Changes In Serum Ferritin Concentrations Research Articles

БІОХІМІЧНІ ПОКАЗНИКИ КРОВІ У ХВОРИХ НА РОЗСІЯНИЙ СКЛЕРОЗ, ЯКІ ПЕРЕНЕСЛИ ІНФЕКЦІЮ SARS-CoV-2

B a c k g r o u n d. Currently, multiple sclerosis (MS) is an important medical and social problem. There are already more than 2.8 million people with MS worldwide, and due to the lack of effective methods of treatment and prevention, the number of patients is increasing constantly. Therefore, the search for new ways and approaches aimed towards stabilizing the patient's condition is a priority task of modern neurobiology. It is also important to identify triggers that can lead to accelerating the rate of disease progression. Since MS is an immune-mediated disorder, we hypothesized that concomitant diseases of infectious etiology, via the activation of an inflammatory reactions cascade, can lead to a worsening of the MS patient's condition. However, the final answer to the question of whether acute viral infections affect the condition of patients with MS has not been obtained yet. In the context of the epidemiological situation that has developed in recent years, due to the spread of the SARS-CoV-2 coronavirus infection, it is interesting to study the possible negative consequences of COVID-19 in people suffering from MS. The aim of the study was to analyze the general biochemical status of patients with MS who had or did not have a confirmed history of COVID-19. M e t h o d s. A total of 271 participants were enrolled in this study, including 97 MS patients and 30 healthy volunteers who matched for age and sex. Patients with MS were divided into two groups: group I (n= 56; 36 women and 20 men, average age: 41.3±5.5, disease duration: 4.4±1.5 years) – patients with MS who did not have confirmed history of COVID-19 and group II (n= 41; 27 women and 14 men, average age: 40.2±5.6, disease duration: 4.6±1.3 years) – patients with MS, who had a laboratory-verified diagnosis of COVID-19 in the past 4-7 months. Blood serum samples of patients and healthy donors were obtained from the University Clinic of O.O. Bogomolets National Medical University, Kyiv, Ukraine. All patients were diagnosed with MS according to the 2017 McDonald criteria. R e s u l t s. It was established that both groups of MS patients had similar changes in blood biochemical parameters compared to the healthy indicators: a decrease in creatinine and uric acid concentrations; decrease in the levels of particular lipid fractions, namely VLDL and TAG; decrease in the activities of AP and LDH; increase in C-reactive protein concentration. The only significant differences between groups I and II were noted due to multidirectional changes in serum ferritin concentration and an increase in the level of amylase activity in the blood serum of patients with MS in post- COVID period. C o n c l u s i o n s. The absence of statistically significant differences between the blood biochemical parameters in patients with MS who had or did not have confirmed history of COVID-19 indicates the absence of a relationship between SARS-CoV-2 infection and changes of particular studied parameters. Among the results obtained, the multidirectional changes in ferritin concentration in MS patients before and after COVID-19 could be of great interest to further research.

Two trade names of deferasirox (Osveral® and Exjade®) in reduction of iron overload parameters in major beta-thalassemia patients: A randomized open labeled clinical trial.

Background:Beta-thalassemia major patients typically require chronic transfusion and iron-chelating agents to reduce serum iron overload. Osveral® is an available Iranian brand name of deferasirox used by majority of thalassemic patients. The aim of this study was to compare the efficacy of Osveral® vs. Exjade® in major beta- thalassemia patients.Methods:In this randomized clinical trial, all patients received a single daily dose of 30 mg/kg either of Osveral® or Exjade® for 6 months. Primary outcome was the mean of bimonthly changes in serum ferritin concentration and secondary outcomes included mean changes of heart and liver MRI T2* after a year.Results:Finally, 80 patients completed the study. The mean serum ferritin level at the end of sixth month significantly decreased in Osveral® and Exjade® groups (p<0.01). After a year, means cardiac MRI T2* in Osveral® group were changed from 25.9±9.6 ms to 25.4±9.7 ms and in Exjade® group from 24.8±9.2 ms to 26.9±5.9 ms, with no significant difference (P=0.43). Mean liver MRI T2* for Osveral® and Exjade® groups were 8.6±6.4 ms (baseline 6.3±4.7) and 6.3±4 ms (baseline 4.9±3.5), respectively and there was no significant difference between two study arms (P=0.1).Conclusion:Osveral® decreased significantly the serum ferritin level and improved heart and liver iron overload as efficient as Exjade®. It can be a suitable cost-effective alternative agent in beta-thalassemia major patients.

