Abstract
Background: Iron status abnormalities are prevalent among postmenopausal women and have been implicated in cardiovascular disease (CVD) risk.
Objective:To explore the association between iron status and CVD risk in postmenopausal women.
Methods: We conducted a nationally representative cross-sectional study in the United States using data from five NHANES survey cycles (1999-2006, 2017-2018). Our analysis included 3,681 participants, among whom 11.41% (420/3681) had prevalent CVD. Iron status was assessed using hemoglobin (Hb), serum ferritin (SF), and transferrin saturation (TSAT). Multivariable logistic regression examined the correlation between SF levels and CVD risk. Given the nonlinear nature of the relationship, weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) models were employed for further analysis.
Results: Multivariable logistic regression revealed a significant negative correlation between SF levels and CVD risk, with a nonlinear pattern and an inflection point at 123 ng/mL for SF. Both WQS and BKMR models indicated a negative association between iron status biomarkers and CVD risk, with Hb showing the most significant influence. Mediation analysis identified serum creatinine as a mediator in the association between iron status biomarkers and CVD risk.
Conclusions: This study reveals an association between iron status biomarkers and CVD risk in postmenopausal women, with serum creatinine partially mediating this relationship. These findings contribute to understanding the mechanisms linking iron status and cardiovascular health in postmenopausal women and suggest potential targeted intervention strategies. However, longitudinal studies are needed to validate these findings and explore early intervention strategies for preventing CVD.