Difference In Ferritin Levels Research Articles

Tiempo de pinzamiento del cordón umbilical y complicaciones neonatales, un estudio prospectivo

ObjectiveTo assess the effects of early or late clamping of the umbilical cord in term newborns, assessing the levels of hemoglobin, hematocrit, and ferritin, and their correlation with some of the complications. Patients and methodsA prospective study of healthy newborns at term or born by dystotic or eutocic delivery in our hospital between May 2009 until May 2010. Patients were assigned according to the time of clamping, group 1 (<60seconds), group 2 (1 to<2minutes), and group 3 (2 to 3minutes). Laboratory tests were performed at birth and at 48hours of life, assessing the levels of hemoglobin, hematocrit, ferritin, and bilirubin. The risk of polycythemia, respiratory distress syndrome, neonatal phototherapy or admission to the Intensive Care Unit and the hospital stay, were evaluated. ResultsA total of 242 patients were included: group 1 (g1=80), group 2 (g2=31) y group 3 (g3=131). The background maternal and neonatal characteristics were similar in all sets. The first test showed significant differences in ferritin levels in those infants with delayed clamping (g1: 111 mg/dl, g2: 125 mg/dl, g3: 173 mg/dl; p<0.01). In the second analysis the values of hemoglobin (g1: 17.3 g/dl, g2: 18.9 g/dl, g3: 19.2 g/dl; p<0.01), hematocrit (g1: 53.4%, g2: 58%, g3: 59%; p<0.01) and ferritin (g1: 254 mg/dl, g2: 254.7 mg/dl, g3: 313 mg/dl; p = 0.008) were statistically higher in this group. As regards complications, a significant increase was observed in the number of cases of polycythemia symptoms in group 3. ConclusionsThe late cord clamping is associated with an increase in hematocrit, hemoglobin and ferritin at 48hours of life, as well as an increased risk of polycythemia present with symptoms.

The Iron Status of Children and Youth in a Community Mental Health Clinic is Lower than that of a National Sample

Iron plays a key role in brain function, and a deficiency of iron has been implicated in various cognitive, motor, and psychiatric disorders. Because of recent evidence that iron deficiency may be related to attention-deficit/hyperactivity disorder (ADHD) and other psychiatric disorders, the goal of this study was to compare the iron status of children and youth seen in a community mental health clinic with a national sample of same-aged subjects. In this study, a consecutive series of 108 patients (79 males) referred to a community mental health clinic was compared with a National Health and Nutrition Examination Survey (NHANES) sample on measures of iron status. Wilcoxon sign rank and median tests were used to compare distributions of ferritin. Quantile regression was performed to compare the ferritin level in the two samples while adjusting for demographic differences. Chi squared (χ2) was used to compare rates of low hemoglobin in the two samples. The iron status of the clinic sample, as measured by ferritin levels (median=23 μg/L), was significantly lower than that of the national sample (median=43 μg/L). After adjustment for age, gender, and race, the clinic sample was found to have 19.2 μg/L lower ferritin than the national sample (95% CI from 7.6 to 30.9, p value=0.001). There were also significantly more subjects in the clinic sample with low hemoglobin than in the national sample. There were no differences in ferritin levels between those patients in the clinic sample with and without an ADHD or other specific psychiatric diagnosis. The ferritin levels of children and youth in a mental health clinic sample were significantly lower than those of the same-aged subjects in a national sample. Therefore, compromised iron status may be an additional biological risk factor for cognitive, behavioral, and psychiatric problems in pediatric populations served by the community mental health clinic.

Effect of timing of umbilical cord clamp on newborns' iron status and its relation to delivery type.

This study was conducted to evaluate the hematological effects of umbilical cord clamp timing and delivery type in term infants 48 hours after birth in Imam Hossein Hospital, Tehran, Iran. From Oct 2007 - March 2008, 100 mother-infant eligible pairs were selected and divided by cord clamp timing (< or =15 s and >15 s) for hematologic value determination between the two groups. Data analysis was performed with SPSS for Windows statistical package (version 13). Maternal hematological status was assessed upon admission to the delivery room. A total of 100 mother-infant pairs were divided into two groups: delayed cord clamp time within 15 s (n=70) or early cord clamp time [15 s after delivery (n=30)]. The groups had similar demographic and biomedical characteristics at baseline. Forty-eight hours after delivery the mean infant hemoglobin (Hgb; 16.08 gm/dL vs. 14.5 gm/dL; P<0.001) and hematocrit (Hct 47.6 vs. 42.8; P<0.001) levels were significantly higher in the delayed clamping group. There was no significant difference in ferritin levels (214.7 vs. 173.6 ng/dL; P=0.08). Fifty infants were born vaginally and 50 were delivered by cesarean section. Infants delivered vaginally had significantly more delayed cord clamp times (>15 s; P<0.001). Delaying cord clamping increases the red cell mass in term infants. It is a safe, simple and low cost delivery procedure that should be incorporated in integrated programs that are aimed at reducing iron deficiency anemia in infants in developing countries. Vaginal delivery facilitates this action.

