Ferritin Group Research Articles

Association between breakfast skipping and blood levels of lead and cadmium in children and adolescents aged 6–17 years: Results from the National Health and Nutrition Examination Survey 2013–2018

IntroductionPrevious research suggests that fasting increases lead absorption in the gastrointestinal tract, and that regularly eating meals may reduce blood lead. However, there is insufficient evidence linking breakfast status and blood-metal levels in children. We assessed the cross-sectional association between breakfast consumption status and children and adolescent’s blood levels of lead and cadmium. We also explored blood hemoglobin, serum ferritin, and age group as potential effect modifiers of these associations. MethodsThis analysis included children and adolescents aged 6–17 years who participated in the National Health and Nutrition Examination Survey (NHANES) cycles 2013–2018 with complete data on breakfast consumption status (consumers vs. skippers), blood metals, and covariates (N=3722). Blood metal variables were log-transformed. Crude and covariate-adjusted, survey-weighted linear regression models were conducted for each blood metal outcome. Potential effect modification was explored using stratification. ResultsOverall fewer participants reported skipping breakfast (n=719) than eating breakfast (n=3003). Mean (SE) concentrations of blood lead and cadmium (µg/L) were 0.63 (0.01) µg/dL and 0.13 (0.00) µg/L, respectively. Children and adolescents who skipped breakfast were more likely to be female (51.2%), older (mean 12.2 years, SE = 0.1), have a higher body mass index (mean 22.8 kg/m2, SE = 0.2), and a lower income-poverty ratio (mean 1.7, SE = 0.1) than breakfast consumers. No associations between breakfast consumption and any of the blood metals were found. When stratified by age (≤ 10, 11–13, and 14–17 years), children aged 11–13 years who consumed breakfast had lower log-transformed blood lead levels [β = −0.14 µg/L; 95% CI: (-0.25, −0.03)] compared to children of the same age who skipped breakfast. ConclusionChildren 11–13 years-old who were breakfast consumers had lower blood lead levels compared to children of the same age who skipped breakfast. Our results support that encouraging breakfast consumption among school-age children may contribute to lower blood lead levels.

Correlation of 25-Hydroxyvitamin D Deficiency with Ferritin, Thyroid-Stimulating Hormone, and Other Biochemical Parameters of Women in Baghdad Province

Abstract Background: The importance of vitamin D in facilitating the absorption of calcium and phosphorus from the intestines and maintaining appropriate levels of these minerals in the blood for normal bone mineralization is well-established. Objectives: Beyond its role in bone health, vitamin D has been shown to exert a significant influence on various biochemical processes and may impact the development of certain diseases, including infections, obesity, heart disease, and certain cancers. This study aimed to investigate the differences in vitamin D levels among women from Baghdad province and its potential associations with ferritin and thyroid-stimulating hormone (TSH). Materials and Methods: This cross-sectional study involved 171 apparently healthy women, categorized into two age groups: the menstrual age group (group A, mean age 36.4 ± 9.2) and the menopausal age group (group B, mean age 57.7 ± 8.4). Vitamin D levels, serum ferritin levels, and hemoglobin levels were assessed to understand the interplay between these parameters. Results: The results revealed that both groups exhibited low levels of vitamin D (group A: 916.56 ± 8.33; group B: 16.86 ± 10.45), low serum ferritin (group A: 11.9 ± 10.66; group B: 28.2 ± 13.67), and low hemoglobin levels (group A: 10.97 ± 1.74; group B: 11.42 ± 1.68). Notably, the results observed no significant differences in all studied parameters between these groups, except for serum ferritin (P < 0.05). Additionally, the finding demonstrated a significant positive association between vitamin D and serum ferritin levels in both groups (group A, r = +0.569, P < 0.000; group B, r = +0.405, P < 0.01). Also, there was a significant moderate positive correlation between vitamin D and hemoglobin levels (group A, r = +0.43, P < 0.001; group B, r = +0.312, P < 0.04). However, no significant correlation was found between vitamin D and TSH, urea, and creatinine levels. Conclusion: The implications of this study suggest that vitamin D deficiency may serve as a useful predictor and have an adverse effect on anemia in women.

