The effect of iron on the progress of atherosclerosis is still controversial. To explore the relationship between atherosclerotic plaques and iron metabolism and how iron is accumulated in plaque macrophages, we performed Oil red 0 staining to detect the lipid of the atherosclerotic plaques, enzyme-linked immunosorbent assay to detect the intracellular lipids (total cholesterol, free cholesterol) and serum hepcidin, Western-blot to examine the iron-related proteins, immunohistochemical and immunofluorescence assays to localize ferroportin 1 in macrophages. The contents of serum iron and transferrin saturation were measured. The results confrimed that atherosclerotic plaques were all lipid-rich. Compared to normal vessel wall, atherosclerotic plaques had significantly higher levels of ferritin and ferroportin I. Strikingly, we found the much lower levels of ferroxidases ceruloplasmin and hephaestin in plaque tissue than the normal vessel, while the content of serum hepcidin, iron and transferrin saturation were similar in these two groups. The novel finding suggests that the inability of ferrous iron to be oxidized into ferric iron might be a potential mechanism for iron retention in plaques. (C) 2015 Elsevier Inc. All rights reserved.