Public Health Nutrition


Serum ferritin contributes to racial or geographic disparities in metabolic syndrome in Taiwan

Jung-Su Changa1, Shiue-Ming Lina2, Jane C-J Chaoa1, Yi-Chun Chena1, Chi-Mei Wanga1, Ni-Hsin Choua1, Wen-Harn Pana3a4 and Chyi-Huey Baia2 c1

a1 School of Nutrition and Health Sciences, Taipei Medical University, Taipei City, Taiwan, Republic of China

a2 Department of Public Health, College of Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei City, Taiwan 110, Republic of China

a3 Institute of Biomedical Science, Academia Sinica, Nankang, Taipei, Taiwan, Republic of China

a4 Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan, Republic of China


Objectives Asians and Pacific Islanders have higher circulating serum ferritin (SF) compared with Caucasians but the clinical significance of this is unclear. There is a higher prevalence of metabolic syndrome (MetS) in Taiwanese Indigenous than Han Chinese. Genetically, Indigenous are related to Austronesians and account for 2 % of Taiwan's population. We tested the hypothesis that accumulation of Fe in the body contributes to the ethnic/racial disparities in MetS in Taiwan.

Design A population-based, cross-sectional study.

Setting National Nutrition and Health Survey in Taiwan and Penghu Island.

Subjects A total of 2638 healthy adults aged ≥19 years. Three ethnic groups were included.

Results Han Chinese and Indigenous people had comparable levels of SF. Austronesia origin was independently associated with MetS (OR = 2·61, 95 % CI 2·02, 3·36). After multiple adjustments, the odds for MetS (OR = 2·49, 95 % CI 1·15, 5·28) was significantly higher among Indigenous people in the highest SF tertile compared with those in the lowest tertile. Hakka and Penghu Islanders yielded the lowest risks (OR = 1·08, 95 % CI 0·44, 2·65 and OR = 1·21, 95 % CI 0·52, 2·78, respectively). Indigenous people in the highest SF tertile had increased risk for abnormal levels of fasting glucose (OR = 2·34, 95 % CI 1·27, 4·29), TAG (OR = 1·94, 95 % CI 1·11, 3·39) and HDL-cholesterol (OR = 2·10, 95 % CI 1·18, 3·73) than those in the lowest SF tertile.

Conclusions Our results raise the possibility that ethnic/racial differences in body Fe store susceptibility may contribute to racial and geographic disparities in MetS.

(Received September 19 2012)

(Revised April 17 2013)

(Accepted May 08 2013)

(Online publication July 18 2013)


  • Metabolic syndrome;
  • Serum ferritin;
  • Odds ratio;
  • Ethnicity;
  • Taiwanese Indigenous


c1 Corresponding author: Email