Cut-off points for serum ferritin to identify low iron stores during the first year of life in a cohort of Mexican infants.

The aim of this study was to identify serum ferritin (SF) cut‐off points (COPs) in a cohort of healthy full‐term normal birth weight infants who had repeated measurements of SF and haemoglobin every 3 months during the first year of life. The study included 746 full‐term infants with birth weight ≥2,500 g, having uncomplicated gestations and births. Participants received prophylactic iron supplementation (1 mg/day of iron element) from the first to the 12th month of life and did not develop anaemia during the first year of life.Two statistical methods were considered to identify COPs for low iron stores at 3, 6, 9 and 12 months of age: deviation from mean and cluster analysis. According to the K‐means cluster analysis results by age and sex, COPs at 3 and 6 months for girls were 39 and 21 μg/L and for boys 23 and 11 μg/L, respectively. A single COP of 10 μg/L was identified, for girls and boys, at both 9 and 12 months. Given the physiological changes in SF concentration during the first year of life, our study identified dynamic COPs, which differed by sex in the first semester. Adequate SF COPs are necessary to identify low iron stores at an early stage of iron deficiency, which represents one of the most widespread public health problems around the world, particularly in low‐ and middle‐income countries.

Evaluation of the efficacy and safety of deferiprone compared with deferasirox in paediatric patients with transfusion-dependent haemoglobinopathies (DEEP-2): a multicentre, randomised, open-label, non-inferiority, phase 3 trial

Transfusion-dependent haemoglobinopathies require lifelong iron chelation therapy with one of the three iron chelators (deferiprone, deferasirox, or deferoxamine). Deferasirox and deferiprone are the only two oral chelators used in adult patients with transfusion-dependent haemoglobinopathies. To our knowledge, there are no randomised clinical trials comparing deferiprone, a less expensive iron chelator, with deferasirox in paediatric patients. We aimed to show the non-inferiority of deferiprone versus deferasirox. DEEP-2 was a phase 3, multicentre, randomised trial in paediatric patients (aged 1 month to 18 years) with transfusion-dependent haemoglobinopathies. The study was done in 21 research hospitals and universities in Italy, Egypt, Greece, Albania, Cyprus, Tunisia, and the UK. Participants were receiving at least 150 mL/kg per year of red blood cells for the past 2 years at the time of enrolment, and were receiving deferoxamine (<100 mg/kg per day) or deferasirox (<40 mg/kg per day; deferasirox is not registered for use in children aged <2 years so only deferoxamine was being used in these patients). Any previous chelation treatment was permitted with a 7-day washout period. Patients were randomly assigned 1:1 to receive orally administered daily deferiprone (75-100 mg/kg per day) or daily deferasirox (20-40 mg/kg per day) administered as dispersible tablets, both with dose adjustment for 12 months, stratified by age (<10 years and ≥10 years) and balanced by country. The primary efficacy endpoint was based on predefined success criteria for changes in serum ferritin concentration (all patients) and cardiac MRI T2-star (T2*; patients aged >10 years) to show non-inferiority of deferiprone versus deferasirox in the per-protocol population, defined as all randomly assigned patients who received the study drugs and had available data for both variables at baseline and after 1 year of treatment, without major protocol violations. Non-inferiority was based on the two-sided 95% CI of the difference in the proportion of patients with treatment success between the two groups and was shown if the lower limit of the two-sided 95% CI was greater than -12·5%. Safety was assessed in all patients who received at least one dose of study drug. This study is registered with EudraCT, 2012-000353-31, and ClinicalTrials.gov, NCT01825512. 435 patients were enrolled between March 17, 2014, and June 16, 2016, 393 of whom were randomly assigned to a treatment group (194 to the deferiprone group; 199 to the deferasirox group). 352 (90%) of 390 patients had β-thalassaemia major, 27 (7%) had sickle cell disease, five (1%) had thalassodrepanocytosis, and six (2%) had other haemoglobinopathies. Median follow-up was 379 days (IQR 294-392) for deferiprone and 381 days (350-392) for deferasirox. Non-inferiority of deferiprone versus deferasirox was established (treatment success in 69 [55·2%] of 125 patients assigned deferiprone with primary composite efficacy endpoint data available at baseline and 1 year vs 80 [54·8%] of 146 assigned deferasirox, difference 0·4%; 95% CI -11·9 to 12·6). No significant difference between the groups was shown in the occurrence of serious and drug-related adverse events. Three (2%) cases of reversible agranulocytosis occurred in the 193 patients in the safety analysis in the deferiprone group and two (1%) cases of reversible renal and urinary disorders (one case of each) occurred in the 197 patients in the deferasirox group. Compliance was similar between treatment groups: 183 (95%) of 193 patients in the deferiprone group versus 192 (97%) of 197 patients in the deferisirox group. In paediatric patients with transfusion-dependent haemoglobinopathies, deferiprone was effective and safe in inducing control of iron overload during 12 months of treatment. Considering the need for availability of more chelation treatments in paediatric populations, deferiprone offers a valuable treatment option for this age group. EU Seventh Framework Programme.

