Average Ferritin Level Research Articles

Factors Impacting Outcome and Prognosis of Invasive Fungal Sinusitis: How Vital is Iron Metabolism?

Iron is an important micronutrient involved in cell biology through vital reactions. We examined the correlations between iron metabolism parameters and the course of invasive fungal sinusitis. Patients with invasive fungal sinusitis were enrolled. Serum iron and ferritin levels, total iron-binding capacity, and transferrin saturation were measured at the initiation of treatment. Patients were followed for 6months, and the clinical course was categorised as improvement or worsening/death. A total of 35 patients were enrolled. The average ferritin levels in mucormycosis patients was 944.9ng/ml, versus 110.7ng/ml for aspergillosis patients. Iron levels were significantly lower in mucormycosis than in aspergillosis (29.14µg/dl vs. 68.55µg/dl). Total iron-binding capacity was significantly different between the two groups (16.76µg/dl vs. 330.36µg/dl). After 6months, improvement, worsening, and death were noted for 18, 8, and 9 patients, respectively. Higher iron levels and lower ferritin levels were linked with improvement. Total iron-binding capacity was significantly higher in improved patients (2314 vs. 151). Iron metabolism parameters play significant roles in the preemptive judgment of the course of fungal sinusitis. Based on these findings, studies on drugs affecting iron metabolism should be conducted.

Anemia profiling in antenatal women at a tertiary care center in northern India: An observational study

: Anemia is a common health issue during pregnancy, with various factors influencing its occurrence. Iron deficiency often leads to iron deficiency anemia (IDA), significantly impacting maternal and fetal health.: This study aims to investigate the complete blood count and nutritional status, including serum iron profile, vitamin B12, and folate levels in antenatal patients. : The study involved 160 participants, predominantly from rural areas. The severity of anemia among the participants was classified according to WHO guidelines.: Iron deficiency was observed in 33.75% of women, folate deficiency in 20%, and vitamin B12 deficiency in 11.25%. Some women exhibited a combination of deficiencies. The average hemoglobin level was found to be 8.69 g/dL, and the mean iron level was 35.95 µg/dL. The average ferritin levels were observed to be 49.65 ng/mL. Lastly, the Vitamin B12 and folate levels averaged at 130.21 pg/mL and 14.76 ng/mL respectively.: These findings provide valuable insights into the nutritional status of pregnant women and highlight the need for targeted interventions to address micronutrient deficiencies during pregnancy.

SERUM FERRITIN AND SERUM LACTATE DEHYDROGENASE LEVELS AMONG COVID-19 PATIENTS

Objectives: The aim of this study was to estimate serum ferritin and serum lactate dehydrogenase (LDH) values among COVID-19-positive and COVID-19-negative subjects. Methods: The study was conducted on 152 cases; 76 were COVID-19 diseased, and 76 were COVID-19 free. Serum ferritin and serum LDH levels were estimated. Result: Average ferritin levels among COVID-19 diseased were 529.33 ng/ml compared to 450.92 ng/ml among negative individuals. Similarly, the LDH level among positive persons was 338.50 IU/L and 303.30 IU/L among hostile people. Conclusion: The uncontrolled and dysfunctional immune response is connected with macrophage activation and hyperferritinemic syndrome. Elevated LDH readings seem to reflect that multiple organ injury and failure may play a more prominent role in influencing the clinical outcomes in patients with COVID-19.

Determination and comparison of ferritin levels among different age groups of pregnant women in Al-Bayda city, eastern Libya

In this study, ferritin levels were determined among different age groups of pregnant women Al-Bayda city, eastern Libya. Where the average age ranged from 18 to 45 years and in a period of twelve Months from the first of February 2020 to June 2021. The reliable serum ferritin level was measured by using an enzyme immunoassay ELASA method using of serum sample. Through this study, it was found that most of the age groups suffer from a deficiency of ferritin level from 18 to 24 years, where the average ferritin level was 7.78 ng/ml, which was less than the normal range of 15-150 ng/ml. The average level for the age group from 25 to 30 years was 14.26 ng/m, while the age group between 31 to 35 years was 19.59 ng/ml. The average rate of ferritin for the age group between 36 to 40 years was 19.13ng/ml and the age group between 41 to 45 years was 22.79ng/mL. The study showed that the age groups of pregnant women who are less than 25 years old are more susceptible to ferritin and iron deficiency than the normal range.

