J Trace Elem Med Biol. 2026 Apr 14;95:127875. doi: 10.1016/j.jtemb.2026.127875. Online ahead of print.
ABSTRACT
BACKGROUND: Iron metabolism has been associated with cardiovascular diseases, but its relationship with cardiovascular health (CVH) in childhood remains unclear. This study aimed to investigate the associations of iron parameters with CVH using the latest Life's Essential 8 (LE8) framework among Chinese children and adolescents.
METHODS: A cross-sectional survey involving 1514 children and adolescents aged 7-18 years was conducted in South China. Iron parameters including serum ferritin (SF) (reflecting iron stores), transferrin saturation (TSAT) (reflecting circulating iron availability), and serum hepcidin (iron regulatory hormone) were measured. CVH was assessed by the American Heart Association's LE8 metrics that comprise three composite scores (CVH, health behavior, and health factor scores), with higher scores indicating better health status. The associations of iron parameters with CVH metrics were examined by regression and restricted cubic spline models.
RESULTS: SF was negatively associated with CVH and health factor scores (P=0.034 and 0.003, respectively), whereas TSAT was positively associated with these two scores (P=0.010 and 0.008, respectively). Serum hepcidin exhibited reverse J-shaped associations with CVH and health behavior scores (both P<0.001). The ratio of hepcidin relative to SF showed a positive association with health factor score (P=0.009), while the ratio of hepcidin relative to TSAT displayed a negative association with CVH score (P=0.024).
CONCLUSIONS: Reduced iron stores and elevated circulating iron availability, as well as moderate serum hepcidin levels, were associated with better CVH status in Chinese children and adolescents. Moreover, hepcidin expression relative to increased iron stores rather than circulating iron availability may be more favorable to CVH.
PMID:42000705 | DOI:10.1016/j.jtemb.2026.127875