A Placebo-Controlled Study of the Impact of Dietary Salmon Protein Hydrolysate Supplementation in Increasing Ferritin and Hemoglobin Levels in Iron-Deficient Anemic Subjects

Iron deficiency anemia is the most common micronutrient deficiency in the world today. This placebo-controlled, iron-deficient anemic, patient study measured the changes in serum ferritin concentration, as well as circulatory hemoglobin concentration, after daily supplementation of their normal diet with 16 grams per day of salmon protein hydrolysate tablets. Salmon protein hydrolysate has a low iron content of 3.1 mg/kg versus 20 mg/kg for the whey protein isolate tested here. Yet, our results show that iron-deficient subjects treated with salmon protein hydrolysate for 6 weeks, showed a 14% increase in hemoglobin levels, while treatment with whey protein isolate showed only a 2% increase. Bioactive peptides in the salmon protein hydrolysate may be playing a significant role in increasing iron uptake from a normal diet.

Serum ferritin levels and the development of metabolic syndrome and its components: a 6.5-year follow-up study.

BackgroundThe aim of this study was to investigate the relationship between changes in serum ferritin concentrations and the development of metabolic syndrome (MetS) and its components over a 6.5 year follow-up period in Finnish adults.MethodsAdults born in Pieksämäki, Finland, in 1942, 1947, 1952, 1957, and 1962 (n = 1294) were invited to health checkups between 1997 and 1998 and 2003 and 2004. All of the required variables for both checkups were available from 691 (53%) subjects (289 men and 402 women). MetS was defined by the National Cholesterol Education Program criteria.ResultsDuring the 6.5-year follow-up period, 122 (18%) subjects developed incident cases of MetS. Increases in serum ferritin levels were significantly higher in both women and men with incident MetS compared with women and men without MetS (p = 0.04, p = 0.03). Also, serum ferritin levels increased significantly less in women in whom the criteria for MetS resolved during the follow-up period (p = 0.01). Increases in serum ferritin levels were significantly lower in women in whom the glucose criterion for MetS resolved, and higher in women for whom the waist criterion developed (p = 0.01 and p <0.001, respectively). Serum ferritin levels decreased significantly more in men in whom the triglyceride criterion for MetS resolved during the follow-up period (p = 0.01). There was a clear and significant correlation between change in serum ferritin level and change in waist circumference both in men and women (p <0.001, p <0.01). In addition, correlations between change in serum ferritin level and change in plasma triglyceride as well as glucose levels were strongly positive in men (p <0.001). There was negative correlation between change in serum ferritin and plasma high density cholesterol level both in men and women.ConclusionsIncreases in serum ferritin over a 6,5 year period are associated with development of MetS in both men and women. Whereas, lower increases in serum ferritin over the same timeframe are associated with resolution of hypertriglyceridemia in men and hyperglycemia in women. Increases in waist circumference was positively correlated with increases in serum ferritin in both men and women.