Выявление и профилактика железодефицитного состояния у доноров крови (компонентов крови)

The problem of iron deficiency among donors is relevant and directly affects the provision of hemocomponents to the blood service. Donors, being a risk group for the development of iron deficiency, are examined before donation, including a study of hemoglobin levels. However, there is no information about the state of iron stores, when depleted, iron deficiency anemia develops. In turn, anemia is a contraindication to donation and, therefore, leads to medical exemptions from donation. The purpose of the study was to evaluate the main indicators of iron metabolism in donors of blood and (or) blood components at risk of developing latent iron deficiency. The examination of 174 donors included a hemogram, assessment of the level of hemoglobin, serum ferritin (SF), transferrin, and soluble transferrin receptors. When assessing the intensity of changes in reserve and transport iron indicators, 228 deviations from the reference range were analyzed. The criterion for the risk of developing iron deficiency was hemoglobin values at the lower limit of normal (130–135 g/l in men and 120–125 g/l in women) and the threshold level of ferritin (30 μg/l in male donors and 20 μg/l in women). The risk group included 58.3% of young donors — women who donate blood 1–2 times during the year (p < 0.01) and 66.6% (p < 0.01) of donors — men who donate blood regularly throughout 4 and > years. The average ferritin level in male donors was 27.37 μg/l (p < 0.02) and lower than the reference values. It is concluded that it is advisable to assess the indicators of iron metabolism in donors in the case of borderline hemoglobin levels, in women of reproductive age after 2 blood donations and in men with the number of donations ≥ 10. To replenish the iron depot in the body, when iron deficiency is detected in donors, it is necessary to consider the issue of prevention.

RBC Exchange Transfusion As an Adjunct Therapy to Control Iron Overload in Patients with Transfusion-Dependent Thalassemia

Background Patients with transfusion-dependent thalassemia (TDT) require red blood cell (RBC) transfusions as frequently as every 2-4 weeks to maintain a pre-transfusion hemoglobin of 9.0-10.5 g/dL for patients without cardiac complications. Chronic RBC transfusions increase body iron stores leading to iron deposition in liver, pancreatic, and cardiac tissues. Deferoxamine, deferiprone, and deferasirox are the iron chelators currently licensed for clinical use to manage iron overload in TDT patients with side effects ranging from nausea to nephrotoxicity and hearing loss. RBC exchange transfusion (RBCX), particularly in conjunction with isovolumic hemodilution, has been utilized for patients with sickle cell disease as a means of stabilizing iron overload. The 2015 ASFA Red Blood Cell Exchange consensus supports RBCX to reduce or prevent iron overload in sickle cell disease. Review of literature shows that RBCX can be beneficial as an acute intervention for patients with TDT and pulmonary hypertension however there is a paucity of literature documenting chronic RBCX use in TDT patients with iron overload. Case series This series presents five patients with TDT who were transitioned from chronic simple RBC transfusions to chronic RBCX after developing treatment-refractory iron overload as evidenced by serum ferritin elevation. Patients were treated on a transfusion schedule with a pre-transfusion goal hemoglobin of 9.5g/dL or higher and interval 4-6 weeks. Patient A is a 14 year-old male who developed significant iron overload (peak ferritin of 7077) on deferasirox 20 mg/kg/day and MRI T2 imaging suggestive of iron deposition. After transition to RBCX, ferritin decreased significantly with a post-RBCX mean of 1382. Blood utilization was 4200 ml three months pre-RBCX and 5625 ml three months post-RBCX. Patient B is a 23 year-old male with a peak ferritin of 1310 prior to RBCX on 23 mg/kg/day of deferasirox complicated by mild hearing loss. Serum ferritin has shown stabilization, with a mean post-RBCX ferritin of 880. Blood utilization was 2400 ml three months pre-RBCX and 8100 ml three months post-RBCX. Patient C is a 17 year-old male with a peak ferritin of 1400 with deferasirox management complicated by acute renal injury. Mean serum ferritin of 633 post-RBCX. Blood utilization was 1200 ml three months pre-RBCX and 5200 ml three months post-RBCX. Patient D is a 17 year-old male managed on 23 mg/kg/day of deferasirox with a peak ferritin of 3060 on pre-RBCX. The patient transitioned to chronic RBCX with mean serum ferritin of 1073. Blood utilization was 1800 ml three months pre-RBCX and 7700 ml three months post-RBCX. Patient E is a 17 year-old male with peak ferritin of 3404 despite 20 mg/kg/day of deferasirox prior to chronic RBCX. Mean serum ferritin after transition to RBCX was found to be 1282. Blood utilization was 1500 ml three months pre-RBCX and 4900 ml three months post-RBCX. All 5 patients have tolerated RBC exchange procedures without complications. Serum ferritin levels pre- and post-RBC exchange were trended pre- and post- RBCX (Figure 1). Serum ferritins were averaged together for each patient to obtain an equal number of time points considered prior to and after starting RBCX therapy. Descriptive statistics (Table 1) were used to summarize average ferritin levels for the patient group. A Wilcoxon signed-rank test was performed to assess the median difference in ferritin level from pre-RBCX to post-RBCX. All analyses were conducted in SAS version 9.4. P <0.05 is considered statistically significant. Median pre-RBCX ferritin level for the study group is 2489.3 (Inter-quartile range (IQR): 1190.0, 2659.0). The median post-RBCX ferritin level for the series is 1329.3 (IQR: 941.0, 1711.0). After subtracting the post-RBCX ferritin level from the pre-RBCX ferritin level, the median change for the group is 457 (IQR: 249.0, 1160.0) (p=0.06). Conclusion This case series documents the successful clinical application of chronic RBCX in TDT patients as a means of stabilizing serum ferritin levels over time. Mean ferritin levels were significantly lower, clinically, after transitioning from chronic simple RBC transfusion to RBCX (Table 1), though analysis is limited due to cohort size. Blood utilization increased after transitioning to RBCX. Next steps in evaluating our practice for the patient group will be to evaluate iron deposition status with MRI T2* imaging.