Human-Beta-Defensin-1, Ferritin, Interleukin-6 and their Relationship with Clinical and Laboratory Parameters of the Severity of the Tuberculosis Process

Establishing relationships between clinical and laboratory parameters, such as general patient’s state, parameters of complete blood count and blood biochemistry and markers of the course of tuberculosis in the future can be used to predict the severity of dysfunction of various organs and tissues in patients with tuberculosis and in particular in patients who receive anti-tuberculosis treatment. Objective — to investigate the relationship between biochemical markers, namely Human-beta-defensin-1, ferritin and interleukin-6, and clinical and laboratory indicators of the severity of the tuberculosis process. Materials and methods. 100 patients diagnosed with pulmonary tuberculosis were included in the study. After receiving 60 doses of anti-tuberculosis treatment, the patients were retrospectively divided into 2 groups. Group 1 (n = 77) consisted of patients in whom sputum conversion was observed after 60 doses of treatment, determined by sputum microscopy. Group 2 (n = 23) comprised patients in whom bacterial secretion was maintained after 60 doses of treatment, as detected by microscopy. In addition to the routine studies provided for the monitoring of patients with tuberculosis by the current orders of the Ministry of Health of Ukraine, the levels of Human-beta-defensin-1, ferritin and interleukin-6 (IL-6) in the fasting blood were additionally measured by ELISA at the beginning of treatment and after 60 days. Statistical data processing was carried out using the Statistica 8.0 software environment. Results. A comparison of the investigated parameters between groups at the beginning of treatment showed significantly higher values of Human-beta-defensin-1 (Group 1 — (18.97 ± 2.42) pg/ml, Group 2 — (55.02 ± ± 15.69) pg/ml), ferritin (Group 1 — (94.86 ± 6.02) ng/ml, Group 2 — (141.61 ± 24.66) ng/ml) and IL-6 (Group 1 — (80.33 ± 5.03) pg/ml, Group 2 — (110.13 ± 10.35) pg/ml) in patients with positive sputum micros­copy after 60 doses of treatment, p < 0.05. All studied markers demonstrated a reliable positive relationship with the massiveness of bacterial excretion, a conditional indicator of the severity of clinical symptoms and signs, ESR and urea level, as well as reliable negative correlations with creatinine level. In addition, patients with a lower body mass index were found to have higher levels of Human-beta-defensin-1 and ferritin. Higher levels of Human-beta-defensin-1 and ferritin are associated with lower hemoglobin levels (Human-beta-defensin-1 was also negatively correlated with erythrocyte count). An increase in the leukocytes level is accompanied by a significant increase in the level of Human-beta-defensin-1 and IL-6. Additionally, a significant negative correlation was found between the level of glucose and ferritin, as well as between the level of bilirubin and ferritin and IL-6. Conclusions. The determined significantly higher levels of Human-beta-defensin-1, ferritin and interleukin-6 in patients in whom sputum microscopy was positive after 60 doses of treatment allow considering the investigated biochemical parameters as markers of the ineffectiveness of anti-tuberculosis therapy. The identified positive relationships with the severity of clinical symptoms indicate the possibility of using the studied parameters as markers of the severity of the tuberculosis course. The possibility of using Human-beta-defensin-1 and ferritin as markers of anemia was also found. Correlations with parameters of blood biochemistry allow us to talk about increased levels of Human-beta-defensin-1, ferritin and interleukin-6 against the background of kidney damage.

Impact of Magnesium and Ferritin Deficiency on Depression Among Adolescent Students.