Changes in Serum Ferritin Concentration during Chemotherapy in Dogs with Multicentric Lymphoma

Changes in Serum Ferritin Concentration during Chemotherapy in Dogs with Multicentric Lymphoma

Serum ferritin and anemia in trained female athletes.

The aim of this study was to establish whether extremely low serum ferritin values in female athletes were associated with indications of iron deficiency anemia and whether serum ferritin values were influenced by the type of training or participants' body size. Hematological data collected during 6 years at the Australian Institute of Sport were reviewed to quantify changes in serum ferritin concentration associated with training and to establish whether decrements in serum ferritin were associated with any change in hemoglobin concentration, mean corpuscular volume, or mean corpuscular hemoglobin concentration. Mean serum ferritin concentrations of 7.5 microg x L(-1) were not associated with any indication of iron-deficiency anemia. Serum ferritin declined by approximately 25% with the onset of rigorous daily training (p < .01) whether training was predominantly weight-bearing or non-weight-bearing. Rowers had significantly higher ferritin concentrations than basketball players of similar stature (p=.02). We conclude that considerable background information such as the stage of training, specific sport, and previous blood results should be sought when interpreting serum ferritin concentrations in female athletes.

Assessment of iron status in association with excess alcohol consumption.

Biochemical evidence of iron overload (transferrin saturation greater than 60% and/or serum ferritin concentration greater than 1000 micrograms/L) was observed in 16% of patients admitted to an alcohol withdrawal unit. No subjects in an age and sex matched control group showed such biochemical changes. Whilst changes in serum ferritin concentration closely correlated with aspartate aminotransferase activity and could be explained by alcohol induced liver damage, the increased transferrin saturation was not similarly explained. In nine patients withdrawal of alcohol resulted in a decrease in transferrin saturation and serum ferritin, the former due to a reduction in serum iron concentration. In patients with high alcohol intake biochemical measures of iron status may be misleading and a decrease in both transferrin saturation and serum ferritin concentration after withdrawal of alcohol may help to rule out the possible diagnosis of hereditary haemochromatosis.

Effects of training on iron status in cross-country skiers.

Haematological changes were studied in cross-country skiers during a 33-week training season (7 h a week). The daily amounts of training were calculated from the duration and the intensity of the exercise and then used to estimate training responses associated with a first order transfer function. The profile of system training responses (STR) was determined by convolution between the amounts of training and a first-order transfer function. Linear regressions were used to determine correlation coefficients between STR and iron status indices. Among the values for the time constants of decay, the one giving the best fit between STR and iron status indices was chosen. A relationship was noted between on the one hand STR and changes in serum ferritin concentration ([FERR]) and on the other hand STR and change in mean cell volume (MCV). The [FERR] was decreased and MCV was increased by training. It is suggested that a decrease in [FERR] could have been related to a decrease in total body iron stores. However, large and rapid changes in [FERR] could not have been a reflection of changes in total body iron stores. Equilibrium between [FERR] and total body iron stores could have been temporarily altered by the effects of training. Moreover, iron stores did not seem to have been sufficiently depleted to restrict erythropoiesis. The MCV increased slightly in response to intense training suggesting that training enhances the proportion of young erythrocytes.

A longitudinal study of serum ferritin concentration during the female adolescent growth spurt.

An 8-year longitudinal study of changes in serum ferritin concentration has been carried out with additional measurements of haemoglobin and serum iron in 39 schoolgirls aged 10 years at entry to the study. This laboratory data was analysed in relation to menarche and stature. The mean serum ferritin concentration declined significantly due to the occurrence of menarch, rather than to a growth spurt and showed the lowest level at the third year after menarche. Thereafter, it increased again. The prevalence of schoolgirls with latent iron deficiency, defined by a low serum ferritin concentration, normal haemoglobin and normal serum iron concentration, also increased after menarche, and reached its highest level (71.8%) at the third year after menarche. Although haemoglobin and iron concentration declined after menarche, these changes were not statistically significant except for haemoglobin at the second year after menarche. These findings show that serum ferritin concentration is a sensitive variable, and indicates that latent iron deficiency follows menarche rather than an increase in height velocity in adolescence.