Effects of Smoking on Serum Ferritin levels in adult population living in Sulaymaniyah, Iraq: A Retrospective Cross-sectional Study

Background: Smoking is a serious issue for global public health, and the prevalence of smoking use is the leading cause of early mortality globally. Serum ferritin, an intracellular protein that stores and releases iron, is considered one of the most important clinical biomarkers to assess iron status.
 Aim: The current study aims to examines the effect of smoking on serum ferritin levels of adult populations in Sulaymaniyah. 
 Methods: The study was conducted on 80 smokers and 20 non-smokers, totally 100 persons. Their ages ranged from 18 to 65 years.
 Results: Result showed that the majority of smokers had elevated ferritin levels. A p-value of less than 0.05 indicated a significant difference in ferritin levels between smokers and non-smokers groups. The average ferritin level among smoker group was 227.40 mg/L, while the average ferritin level among non-smokers group was 118.3 mg/L. Regarding the associated between age groups and average ferritin levels, the average ferritin level is highest in the age groups between 51-61 years old. In addition, obesity may play a role in raising ferritin levels, people with obese conditions (BMI > 30) have the highest average ferritin levels than others.
 Conclusion: This study provides evidence that smoking negatively affect serum ferritin levels, since increases in mean ferritin levels are very striking in smoking and obese group.

The Relationship between Ferritin Levels and Uterine Inertia in Labor Women

Objective: To determine the relationship between ferritin levels and the incidence of uterine inertia in pregnant women. Method: This study uses a prospective cohort design. The study was conducted on all pregnant women aged 20-40 years who had antenatal care and be in labor at the Teaching Hospital in the Department of Obstetrics and Gynecology, Faculty of Medicine, Hasanuddin University. Data were analyzed with the chi-square test and the Mann-Whitney test. Results: Obtained 76 pregnant women where 44.7% of them had uterine inertia. The average ferritin level in the uterine inertia group was significantly lower (3.80 ± 2.84 ng/mL) than without the uterine inertia group (12.99 ± 11.40 ng/mL) with a value p<0.001. The average ferritin level in the mild anemia group was significantly higher (9.83 ± 10.35 ng/mL) than in the moderate anemia group (3.82 ± 2.51 ng/mL) with a p-value <0.05. Pregnant women with moderate anemia were found to be 4.68 more susceptible uterine inertia than pregnant women with mild anemia. Conclusion: There was a relationship between ferritin levels in pregnant women and the incidence of uterine inertia where low ferritin levels was risk factor of uterine inertia.

