM). A cross-sectional survey of 208 adults was conducted in Taipei Medical University Hospital (Taipei, Taiwan). A reduced-rank regression from 31 food groups was used for a dietary pattern analysis. DIM was defined as at least four of the following criteria: serum hepcidin (men >200 ng/mL and women >140 ng/mL), hyperferritinemia (serum ferritin of >300 ng/mL in men and >200 ng/mL in women), central obesity, non-alcoholic fatty liver disease, and two or more abnormal metabolic profiles. Compared to non-DIM patients, DIM patients were associated with an altered body composition and had a 4.52-fold (95% confidence interval (CI): (1.95-10.49); p < 0.001) greater risk of metabolic syndrome (MetS) after adjusting for covariates. A DIM-associated dietary pattern (high intake of deep-fried food, processed meats, chicken, pork, eating out, coffee, and animal fat/skin but low intake of steamed/boiled/raw foods and dairy products) independently predicted central obesity (odds ratio (OR): 1.57; 95% CI: 1.05-2.34; p < 0.05) and MetS (OR: 1.89; 95% CI: 1.07-3.35; p < 0.05). Individuals with the highest DIM pattern scores (tertile 3) had a higher visceral fat mass (%) (β = 0.232; 95% CI: 0.011-0.453; p < 0.05) but lower skeletal muscle mass (%) (β = -1.208; 95% CI: -2.177--0.239; p < 0.05) compared to those with the lowest DIM pattern scores (tertile 1). In conclusion, a high score for the identified DIM-associated dietary pattern was associated with an unhealthier body composition and a higher risk of MetS.

Keywords: central obesity; dietary pattern; dysregulated iron metabolism; ferritin; hepcidin; metabolic syndrome; skeletal muscle mass; visceral fat.

Figure 1

Direct acyclic graph of the reduced-rank regression (RRR) conceptual framework. ALT, alanine aminotransferase; HDL-C, high-density lipoprotein cholesterol.

Figure 2

Adjusted multivariate linear and logistic regression and 95% confidence intervals of dysregulated iron metabolism (DIM) in terms of visceral fat mass (%) and skeletal muscle mass (%) (A) and metabolic syndrome (B). (A) the Beta coefficient (β-value) was adjusted by age and sex, and (B) odds ratio (OR) was adjusted by age, sex, and body-mass index (BMI) (N = 208). *** p ≤ 0.001.

Figure 3

Multivariate logistic analysis adjusted for age, gender, and body-mass index and linear regression and 95% confidence intervals (CIs) of dysregulated iron metabolism (DIM)-associated dietary pattern scores for predicting DIM (A), metabolic syndrome (MetS) (A), central obesity (A), visceral fat mass (%) (B), and skeletal muscle mass (%) (C). * p < 0.05; ** p < 0.01; *** p ≤ 0.001.