Iron Status in Female Athletes Participating in Team Ball-Sports

Iron deficiency anemia is the most prevalent micronutrient deficiency in the world, affecting 20-50% of the world's population. It is estimated that 10 and 20% of male and female athletes are iron deficient, respectively. Iron deficiency has deleterious effects on the physical performance of athletes. It decreases aerobic capacity, increases heart rate and elongates the recovery time after exercise. In this cross-sectional study, 42 semi-professional female athletes who had been playing in basketball, volleyball and handball super league teams served as subjects. Data on socioeconomic and fertility status as well as the type of sport were obtained through a questionnaire. Nutritional data were gathered with a 3 day dietary recall. Total intake of calorie, iron, zinc, folate, vitamin C and B12 were also analyzed. In addition, ferritin and TIBC were measured and a CBC test was done for each subject. The results showed that the mean total calorie intake of women was 2049.79 +/- 735.12 kcal, where their iron intake was 22.33 +/- 9.24 mg day(-1). There was a significant difference between the iron intake of basketball and volleyball players (p = 0.036). Of our subjects, 33.33% had low ferritin levels (< 30 ng mL(-1)) and it was lowest in handball players. Higher than normal ferritin levels were seen in 12.5% of the subjects. We saw a significant difference in ferritin levels of basketball and handball players (p = 0.047). We conclude that the intake of calorie and iron is low in female athletes and therefore, their hematological indices such as ferritin level are below standard values.

Evaluation of Liver Disease in a Cohort of Patients Affected by Thalassemia Intermedia.

Abstract 4064Poster Board III-999 IntroductionLiver disease is the second cause of death for thalassemia major (TM) patients, mainly due to HCV infection and transfusional iron overload. Few data are so far available for thalassemia intermedia (TI) patients who are much less transfused but, because of chronic anemia they have an increased iron absorption. Aimthe aim of this study was to evaluate the prevalence of liver disease and its progression in adult non-transfusion dependent TI patients. Patients and MethodsSeventy adult TI patients (32 female/38 male, aged 42±14 years, range 22-77) regularly cared at Hereditary Anemia Center, University of Milan, were enrolled in this study in 1997 and followed for 10±1 years. Seven patients were lost and 4 died during follow-up. At enrolment (T0) 50 were splenectomized, 51 were occasionally transfused, 46 were irregularly chelated. Twenty-four (34,2%) patients were anti HCV positive of whom 13 (54,1%) were RNA positive. ResultsLiver transaminases were significantly different (p=0.001) among HCV-RNA positive and negative patients (ALT 59,7±32,1 vs 26,9±20,3 U/L; AST 49,1±22,8 vs 30,6±17,0 U/L respectively). Ferritin levels in the overall group were significantly higher than normal values (734±748 ng/ml). No significant difference in ferritin levels was detected among HCV-RNA positive and negative patients, while overall a correlation (r=0.687, p<0.001) between ferritin and ALT was observed. Among HCV-RNA negative patients regularly followed (49), at enrolment 12 (24,4%) had abnormal transaminases. During the follow up 12/37 (32,4%) who had normal transaminases at T0 showed abnormal values, and evaluating the overall HCV-RNA negative group abnormal transaminases were noticed in 24/49 (48,9%). Ferritin levels were increased also at the final observation (T1), but not as much as supposed to be considering the annual increased iron absorption. At T1Transient Elastography (TE), for evaluating liver fibrosis, and MRI T2*, for measuring liver iron, became available thus 42 patients had these evaluations: 9/42 had TE values >7.9 kPa (corresponding to fibrosis stage F≥2 of Metavir), and the mean value was 6,7±6,2 kPa; almost all the patients (39/42 – 92,8%) had significant high level of liver iron concentration (LIC measured through MRI T2*≥2 mg/g d.w.) with a correlation between LIC T2* and Fibroscan values (r=0.489, p=0.003). During the follow up 4 patients died: 1 for stroke and 3/4 for liver disease,(one Hepatocarcinoma (HCC) in HCV-RNA positive patient and 2 decompensated cirrhosis). Other two cases of HCC were observed, one in a patient HCV-RNA positive and 1 in an HCV-RNA negative patient; the latter having significant iron overload (LIC through MRI T2* 23,29 mg/g/dw) and a Fibroscan value diagnostic for cirrhosis (43,5 kPa). ConclusionsLiver disease is the first cause of death in TI patients; 3 cases of HCC were observed in patient aged 49±1 years old of whom 1 without hepatitis viral infection. The liver damage, detected with high levels of ALT and AST in both HCV-RNA positive and negative patients is mainly related to the parenchymal iron overload and HCV infection. Ferritin, commonly used to monitor iron overload, properly reflects the degree of iron concentration in TM, while is inadequate in TI patients because, even though it correlates with LIC, it underestimates the iron overload. Actually in TI patients iron coming from duodenal absorption is mainly stored in parenchymal liver tissue, while in TM it's primarily distributed in the reticulo-endothelial system that stimulate ferritin production. In conclusion it's mandatory the use of other methods to evaluate LIC, such as MRI T2*, and the introduction of regular chelation therapy in the management of TI patients. Disclosures:No relevant conflicts of interest to declare.