Effects of Smoking on Serum Ferritin levels in adult population living in Sulaymaniyah, Iraq: A Retrospective Cross-sectional Study

Objectives: The current study aims to examines the effect of smoking on serum ferritin levels of adult populations in Sulaymaniyah. 
 Methods: The study was conducted on 80 smokers and 20 non-smokers, totally 100 persons. Their ages ranged from 18 to 65 years.
 Results: This study showed that the majority of smokers had elevated ferritin levels. A p-value of less than 0.05 indicated a significant difference in ferritin levels between smokers and non-smokers groups. The average ferritin level among smoker group was 227.40 mg/L, while the average ferritin level among non-smokers group was 118.3 mg/L. Regarding the associated between age groups and average ferritin levels, the average ferritin level is highest in the age groups between 51-61 years old. In addition, obesity may play a role in raising ferritin levels, people with obese conditions (BMI > 30) have the highest average ferritin levels than others.
 Conclusion: This study provides evidence that smoking negatively affect serum ferritin levels, since increases in mean ferritin levels are very striking in smoking and obese group.

Abstract #1404780: Implementing a Screening Protocol for Endocrinopathies in Patients with Secondary Hemochromatosis due to Sickle Cell Anemia

Sickle cell disease (SCD) is an autosomal recessive hemoglobinopathy characterized by hemolytic anemia, intermittent small vessel occlusion, and organ dysfunction. Red blood cell transfusions are a therapeutic mainstay in SCD, which can lead to iron overload and endocrine disease. However, due to diagnostic difficulties and lack of data, there is not a wide consensus in approach. This has led to many practitioners screening for endocrinopathies only once patients are symptomatic. In this study, we implemented a standardized protocol for screening of iron overload and certain endocrinopathies in a single-study cohort of patients with SCD to assess viability in real-world practice and to detect disease prior to significant burden. We studied 19 patients diagnosed with SCD or sickle-cell trait (SCT) at a single institution. Patients had serum testing for ferritin and a metabolic panel at usual clinical visits. Iron overload was diagnosed with serum ferritin levels of at least 1000 ng/mL. If iron overload was detected, additional testing for 25-Hydroxyvitamin D (OHD), Thyroid Stimulating Hormone (TSH), Parathyroid Hormone (PTH), and Insulin-Like Growth Factor-1 (IGF-1) was obtained. Nineteen patients (12 men and 7 women) were included with a mean age of 32 years old. Twelve patients and seven patients were diagnosed with SCD and SCT, respectively. The average ferritin levels of SCD and SCT patients were 4874 and 270 ng/mL, respectively. Nine patients had ferritin levels greater than 1000 ng/mL, eight of which were diagnosed with SCD, one was diagnosed with SCT, and seven of which were prescribed iron chelation therapy. Of these nine patients, the average random glucose was 103 ng/mL. The average serum calcium corrected for albumin levels was 9.3 ng/mL. Seven of eight patients were found to have low 25-OHD levels with two of four patients showing elevated serum PTH. One of six patients had abnormal thyroid testing, with an elevated TSH and normal free thyroxine. Three of five patients showed abnormal IGF-1 testing, with low IGF-1 levels and low IGF-1 binding protein levels. This study successfully implemented a protocol for screening for endocrinopathies in a cohort of SCD and SCT patients at a single institution. We showed evidence that many patients with iron overload demonstrated abnormalities in 25-OHD, PTH, TSH, and IGF-1. The few studies that have been done to analyze this topic have shown findings of growth failure, osteopenia, hypogonadism, hypothyroidism, and glucose intolerance in SCD and SCT patients. This study did not explore bone disease or sex hormone function due to difficulty in performing these tests and obtaining insurance payor coverage. An additional limitation includes low sample size. However, this study replicates real-world care for these patients due to these barriers, making these methods easily translatable to other clinical settings. Our findings suggest implementation of a standardized protocol for iron overload and endocrinopathy screening in SCD and SCT patients is not only viable but could also detect disease before symptom onset when intervention is more effective.

Investigation of Serum Ferritin for the Prediction of COVID-19 Severity and Mortality: A Cross-Sectional Study.