Depression is considered the fourth-leading cause of health problems. It is the fourth-leading cause of health problems and disability, which causes 16% of the worldwide burden of disease and injury among adolescents. The aim of the present study was to evaluate the possible association of magnesium (Mg) and ferritin deficiency with depression in adolescent students. This case control study in secondary schools at Al-Ghanayem discrete. The total number included was 358 students. All were screened for depression by the Arabic version of the Beck questionnaire. The students who had positive score was selected as cases 86 and a matched same number of students with negative score was selected as controls. Serum level of ferritin and magnesium was measured in the 2 groups. There was statistically significant difference between the studied groups when comparing depression grade with each of ferritin and Mg Depressed group cases had lower mean values of ferritin and Mg. The ferritin cut-off level for the prediction of depression was (35.5 μg/dL, which had a sensitivity of 74.4% and a specificity of 75.6%. The magnesium cut-off levels for the prediction of depression were1.95 mg/dL and 104.5 ng/dL which had a sensitivity of 70% and 64%, respectively. There was a statistically significant negative correlation between depression severity and each of socio-economic status ferritin and Mg. Each of ferritin and Mg were predictors for depression.

Clinical significance of serum levels of ferritin, interleukins 6 and 17A in rheumatoid arthritis

Rheumatoid arthritis (RA) is characterized by significant clinical polymorphism. To optimize the treatment of RA, it is necessary to develop a personalized approach based on the determination of the value of various biomarkers in the clinical course of RA. The aim of this work was to determine the levels of proinflammatory cytokines and ferritin in RA and to establish their effect on the clinical course of RA. Methods. The object of the study was 62 patients with RA and 33 healthy volunteers. Serum levels of interleukin 6 (IL-6), interleukin 17A (IL-17A), and ferritin were determined. The study of the interrelationships of the studied indicators with clinical and laboratory-instrumental parameters was carried out. Results. The study found an increase in the levels of cytokines IL-6 and IL-17A, as well as ferritin in RA compared with the control group (p<0.05). Subsequently, all patients were divided into three groups depending on the level of ferritin established in the study. The presence of differences in the main clinical and immunological parameters between the groups was analyzed. Differences in CRP levels were found between the study groups, it was the lowest in the low ferritin group compared to the other two groups (p<0.05). The levels of IL-17A and IL-6 did not differ between the groups (p>0.05). Conclusions. Serum ferritin is a promising and affordable biomarker in RA and can be used for personalized assessment of the condition of a patient with RA, differential diagnosis of anemia, and risk assessment of macrophage activation syndrome. The pathogenetic pathways of ferritin regulation in RA require further study.

Serum Hepcidin Is an Early Predictor of Iron Depletion in Non-Anemic Blood Donors

