Elevation Of Serum Ferritin Levels Research Articles

Dietary iron intake aggravates dyslipidaemia by elevating ferritin levels in patients with insulin resistance and cardiovascular diseases: A cross-sectional study

AbstractDietary iron intake causes the elevation of ferritin levels, and higher iron intake might improve insulin resistance and cardiovascular diseases. The aim of this study was to determine the relationship between dietary iron intake and serum ferritin levels, insulin resistance, and nutritional status in patients with cardiovascular disease. Health information of individuals were obtained with a questionnaire form. There were a total of 103 patients, 59 male (57.3%) and 44 female (42.7%). Patients also filled a questionnaire on dietary habits, a 3-day food record. There was a statistically significant difference between ferritin quartiles and total cholesterol, HDL-C, non-HDL-C, LDL-C/HDL-C ratio, and TG/HDL-C ratio (P < 0.05). Study data show that dietary iron intake was associated with the elevation of serum ferritin levels (P < 0.05) and this difference was significant in Q1 and Q4 groups in post-hoc analysis. There was a negative correlation between serum ferritin levels and total cholesterol and HDL-C in patients with insulin resistance (r = −0.384, P < 0.05; r = −0.520, P < 0.05). In conclusion we found a strong association between serum ferritin levels and inflammation, causing an oxidative stress, atherosclerosis, and bringing along cardiometabolic diseases such as cardiovascular diseases and type 2 DM.

Can ferritin be a surrogate marker for CD4 cells in human immunodeficiency virus patients? A cross-sectional study of association of serum ferritin levels with immunological staging of human immunodeficiency virus patients.

The human immunodeficiency virus (HIV)/AIDS in India came into public view in 1986 with the detection of the first case of HIV in Chennai, Tamil Nadu, and the first AIDS case in Mumbai, Maharashtra in 1987. In acute phase response, iron distribution occurs in the liver and mononuclear phagocytic system. A high prevalence of elevated serum ferritin levels is reported in HIV infection and serum ferritin levels increase with the clinical worsening of infection and with decreasing CD4 lymphocyte counts. This study is designed to find the role of acute phase reactant serum ferritin in the progression of the disease of HIV which is complicated by opportunistic infections, by finding the correlation of serum ferritin with immunological stages of HIV. This cross-sectional study was conducted on 75 patients admitted to various wards of the Department of Medicine or attending medicine outdoor or ART Centre, Maharana Bhupal Government Hospital, RNT Medical College Udaipur. Serum ferritin, total iron binding capacity, and total serum iron were analyzed in Cobas® analyzer. CD4 cells are measured using the flow cytometry technique. The results were tabulated and subjected to statistical analysis. There was a negative correlation among serum ferritin and CD4 cells with r = -0.195 which was statistically significant (P < 0.05). As the CD4 cell count decreased incidence of serum ferritin increased. Elevation of serum ferritin levels is associated with a low count of the CD4+ in HIV-diagnosed patients. In a patient diagnosed with HIV, elevated serum ferritin indicates underlying inflammatory pathology. Serum ferritin can be used as a guide to further evaluation of underlying disease in HIV patients.

Evaluation of serum ferritin levels in patients of hypertension

Elevation of serum ferritin levels leads to serious complications. Increased serum ferritin levels leads to increased oxidative stress, further leading to inflammation, endothelial damage and consequently increasing the risk of hypertension.The aim of the present study was to estimate and compare serum ferritin levels in the hypertensive patients and control group.The present study was a hospital-based observational and analytical study. The study was conducted over a period of 1 year on 102 patients. The study group comprised of 51 patients (diagnosed with hypertension), and the control group comprised of 51 (age and gender matched) individuals. The levels of serum ferritin were analysed by the Sandwich ELISA method. The results of the present study show that, the mean value of serum ferritin was 293.27±219.84 ng/ml in study group and 72.23 ± 29.75 ng/ml in control group. The mean SBP was 151.45 ± 14.77 mm/Hg in study group and 109.88 ± 5.43 mm/Hg in control group. The mean DBP was 95.56 ± 7.46 mm/Hg in study group and 72.43 ± 2.97 mm/Hg in control group. The results of the present study indicate that the difference between the mean serum ferritin and mean SBP, mean DBP among the study group and control group was found to be significant statistically (p=&amp;#60;0.05).The present study concluded that there exists a positive correlation between the mean serum ferritin levels and hypertension among the study group (patients with hypertension).