Acute respiratory failure develops quickly in patients with a severe form of coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome Coronavirus 2 (SARS‑CoV‑2). Despite being commonly acknowledged as a measure of the body's overall iron storage, ferritin's predictive value is associated with COVID-19. This study aimed to evaluate the relationship between COVID-19 and serum ferritin levels as the biochemical markers of SARS-CoV-2 infection in Sulaymaniyah, Iraq. A biochemical test was performed at Baxshin Hospital in the period from February 2022 to April 2022. It was performed on a total of 85 patients (63.53% males and 36.47% females), ranging in age from 25 to 79 years old, with an average age of 48.4 years old. The patient's blood samples were taken to screen for ferritin levels. The resulting outcome of this work is high serum ferritin levels for the majority of infected patients. Overall, there is a significant difference between male and female serum ferritin observed with a p-value < 0.05. The median interquartile range (IQR) of serum ferritin was 896 ng/mL for males, while it was only 611 ng/mL for females. The current study showed that age level has a great effect on elevated ferritin levels. It has been discovered that gender impacts increasing ferritin levels; 62% were found to be men and 38% were found to be women, with average ferritin levels of 1111 ng/mL and 712.8 ng/mL, respectively. SARS-CoV-2 infection causes significant laboratory abnormalities, including a high level of serum ferritin.

Intravenous iron therapy in the pediatric sleep clinic: a single institution experience.

Initial reports of intravenous (IV) iron administration have been promising for children with restless legs syndrome, periodic limb movement disorder, and restless sleep disorder. The aim of the current study was to evaluate further the clinical response to IV iron supplementation in children seen in a pediatric sleep clinic. We performed a retrospective chart review of children cared for in a single pediatric sleep clinic who also underwent IV iron infusion. Pre and post IV data regarding their sleep symptoms and ferritin levels were abstracted. Overall, 63 pediatric sleep patients underwent IV iron infusion, mostly with ferric carboxymaltose (n = 60), for restless legs syndrome (n = 30), periodic limb movement disorder (n = 22), and restless sleep disorder (n = 17). Of the 59 patients with clinical follow-up, 39 (73%) noted improvement in at least 1 symptom, and 14 (26%) did not notice improvement or noticed worsening symptoms. Of the 59 patients with preinfusion and postinfusion labs, the average ferritin level increased from 21.7 (13.3) to 147.9 (120.9) μg/L, P < .001. Comparing patients who experienced clinical improvement vs those who did not, there were no statistically significant differences in change in ferritin levels (P = .278), sex (P = .452), or age (P = .391). Ferritin change with infusion according to diagnostic subgroups (restless legs syndrome/periodic limb movement disorder/restless sleep disorder) was examined, and no significant differences were noted (F(2,56) = 0.852, P = .432). In terms of immediate adverse reactions to the IV infusion, 7 (11%) experienced at least 1 side effect, with the most common being behavior change (n = 6) or gastrointestinal discomfort (n = 4); no episodes of anaphylaxis or extravasation were noted. These data provide additional support for the efficacy and safety of IV iron for pediatric restless legs syndrome, periodic limb movement disorder, and restless sleep disorder recalcitrant to oral iron. Ingram DG, Al-Shawwa B, DelRosso LM, Sharma M. Intravenous iron therapy in the pediatric sleep clinic: a single institution experience. J Clin Sleep Med. 2022;18(11):2545-2551.

Ferritin Level as Independent Predictor of Covid-19 : a Cross Sectional Study

COVID-19 is an infectious disease caused by SARS-CoV-2. In severe cases of COVID-19, it is often accompanied by a syndrome known as cytokine storm or cytokine release syndrome (CRS). Serum ferritin levels, increase as the disease worsens. This study aims to see the relationship between ferritin levels and the degree of COVID-19 and evaluate ferritin levels as a predictor of severity in COVID-19 patients at RSPI Prof Dr Sulianti Saroso. This type of research is quantitative with a cross sectional approach. Data analysis using Kruskal Wallis test. Secondary data from medical records of confirmed COVID-19 patients based on the results of PCR examinations during March 2020 to December 2020 who examined ferrittin levels as many as 554 patients. The results showed that the average ferritin level was 164.78, moderate was 524.13, severe was 1377.52 and critical was 1592.46. The results of the analysis with the Kruskal Wallis test obtained P value = 0.000 &lt; (0.05) so it can be explained that there are differences in ferritin levels of the four degrees of disease. This shows that there is an effect of the relationship between ferritin levels and the degree of disease in COVID-19 patients.

