Gender-Specific Associations Between Iron Status and History of Attempted Suicide: Implications for Gender Paradox

Purpose: Iron deficiency (ID) has been linked with high impulsivity, and an increased risk of ID was reported among suicide attempters. We hypothesized that poor iron status might be prevalent among suicide attempters, who have high impulsivity.

Methods: As a part of the third National Health and Nutrition Examination Survey (1988–1994), a set of iron indices were measured in 2598 men and 2975 women aged 17–39 years, who completed a mental disorder diagnostic interview.

Results: Using non-attempters as reference within each gender, we observed a gender-dependent association between poor iron status and the history of attempted suicide. For male attempters (n = 74), the prevalence ratios (PR) of abnormal serum ferritin, serum iron and protoporphyrin were 18.3 (95%CI = 3.3–101.7), 3.2 (1.1–9.4) and 5.4(1.8–15.6). In contrast, the PR of abnormal serum ferritin for female attempters (n = 217) was 0.3 (0.1–0.6). The hematological indices did not differ significantly between attempters and non-attempters among either men or women. Compared with non-attempters, male attempters were prone to a higher odds [17.5 (4.2–72.4)] while female attempters to a lower odds [0.6 (0.3–1.1)] of ID.

Conclusion: These data suggest new opportunities for exploring biological bases of gender paradox of suicidal behaviors and a novel way to enhance therapeutic and preventive interventions against suicide.