Elevation of serum ferritin levels for predicting a poor outcome in hospitalized patients with influenza infection

ObjectivesThere is increasing evidence that ferritin is a key marker of macrophage activation, but its potential role in influenza infection remains unexplored. Our aim was to assess whether hyperferritinaemia (ferritin ≥500 ng/mL) could be a marker of poor prognosis in hospitalized patients with confirmed influenza A infection. MethodsWe prospectively recruited all hospitalized adult patients who tested positive for the influenza A rRT-PCR assay performed on respiratory samples in two consecutive influenza periods (2016–17 and 2017–18). Poor outcome was defined as the presence of at least one of the following: respiratory failure, admission to the intensive care unit, or in-hospital mortality. ResultsAmong 494 patients, 68 (14%) developed poor outcomes; 112 patients (23%) had hyperferritinaemia (39/68, 57% in the poor-outcome group versus 73/426, 17% in the remaining patients, p < 0.0001). Median serum ferritin levels were significantly higher in the subgroup of patients with poor outcomes (609 ng/mL, range 231–967 versus 217 ng/mL, range 140–394, p < 0.0001). In multivariate analysis, hyperferritinaemia was associated with a five-fold increase in the odds ratio of developing poor outcome. After adjusting for classic influenza risk factors, ferritin remained as a significant predictive factor in all exploratory models. Ferritin levels had a good discriminative capacity with an area under the ROC curve of 0.72 (95% confidence interval (CI) 0.65–0.8, p < 0.001) and an overall diagnostic accuracy for predicting poor outcome of 79.3% (95%CI 75.4–82.7%). ConclusionsSerum ferritin may discriminate a subgroup of patients with influenza infection who have a higher risk of developing a poor outcome.

Serum ferritin level is associated with liver steatosis and fibrosis in Korean general population.

Elevation of serum ferritin levels is frequently observed in non-alcoholic fatty liver disease (NAFLD) patients. Our study aims to examine the association between serum ferritin levels and NAFLD in Korean population. A total of 25,597 participants were selected from Korean National Health and Nutritional Examination Surveys 2007-2012. The NAFLD liver fat score (NLFS) was used to define NAFLD. Elevation of ALT levels was defined as ALT level > 40IU/L for male and ALT level > 31IU/L for female. Multiple logistic regression was used to examine the association of serum ferritin levels and NAFLD by sex. After adjusting for multiple covariates, the ORs (95% CI) of the elevated ALT levels were 1.56 (95% CI: 1.17-2.07), 1.84 (95% CI: 1.39-2.45), and 4.08 (95% CI: 3.08-5.40) for the second, third and fourth serum ferritin quartiles in male (p for trend < 0.01), 1.67 (95% CI: 1.24-2.23), 2.23 (95% CI: 1.68-2.96), and 5.72 (95% CI: 4.32-7.60) for the second, third and fourth serum ferritin quartiles in female (p for trend < 0.01). Serum ferritin levels were also significantly associated with NAFLD and liver fibrosis both in male and female. Elevation of serum ferritin level is significantly associated with NAFLD and blood ALT elevation in Korean general population.

An Elevation of Serum Ferritin Level Might Increase Clinical Risk for the Persistence of Patent Ductus Arteriosus, Sepsis and Bronchopulmonary Dysplasia in Erythropoietin-Treated Very-Low-Birth-Weight Infants

Background: The substantial risk of iron overload is not routinely monitored in most of the neonatal intensive care units (NICUs) in Japan; however, blood transfusion is an essential strategy for successfully treating preterm low-birth-weight infants. Objective: The aim of this study was to investigate the iron status and clinical features of infants with a birth weight of <1,500 g, i.e. very-low-birth-weight infants (VLBWIs). Methods: This prospective observational study enrolled 176 (82.6%) patients from a total of 213 VLBWIs admitted to our NICU from 2009 to 2014. Clinical information was collected including maternal records and infant morbidity and treatment. Management strategies including enteral iron supplementation, erythropoietin administration and blood transfusion were allowed according to the consensus in Japan. The hematological status was surveyed from birth to 12 postnatal weeks of age. The iron status was determined according to serum iron, unbound iron-binding capacity and serum ferritin. The definition of hyperferritinemia was set as a value of ≥500 ng/ml. Results: Twenty-four (13.6%) infants displayed hyperferritinemia. A multiple logistic analysis selected 3 associated factors of hyperferritinemia: surgical ligation for patent ductus arteriosus, sepsis and moderate or severe states of bronchopulmonary dysplasia. We also verified that the value of ferritin was significantly correlated with those of aspartate transaminase, creatine kinase and C-reactive protein according to a multilinear regression analysis. After excluding the ferritin data of these outliers, we did not observe any factors associated with hyperferritinemia. Conclusions: Hyperferritinemia might be associated with oxygen radical diseases and susceptibility to infection.