0498 Intravenous Iron Therapy in the Pediatric Sleep Clinic: A Single Institution Experience

Abstract Introduction Initial reports of intravenous (IV) iron administration have been promising for children with restless legs syndrome (RLS), periodic limb movement disorder (PLMD), and restless sleep. The aim of the current study was to further evaluate the clinical response to IV iron supplementation in children seen in a pediatric sleep clinic. Methods We performed a retrospective chart review of children cared for in a single pediatric sleep clinic who also underwent IV iron infusion. Data regarding their sleep symptoms and ferritin levels were abstracted. Results Overall, 63 pediatric sleep patients underwent IV iron infusion, mostly with ferric carboxymaltose (n=60). Of the 59 patients with clinical follow-up, 39 (73%) noted improvement in at least one symptom, and 14 (26%) did not notice improvement or noticed worsening symptoms. Of the 59 patients with pre- and post-infusion labs, the average ferritin level increased from 21.7+/-13.3 to 147.9+/-120.9, p&amp;lt;0.001. Comparing patients who experienced clinical improvement versus those who did not, there were no statistically significant differences in change in ferritin levels (176.6+/-127.7 vs 120.5+/-118.1, p=0.278), sex (68% in females vs 77% in males, p=0.452), or age (8.8+/-5.9 vs 7.0+/-5.1, p=0.391). In terms of immediate adverse reactions to the IV infusion, 7 (11%) experienced at least 1 side effect, with the most common being behavior change (n=6) or gastrointestinal discomfort (n=4); no episodes of anaphylaxis or extravasation were noted. Conclusion These data provide additional support for the efficacy and safety of IV iron for pediatric RLS, PLMD, and restless sleep recalcitrant to oral iron. Support (If Any)

Prevalence and risk factors of fractures in transfusion dependent thalassemia - A Hong Kong Chinese population cohort.

ObjectiveTo delineate the prevalence and associated risk factors of low BMD, osteoporosis/bone fragility and fracture in transfusion‐dependent thalassemia (TDT) in the Chinese population in Hong Kong.Design, Patients and MeasurementsA retrospective cohort study design was employed. Patients of TDT who had serial Hologic dual‐energy X‐ray absorptiometry (DXA) from 2010 to 2016 and received regular transfusion for at least 5 years were recruited. Clinical and biochemical data, from 5 years before the first DXA scan, were retrieved from the electronic record system of the Hospital Authority, till 30 June 2020. Low bone mineral density and osteoporosis/bone fragility are defined by the ISCD 2019 position guidelines.ResultsSeventy‐seven patients were included in the analysis. The fracture prevalence of TDT among the Chinese population in Hong Kong was 15.58%. Up to 55.84% of patients had low bone mineral density, and 5.19% patients had osteoporosis/bone fragility state. The median age at first fracture was 31.73 years (range 24.06–44.18 years). In the regression analysis, a higher log(10) transformation of average ferritin levels over 5 years before the first DXA scan was significantly associated with fracture occurrence regardless of bisphosphonate treatment (OR 310.73, 95% CI 3.99–24183.89, p = .010). Mean average ferritin level over 5 years was 6695.5 ± 2365.7 pmol/L (fracture group) versus 4350.7 ± 3103.2 pmol/L (non‐fracture group), p = .016. Hip and spine BMD Z‐score did not have statistically significant association with fracture occurrence.ConclusionIron overloading plays an important role in adverse bone health in TDT. Dual X‐ray densitometry is insufficient in predicting fracture risk.