Introduction Iron deficiency is one of the major concerns in repeated whole blood donors. Although taking iron supplementation, frequent whole blood donors sometimes suffer from iron depletion which contributes to adverse impact on donor's health and may reduce the donor blood pool. Laboratory parameters identifying iron depleted status could help early recognize donors at risk of iron deficiency. Hepcidin is a key iron regulator, which blocks ferroportin to inhibit iron absorption and iron release from hepatocytes. In iron depletion, hepcidin down regulates to encourage iron absorption. Previous data reported that serum hepcidin at less than 10 ng/mL was significantly associated with iron deficiency. According to the biological function and physiological response of hepcidin, we hypothesize that hepcidin could be an early predictor of iron deficiency status in non-anemic individuals. Methods This cross-sectional study was conducted at the Blood Bank Center at Chiang Mai University Hospital, Chiang Mai, Thailand in May 2023. After the informed consent was obtained, ninety-seven healthy repeated whole blood donors who had donated blood at least twice in the past year were recruited. The medical records were reviewed. Basic characteristics and laboratories including complete blood count, reticulocyte indices, iron parameters, and serum hepcidin were evaluated. Donors who had serum ferritin level less than 30 and 30-100 ng/mL were categorized as iron deficiency, and low ferritin group, respectively. Those who had ferritin more than 100 ng/mL were the control group. Logistic regression analysis was done to determine the value of serum hepcidin in predicting iron deficiency status in each group. Results The total of 97 repeated whole blood donors were recruited, 48 (49.5%) were women. Mean age was 34.6 ± 10.7 years. There were 8 donors in the iron deficiency group, 38 in the low ferritin group, and 51 donors in the control group. Mean hemoglobin levels were 13.4 ± 1.1, 13.8 ± 1.2, and 14.2 ± 1.2 g/dL in the iron deficiency, low ferritin group and control, respectively, (p = 0.796). White blood cell and platelet count were not different in these groups. Similarly, red cell indices including mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), and reticulocyte indices showed no difference among groups. Serum hepcidin had a significant difference between the three groups. Median levels of hepcidin were 2.61 (1.37, 3.4) and 12.35 (10.12, 15.57) ng/mL in the iron deficiency and the low ferritin group, respectively, compared to 26.01 (21.36, 39.08) ng/mL in the control group, (p < 0.001). Low serum hepcidin (less than 10 ng/mL) were found in 14 (36.8 %) donors who had ferritin levels less than 100 ng/mL, compared to only 1 (2.4%) donor in the control group, (p < 0.001). In addition, serum hepcidin showed a strong correlation with ferritin levels (r = 0.779). Logistic regression model showed that only female sex (OR: 2.87; 95% CI: 1.26, 6.56) and hepcidin (OR: 0.76; 95% CI: 0.66, 0.86) were significant predictors of repeated donors who were at risk of iron depletion and had the ferritin levels less than 100 ng/mL. Conclusions Frequent blood donors are at risk of iron depletion. Serum hepcidin was a significant predictor of iron depleted status in non-anemic donors. Serum hepcidin also showed a significant correlation with ferritin levels. The downregulation of serum hepcidin was detected prior to the changes of red blood cell indices and reticulocyte responses. Early recognition and identification of donors at risk of iron depletion and prompt iron restoration are the key to ensuring the donor safety and preserving adequate blood donor pool.

Prognostic Value of Ferritin in ASCT MM Patients: Integration with GEP Models and ISS Series Systems

INTRODUCTION Ferritin is associated with myeloma poor prognosis, but it was never included into current myeloma prognostic models. Here, we conducted an analysis of individual data from 3446 consecutive patients with multiple myeloma (MM) who received autologous stem cell transplantation (ASCT) therapy. The median follow-up time was 87.2 months (Q1: 44.1 months, Q3: 137.2 months). Using multivariate Cox regression analysis, we determined that serum ferritin was an independent risk factor for MM. We further investigated the prognostic effect of ferritin in the context of gene expression profiling (GEP) models and the different ISS series systems (including ISS, R-ISS, and R2-ISS). Our study showed that 39.5% of MM patients had high (above the normal range) serum ferritin levels. High serum ferritin was an independent poor prognostic factor regardless of age, gender, race, treatment modality, all GEP models and most of the ISS series system stages. ISS I&II patients with high ferritin should have a higher risk score, while R-ISS and R2-ISS III patients with normal ferritin should have a lower risk score than in their original scoring systems. Furthermore, ferritin's prognostic role was also explored in a dataset comprising 708 non-transplanted MM patients. METHODS We conducted an analysis of individual data from 3446 consecutive patients with multiple myeloma (MM) who received autologous stem cell transplantation (ASCT) therapy. Data analyzed included serum ferritin and other parameters such as gender, race, age, albumin (ALB), beta-2-microglobulin (B2M), lactate dehydrogenase (LDH), triple color interphase fluorescence in-situ hybridization (TriFISH), and gene expression profiling (GEP) scores. Serum ferritin was included in a multivariate Cox regression analysis and was identified as an independent prognostic factor. We further investigated the prognostic effect of ferritin on the different stages of the ISS (including ISS, R-ISS, and R2-ISS) and GEP models. Furthermore, we validated ferritin's prognostic role in a dataset comprising 708 non-transplanted MM patients. RESULTS Our study showed that 39.5% of MM patients had high serum ferritin levels. High serum ferritin (≥ 336mg/L for males and ≥ 306mg/L for females) had a hazard ratio (1.90, 95%CI: [1.75, 2.07] for overall survival and 1.74, 95%CI: [1.69, 1.81] for progression-free survival. The group with high ferritin levels had a median progression-free survival (PFS) of 40.5 months, whereas the normal ferritin group had a median PFS of 87.5 months. High serum ferritin was an independent poor prognostic factor regardless of age, gender, race, treatment modality, most of the ISS series system stages, and all GEP models. ISS I&II patients with high ferritin should have higher risk score, while R-ISS and R2-ISS III patients with normal ferritin should have lower risk score. And in a 708 non-transplant MM cohort, ferritin's prognostic role was also explored combine with demographic variables and ISS system. CONCLUSIONS Serum ferritin is a reliable prognostic factor for patients with MM and, therefore, should be routinely performed. Based on our findings, we recommend incorporation of ferritin into the ISS series models