Serum ferritin levels as a useful diagnostic marker for the distinction of systemic juvenile idiopathic arthritis and Kawasaki disease

Objectives: The clinical features and laboratory parameters of patients with Kawasaki disease (KD) and systemic juvenile idiopathic arthritis (s-JIA) tend to overlap. Furthermore, there have been no definitive biomarkers for these diseases, making clinical diagnosis difficult. The purpose of this study was to investigate the diagnostic value of serum ferritin levels for differentiating KD from s-JIA and predicting the disease severity of KD.Methods: We analyzed 228 patients with KD and 81 patients with s-JIA. Serum ferritin levels were compared between patients with s-JIA and KD. Furthermore, serum ferritin levels in patients with KD were compared with respect to clinical features such as responsiveness to intravenous immunoglobulin (IVIG) therapy.Results: Serum ferritin levels in KD patients with no response to IVIG therapy were significantly higher than those in KD patients with a good response to IVIG therapy. Serum ferritin levels in patients with KD needing plasma exchange (PE) were significantly higher than those in patients not needing PE. However, serum ferritin levels overlapped between severe KD patients with nonresponsiveness to IVIG therapy or needing PE and other patients with mild KD. Furthermore, patients with s-JIA showed a distinct elevation of serum ferritin levels compared with KD patients. The cutoff value of serum ferritin levels for differentiating KD from s-JIA was 369.6 ng/ml.Conclusions: Serum ferritin levels were significantly elevated in s-JIA patients compared with KD patients. Measurement of serum ferritin levels can be useful for differentiating s-JIA from KD.

Meta-analysis of the relationship between amyotrophic lateral sclerosis and susceptibility to serum ferritin level elevation.

Objective:To study the possible relationship between amyotrophic lateral sclerosis (ALS) patients and their susceptibility to serum ferritin level elevation.Methods:We searched the PubMed, Springer, Medline, and OVID databases for any-language original research articles relating to serum ferritin levels in ALS patients published between June 2005 and June 2015. The search term used with ‘amyotrophic lateral sclerosis’, ‘ferritins’, ‘ferritin’, ‘iron’, ‘iron stores, ‘iron status, ‘iron intake’, and ‘iron consumption’. The meta-analysis software RevMan 5.0 was used for the heterogeneity test, and to test for the overall effect.Results:Six case-control studies met our inclusion criteria including data from a total of 1813 participants. The mean difference of serum ferritin levels comparing ALS to healthy controls was 69.05 (95% confidence interval: 52.56-85.54; p<0.00001); heterogeneity: p=0.03; I2=50%. The findings indicate homology in the sensitivity analysis. Funnel plot assessment indicated publication bias.Conclusion:Our results suggest that ALS is positively associated with susceptibility to the elevation of serum ferritin levels; however, further evidence is required to support this.

Role of L-Carnitine in Treatment of β-Thalassemia Major Disease

β-thalassemia syndromes are a group of hereditary disorders characterized by a genetic deficiency in the synthesis of β-globin chains. L-Carnitine is often sold as a nutritional supplement. L-Carnitine has been proposed as a treatment for many conditions because it helps reducing oxidative stress. This study was carried out on 30 β-thalassemia major patients (15 females), aged from 1.3 to 14 years old and their weights ranged from 7 kg to 32 kg; collected from hematology clinic at Beni Suef University Hospital. Group A received dose 100mg\kg\day, group B received dose 50mg\kg\day, control group received L-Carnitine but with an inadequate dose or in irregular manner. Patients were represented to full history taking, clinical examination, laboratory investigations and determination of blood transfusion frequency on admission and every month for six months. There was an improvement in general health of children after therapy, an improvement in pallor, decreasing in elevation of serum ferritin level, decreasing in blood transfusion times, increasing in blood transfusion intervals and increasing in hemoglobin level. The increase in Reticulocyte count% (retics count %) was in all groups, more in control group, but still with no significant difference between the three groups. Using of dose 100mg\kg\day of L-Carnitine showed more improvement than dose 50mg\kg\day in pallor and laboratory findings except retics count % and more effective in reduction of times of blood transfusion.