CORRELATION BETWEEN THE PERCENTAGE OF HYPOCHROMIC ERYTHROCYTES AND FERRITINE LEVELS IN CHRONIC KIDNEY DISEASE PATIENTS UNDERGOING HEMODIALYSIS IN PKU BANTUL HOSPITAL

Abstrak: The incidence of CKD in the world is more than 500 million patients and up to 1.5 million patients need to undergo renal replacement therapy in the form of hemodialysis. Chronic kidney disease is inseparable from several complications, one of which is anemia. Confirmation of the diagnosis of anemia in CKD patients can be confirmed through various examinations such as the classic examination of serum ferritine levels, but ferritine is known to be involved in the inflammatory process that occurs in CKD. The aims of this study were to determine the relationship between the percentage of hypochromic erythrocytes and ferritine levels, to determine the average percentage of hypochromic erythrocytes and to determine the average ferritin level in CKD patients undergoing hemodiliasis at PKU Bantul Hospital. This study was conducted using a cross-sectional method involving 50 CKD patients at PKU Bantul Hospital. Blood samples were taken to check ferritine levels and hypochromic erythrocyte percentage. Data analysis was carried out with two types, univariate analysis and bivariate analysis which were carried out with the Spearman correlation test. Based on the results of univariate analysis, the median percentage of hypochromic erythrocytes of the research subjects was 0.95%. The median ferritine in research subjects was 105.5 ng/mL. based on the results of bivariate analysis, there was no significant relationship between the percentage of hypochromic erythrocytes and ferritine levels (p=0.130, r=-0.217). There was no significant relationship between the percentage of hypochromic erythrocytes and ferritine levels. Keywords: anemia; ferritine serum, chronic kidney disease, reticulocytes hemoglobin

Correlation of Transferrin Saturation and Serum Ferritin with Bone Mass Density in Adult Transfusion Dependent Beta-Thalassemia Patients.

BackgroundThe use of regular blood transfusions and iron chelation therapy to treat thalassemia has improved survival and increased the incidence of osteoporosis. Moreover, iron toxicity is one of the contributing factors that reduce bone mass density in adult transfusion-dependent beta-thalassemia patients. Therefore, this study aims to determine the proportion of low bone mass density in adult thalassemia patients and transferrin saturation, as well as serum ferritin, which correlates to the skeletal condition.MethodsThis is a cross-sectional study conducted in Thalassemia and Hematology Medical Oncology Clinics of Cipto Mangunkusumo Hospital in March 2016. The anthropometric data and hemoglobin levels were obtained before transfusion. Subsequently, the average ferritin levels, bone mineral density, and radiographic results were obtained.ResultsThe percentage of adult thalassemia major and intermedia patients with low bone mass density was 68%. Also, there was a weak inverse correlation between bone mass density and transferrin saturation (r = −0.329, p = 0.01), while no correlation was shown between bone mass density and ferritin (r = −0.088, p = 0.504). The transferrin saturation cutoff point value used to distinguish the incidence of low and normal bone density in patients with transfusion-dependent beta-thalassemia was 89.5%. In addition, there was weak correlation between Singh index and bone mass density (r = 0.273, p = 0.038).ConclusionAmong the transfusion-dependent beta-thalassemia patients, 68% had low bone mass density, which inversely correlated to transferrin saturation. Furthermore, the cutoff value of transferrin saturation to differentiate the incidence of low and normal bone density in thalassemia major compared to thalassemia intermedia was 89.5%. Singh Index correlates weakly with bone mass density and might be used to detect low bone mass density in remote healthcare facilities.

Phlebotomy requirements are lower in polycythemia vera patients with low ferritin stores.