Iron and Ferritin Concentrations in Exhaled Breath Condensate of Children with Asthma

Maintenance of iron homeostasis is of utmost importance for the respiratory system physiology and pathophysiology. Local iron deficiency or accumulation may result in particular respiratory function impairment. The aim of the present study was to find out whether iron and ferritin could be determined in exhaled breath condensate (EBC) of healthy children and children with asthma. Oxidative stress was verified by determination of EBC superoxide dismutase (SOD) activity, and the airway inflammatory process by determination of exhaled nitric oxide (FENO). EBC was collected from 39 children (22 healthy children as a control group and 17 asthmatics) using an EcoScreen condenser. Iron, ferritin, and SOD were determined on optimization and validation for low concentrations. In comparison with a control group, asthma patients had a statistically significantly lower iron concentration (p = 0.0001) and higher SOD catalytic activity (p = 0.0160), with no significant difference in ferritin levels (p = 0.5252), although percentile values indicated elevated ferritin concentration in about half of asthma patients. FENO values were significantly higher in the asthma group (p = 0.0047). This preliminary study demonstrated the possibility of determining iron and ferritin concentrations and SOD activity in EBC, and a significant difference in EBC iron and SOD between asthma patients and healthy children.

Red Blood Cell Transfusion Dependence and Outcome after Allogeneic Peripheral Blood Stem Cell Transplantation in Patients with de Novo Myelodysplastic Syndrome (MDS)

The prognosis of patients with de novo myelodysplastic syndrome (MDS) who are red blood cell transfusion-dependent (TD) and receive supportive care is inferior to that of patients who do not require transfusions. Whether TD also affects outcome after allogeneic transplantation is unknown. Consequently, in 172 de novo MDS patients (median age, 51 years), we analyzed the impact of TD on outcome after high-dose conditioning and allogeneic peripheral blood stem cell transplantation (PBSCT). With a median follow-up of 37 months, the probability of 3-year overall survival (OS) did not differ significantly between patients who were TD and those who were not TD before PBSCT (P=.1); however, transfusion burden, as reflected by ferritin levels, was correlated with a greater probability of severe acute graft-versus-host disease (aGVHD; P=.03) and a higher comorbidity index (P=.01), and OS was inferior in those patients with a ferritin level>1000 microg/L before PBSCT (P=.03). In multivariate analysis, only marrow myeloblast count (P=.01) and comorbidity index (P=.001) had a significant impact on OS. Our data do not identify TD as an independent negative prognostic factor for outcome after allogeneic PBSCT' however, iron overload (presumably transfusion-related) may contribute to poor transplantation success by adding to the overall comorbidities. Whether clinical intervention in the form of iron chelation can improve the outcome of allogeneic PBSCT in TD patients with MDS remains to be determined.

Frequency of HFE mutations among Turkish blood donors according to transferrin saturation: genotype screening for hereditary hemochromatosis among voluntary blood donors in Turkey.

The C282Y and H63D mutations of HFE gene are associated with hereditary hemochromatosis (HH), the most common autosomal recessive disorder in European population. This is the first Turkish population study of, the prevalence of these mutations. 2677 healthy volunteer blood donors were screened by means of transferrin saturation (TS) with the cutoff value of 45. As study group, 86 donors with a TS 45 or higher and as control group 57 donors with TS less than 45 were tested for these mutations, ferritin, and alanin aminotransferase (ALT) levels. The mean age of donors were 33+/-9 and 94.1% of them were male. The number of donors with TS 45 or higher was 265 (9.9%). C282Y mutation was not detected. The frequency of H63D mutation in the study, control and general groups were 27.32%, 21.05%, and 24.83%, respectively. As a result, the H63D mutation was present in 60 out of 143 participants in whom 49 were heterozygote (frequency of heterozygote allele 49/286 = 17.13%), 11 were homozygote (frequency of homozygote allele 22/286 = 7.69%). Serum ALT and TS were not affected from the type of H63D mutation. There was no difference in ferritin levels according to type of H63D mutations among 143 blood donors. This study revealed the absence of C282Y mutation in our population. Although the frequency of H63D heterozygosity seems to be higher than the other population, the genetic screening for the HFE gene mutation is inadequate and the phenotypic screening with TS and ferritin seems to be preferable in Turkish population.