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Regulatory failure of serum prohepcidin levels in patients with hepatitis C

Elevated serum ferritin and hepatic iron concentrations are frequently observed in chronic hepatitis C (CHC), which may be related to hepcidin. Because the role of hepcidin in CHC patients remains unknown, we aimed in this study to generate some information about hepcidin in CHC. To determine whether serum hepcidin correlates with markers of iron status in patients with viral hepatitis, we measured serum prohepcidin levels in patients with hepatitis C virus (HCV) and hepatitis B virus (HBV) infection and in healthy controls. Serum prohepcidin and ferritin levels were negatively correlated (r=-0.182, P=0.037) in HCV patients and positively correlated in HBV patients and in healthy controls. The total iron scores in liver specimens from HCV patients were also negatively correlated (r=-0.403, P=0.013). Serum prohepcidin levels in patients with liver cirrhosis (LC) were significantly lower than in patients with chronic hepatitis (CH). In both CH and LC patients, serum prohepcidin levels were significantly lower in HCV patients than in HBV patients. Failure of homeostatic regulation of serum prohepcidin concentrations may be induced by HCV infection, resulting in elevation of serum ferritin levels, which leads to the progression of liver injury by iron overload in CHC patients.

Differential diagnosis of West Nile encephalitis.

This article reviews recent developments in West Nile encephalitis. Because of the large number of individuals infected in the United States, an expanded spectrum of the disease has been recognized. Flaccid paralysis presenting as poliomyelitis-like syndrome is being increasingly recognized. Since 1999, West Nile encephalitis in the United States has involved thousands of patients providing an opportunity to observe the protean manifestations of the virus. Recently, ophthalmological manifestations have been described that appear to be common and specific for the virus. Clinicians in endemic areas should be careful to distinguish between West Nile encephalitis and its mimics. The virus may occur in patients with underlying disorders that have encephalopathy as a clinical feature, and clinicians should test for the virus during the mosquito season, even in patients that appear to have an explanation for their encephalopathy. West Nile encephalitis may present as viral aseptic meningitis, meningoencephalitis, or encephalitis. Muscle weakness may or may not accompany any of these clinical variants. This virus may be transmitted via blood transfusion. Clinical manifestations of West Nile encephalitis continue to expand following each year's outbreaks. New neurologic and ophthalmologic manifestations continue to be described. Because of the protean manifestations, testing should be carried out during mosquito season, even in patients that have another explanation for their encephalopathy. There is no effective therapy. Flaccid paralysis may be prolonged/permanent. Prognosis may be related to the degree of relative lymphopenia on presentation, the degree of elevation of serum ferritin levels and advanced age. The course of West Nile encephalitis and its clinical manifestations are the same in normal and compromised hosts.

Serum ferritin in ascorbic acid deficiency.

Summary Serum ferritin levels were monitored in guinea‐pigs rendered scorbutic by dietary deprivation of ascorbic acid (AA). Hepatic and splenic concentrations of AA fell rapidly during the first 8 d of deprivation, and then declined more slowly to reach approximately 10% of control values after 14 d. Normal levels of serum ferritin (geometric mean, 324 μg/1) were observed for 20 d but a significant fall occurred between days 20 and 23 of deficiency (143 γg/1; P&lt;0·05).Intramuscular administration of iron dextran to scorbutic animals (75 mg Fe per kg body weight) resulted in a non‐significant elevation of serum ferritin levels (geometric mean, 470 μg/1; P&gt;0·1). In control animals, the same dose of iron dextran caused a 10‐fold rise in serum ferritin levels (3400 μg/1). A single subcutaneous dose of AA (75 mg/kg weight) given to scorbutic animals caused a significant rise in serum ferritin levels to 599 μg/1 (P&lt;0·001) but had no effect in control animals. The same dose of AA given to iron loaded, scorbutic animals elevated serum ferritin levels from 554 μg/1 to 1297 μg/1 (P&lt;0·025).Thus, AA deficiency in guinea‐pigs caused serum ferritin levels to fall and blocked the rise in serum ferritin levels observed in response to acute iron loading in control animals. Adequate tissue concentrations of AA appeared to be necessary for the maintenance of a quantitative correlation between tissue iron stores and serum ferritin levels. The mechanisms by which AA influences serum ferritin levels are at present unknown.