Body iron stores in patients subjected to surgery of the large bowel.

Iron stores as estimated by serum ferritin concentration were studied in 40 patients subjected to colon surgery in reference to postoperative complications and restoration of iron stores, as well as to dietary and supplementary iron. The results showed that empty iron stores are common in patients subjected to colon surgery; 40 percent of the patients had a total loss before the operation. Preoperatively empty iron stores were associated (P less than .01) with an increased risk of postoperative complications that were not explained by other nutritional parameters. Surgery of the colon did not affect serum ferritin concentration or iron stores acutely or long-term. Intake of dietary iron was determined by food recording for seven days in all patients and was compared to 40 controls. The preoperative hemorrhagia and lower daily intake of dietary iron (8 +/- 3 mg) in the patients than in the controls (14 +/- 4 mg) may explain the empty iron stores. However, patients with normal iron stores also had low amounts of dietary iron (9 +/- 3 mg). In 12 patients with empty iron stores the effects of ferrous sulfate (80 mg Fe++) three times daily for six weeks were studied. The patients responded well to the therapy. It is concluded that preoperatively empty iron stores are common in patients subjected to colon surgery, and that this raises the risk of postoperative complications. Colon operations are not followed by acute or long-term changes in serum ferritin concentration or iron stores. The restoration of iron is achieved by oral iron therapy.

Caisson Disease of Bone

Caisson disease of bone, which may affect compressed air workers and divers, is characterized by regions of bone and marrow necrosis that may lead to secondary osteoarthrosis of the hip and shoulder joints. A review of the pathologic, radiologic, and clinical aspects demonstrated uncertainties in the exact etiology. Early diagnosis is often not possible because of the delayed appearance of radiologic abnormalities. Research into these two aspects of this condition was carried out by the Medical Research Council Decompression Sickness Research Team in Newcastle upon Tyne over a ten-year period (1972 to 1982). Because no suitable animal model exists for the study of this condition, bone and marrow necrosis was produced by embolism of bone blood vessels with glass microspheres. With this model, it was shown that the presence of bone and marrow necrosis could be detected by bone scintigraphy using 99mTc-MDP and by measuring changes in serum ferritin concentration at a much earlier stage than was possible by radiography. However, only the former method has proved useful in clinical practice. Investigations into the etiology of caisson disease of bone have shown evidence for an increase in marrow fat cell size resulting from hyperoxia. This phenomenon may play a role in the production and localization of gas bubble emboli, which are thought to be the cause of the bone and marrow necrosis.

Developmental Changes in Serum Ferritin Concentration of Dairy Calves

Serum ferritin concentration of nursing calves was measured by a two-site immunoradiometric assay to assess developmental changes and to evaluate relationships of serum ferritin with iron-related blood characteristics. Serum ferritin concentration of calves was low at birth and elevated slightly at 3 days of age. From 1 wk of age onward, serum ferritin concentration of untreated calves and calves fed only whole milk for 4 wk decreased and remained low throughout the nursing period. This finding almost coincided with hematological characteristics. However, that nearly normal hematological measures and weight gain persisted and that they did not develop any anemic symptom indicate that serum ferritin concentration is more sensitive than other hematological characteristics to iron depletion. However, serum ferritin concentration of calves administered 130mg of ferrous fumarate (40mg iron) daily from 3 to 22 days of age or injected with 4ml of iron-dextran intramuscularly (400mg iron) at 3 days and 2 wk of age increased sharply just after treatment and persisted high for 2 to 6 wk of age. However, there was large variation between animals for serum ferritin concentration. Thus, it seems likely that serum ferritin concentration is an index for monitoring prelatent iron deficiency of calves.