The relationship between serum ferritin levels and disease activity in systemic lupus erythematosus

Objective: The aim of this study is to investigate the relationship between serum ferritin levels and disease activity in patients with systemic lupus erythematosus (SLE).Methods: Serum ferritin levels of 72 SLE patients were measured. The SLE patients were subdivided into two groups according to SLE disease activity index (SLEDAI) as ≤10 and ≥11. The results were compared with 31 patients with rheumatoid arthritis (RA). 36 patients among 72 with SLE were evaluated before and after treatment.Results: Serum levels of ferritin in SLE patients were higher than RA patients (p<0,001). There was a significant difference in ferritin levels before and after treatment. The levels of ferritin in SLE were positively correlated with SLEDAI scores. Patients with SLEDAI scores ≥11 had significantly higher serum ferritin levels.Conclusion: Serum ferritin levels may be a useful marker of disease activity in SLE patients.

Serum iron levels in schizophrenic patients with or without akathisia

The pathophysiology of akathisia still remains controversial. Iron deficiency was proposed to be an important factor in the development of akathisia. In the present study, it was aimed to compare levels of serum iron and linked variables in chronic akathisic ( n=30), and non-akathisic patients ( n=30) with schizophrenia and healthy controls ( n=30) because of the controversy in the association of iron and akathisia. The Barnes Akathisia Scale for akathisia and Simpson–Angus Rating Scale for extrapyramidal side effects were used. Serum iron and linked variables and hematological profile of the patients and control subjects were determined. Serum iron levels were significantly lower both in akathisic and non-akathisic groups compared to the control group ( P<0.001). Moreover, akathisic patients had significantly lower iron levels than non-akathisic patients ( P<0.05). Total iron binding capacity was significantly higher in patients with akathisia compared to the control group ( P<0.01). Although non-akathisic patients had a mild increase in total iron binding capacity, it was not statistically significant compared to the control group ( P>0.05). Ferritin levels were determined to be significantly lower in both groups compared to the control group ( P<0.01). In addition, there was a significant difference in ferritin levels between the patients with and without akathisia ( P<0.05). In conclusion, our results support the hypothesis that an association between akathisia and iron metabolism exists.

The place of ferritin among risk factors associated with coronary artery disease

Prospective studies of East Finnish men demonstrated an increased risk of myocardial infarction in association with elevated serum ferritin levels (> or = 200 micrograms/l). The present study was designed to explore whether serum ferritin concentrations are related to angiographically determined coronary artery disease or to a past history of myocardial infarction. We studied 225 men and 74 women, most of them of French-Canadian origin, undergoing elective coronary arteriography, and classified them according to the presence, absence, and severity of angiographic findings. A history of myocardial infarction was defined as clinical and electrocardiographic and/or enzymatic evidence of a myocardial infarction occurring more than 12 weeks previously or akinesia of the left ventricle. Serum ferritin was measured with the Baxter Stratus II immunoassay system. There were no significant differences in ferritin levels between patients with > or = 50% diameter stenosis (195 men, 48 women) and those with intact or minimally affected arteries (31 men, 26 women) either in men or in women. There was no correlation between the quartiles of serum ferritin and the severity of coronary artery disease. There were no differences in ferritin levels in patients with (95 men, 25 women) or without (71 men, 43 women) a history of myocardial infarction. However, serum lipid levels were significantly related to all the above conditions. In a French-Canadian population, serum ferritin levels, unlike serum lipids, were not related to the presence or severity of angiographically determined coronary artery disease, nor to a history of myocardial infarction.

Plasma ferritin in old age. Influence of biological and pathological factors in a large elderly population

The effects of biological (age, sex, weight) and pathological factors on plasma ferritin concentrations were documented in 776 unselected elderly patients aged 80.9 ± 9.7 yr. A marked shift towards high values (159 ± 142 μg/l) was observed in this elderly population together with the persistence of the well-known sex-related difference in ferritin levels (higher levels in men). Twenty-five percent of the population had high levels of ferritin (⩾ 220 μg/l) but 75% of these high values (i.e. 18.5% of the population) could be readily explained by their known association with a particular pathology (inflammatory syndrome, renal failure, cardiovascular diseases, alcoholism). Only 6% of the population had unexplained high ferritin concentrations. Therefore, our data strongly suggest that the repeatedly reported increase of ferritin in the aged population is merely related to an age-associated pathology and may not be a normal physiological event occurring during the process of aging.