e19537 Background: Polycythemia vera (PV) is a myeloid neoplasm of clonal red cell proliferation. Most PV patients are iron deficient at diagnosis, prior to the onset of therapeutic phlebotomy, the mainstay of treatment. More recent studies have also suggested that aberrant iron homeostasis contributes to persistently elevated hematocrit in iron deficient PV patients. In healthy individuals, iron deficiency leads to anemia such that the co-occurrence of polycythemia and iron deficiency in PV is pathological. The purpose of our study is to investigate whether iron deficiency, as defined by serum ferritin &lt; 15 μg/L, at PV diagnosis can predict phlebotomy requirements in PV patients. Methods: 173 patients were diagnosed with PV between 2010 and 2019 at our institution. We analyze ferritin levels, phlebotomy frequency, and cytoreductive therapy in PV patients. Patients are stratified into a “high ferritin” (serum ferritin &gt; 30 μg/L) or “low ferritin” (serum ferritin &lt; 15 μg/L) groups and analyzed at 0-6 months and 4-6 years after diagnosis. 91% of PV patients were treated with phlebotomy and 70% with cytoreductive therapy. 23 and 13 patients had both a ferritin level and a record of the number of phlebotomies at 0-6 months or 4-6 years after diagnosis, respectively. Results: The average number of phlebotomies at 0-6 months after diagnosis was 3.1±1.7, with no statistically significant difference between the low and high ferritin groups. The average number of phlebotomies at 4-6 years after diagnosis was 2.9±2.5, with no statistically significant difference between the low and high ferritin groups (1.9 vs. 4.6 phlebotomies, respectively; p = 0.136). In patients with low ferritin at diagnosis, phlebotomy requirements decreased at 4-6 years relative to 0-6 months after diagnosis (1.9 vs. 3.1 phlebotomies; p = 0.009) while no difference occurred in the high ferritin group. In all PV patients, average serum ferritin increased with time from diagnosis (R = 0.81) and cannot be explained by cytoreductive therapy as there was no significant effect on average ferritin levels (137 vs. 60 μg/L; p = 0.295) or phlebotomy requirements (3.2 vs. 3.4; p = 0.803) at 4-6 years after PV diagnosis. Conclusions: Low ferritin levels at PV diagnosis decreased phlebotomy frequency at 4-6 years relative to 0-6 months after diagnosis. Additionally, cytoreductive therapy did not significantly affect phlebotomy requirements or ferritin levels at 4-6 years post-PV diagnosis. Further work is needed to assess the molecular pathways involved in iron-deficient erythrocytosis in PV.

Ferritin level prospectively predicts hepatocarcinogenesis in patients with chronic hepatitis B virus infection.

Previous studies have detected a higher level of ferritin in patients with hepatocellular carcinoma (HCC), but a potential causal association between serum ferritin level and hepatocarcinogenesis remains to be clarified. Using a well-established prospective cohort and longitudinally collected serial blood samples, the association between baseline ferritin levels and HCC risk were evaluated in 1,152 patients infected with hepatitis B virus (HBV), a major risk factor for HCC. The association was assessed by Cox proportional hazards regression model using univariate and multivariate analyses and longitudinal analysis. It was demonstrated that HBV patients who developed HCC had a significantly higher baseline ferritin level than those who remained cancer-free (188.00 vs. 108.00 ng/ml, P<0.0001). The patients with a high ferritin level (≥200 ng/ml) had 2.43-fold increased risk of HCC compared to those with lower ferritin levels [hazard ratio (HR), 2.43; 95% confidence interval, 1.63–3.63]. A significant trend of increasing HRs along with elevated ferritin levels was observed (P for trend <0.0001). The association was still significant after multivariate adjustment. Incorporating ferritin into the α-fetoprotein (AFP) model significantly improved the performance of HCC prediction (the area under the curve from 0.74 to 0.77, P=0.003). Longitudinal analysis showed that the average ferritin level in HBV patients who developed HCC was persistently higher than in those who were cancer-free during follow-up. HCC risk reached a peak at approximately the fifth year after baseline ferritin detection. Moreover, stratified analyses showed that the association was noted in both males and females, and was prominent in patients with a low AFP value. In short, serum ferritin level could independently predict the risk of HBV-related HCC and may have a complementary role in AFP-based HCC diagnosis. Future studies are warranted to validate these findings and test its clinical applicability in HCC prevention and management.

ASSOCIATION BETWEEN SERUM FERRITIN CONCENTRATION WITH OVERWEIGHT AND OBESITY STATUS, LIPID PROFILES AND ATHEROSCLEROSIS INDEX IN PATIENTS WITH HYPERTENSION

Objective: To evaluate the association between serum ferritin concentrations with BMI, lipid profile and atherosclerosis index in hypertensive patients. Subjects and methods: The study of 72 patients with hypertension are treated at the department of general internal geriatric Hue Central Hospital, patients were excluded diseases causing increased ferritin and measured weight, height, BMI, lipid profile testing and atherogenic index. Results: Ferritin in patients with overweight, obesity patients was higher (p &lt;0.05), the rate of increase in ferritin in high atherosclerosis index patients was higher than those of lowgh atherosclerosis index patients, average ferritin levels in hypertensive patients with TG increase was higher in hypertensive patients did not increase TG, the percentage increased ferritin unrelated to TC, HDL-C and LDL-C. Conclusion: The concentration of serum ferritin is associated with BMI, atherosclerosis, and TG index in hypertensive patients.