The Effect of Ferritin Level on Respiratory Functions in Patients with β-Thalassemia Major

Introduction-Purpose β-thalassemia major (β-TM) is an autosomal recessive disorder caused by mutations in the β-globin gene of hemoglobin. The disease is characterized by splenomegaly due to ineffective erythropoiesis, iron accumulation signs in tissues as a result of increased iron absorption, bone expansion due to increased erythropoietic activity, and decreased tissue oxygenation. One of the effected organ can be the lungs due to excessive iron deposition in these patients. The current study aimed to investigate the effect of serum ferritin level, which is known as a marker of iron accumulation in tissues, on pulmonary function tests (PFT) in patients with β-TM. Methods and Materials Patients aged ≥6 years who were regularly followed in the pediatric hematology section of Mersin City Research and Training Hospital with a diagnosis of β-TM were included. All patients received regular blood transfusion and iron chelation therapy. Study participants underwent PFT prior to blood transfusion in the pediatric pulmonology section Results A total of 43 patients with β-TM were studied. Included patients were divided into two groups according to the mean annual ferritin level; low ferritin group if below 2000 ml/ng and high ferritin group if above 2000 ml/ng. The low ferritin group was consisted of 19 patients and the high ferritin group was consisted of 24 patients. The characteristics of these two groups are shown in Table 1. There were no statistical significance in age, gender, body mass index, age at diagnosis, mean annual hemoglobin, splenectomy, cardiac involvement and oxygen saturation among both groups, but the number of annual transfusion was significantly higher in the high ferritin group than lower ferritin group. When PFT parameters of both groups were compared, FVC (forced vital capacity) was statistically lower in the high ferritin group compared to the low ferritin group. Other parameters included FEV 1 (forced expiratory volume in 1 second), FEV 1/FVC ratio, PEF (peak expiratory flow) and FEF 25-75 (forced expiratory flow between 25% and 75% of vital capacity) were similar among groups. (Table 2) Discussion Patients with β-TM may accumulate iron in the interstitial area of the lungs which can lead fibrosis and impaired lung function over time. There are several studies investigated lung dysfunction and its etiology in these patients. Although the results of the studies are varied, the majority of them reported a restrictive pattern of respiratory dysfunction in thalassemia patients. Additionally, some studies showed the presence of mild or moderate obstruction in small airways and decrease in diffusion capacity with the increase of alveolar-capillary membrane thickness at advanced ages. In the present study, we found that patients with β-TM who had high ferritin level showed restrictive type lung function compared to those with low ferritin level. There were no difference among the groups in obstructive parameters (i.e. FEV 1, FEV 1/FVC, FEF 25-75) of PFT. In the literature, studies investigating PFT in patients with high ferritin levels had variable results, impaired or no change, in pulmonary status. In conclusion, loss of respiratory function and impaired tissue oxygenation in patients with β-TM may develop over time due to iron deposition in the interstitial area. PFT assessment of these patients is essential and recommended for the detection of early lung disease. Routine PFT follow in patients with β-TM of high ferritin values is highly important.

Association between Serum Ferritin and Prognosis in Patients with Ischemic Heart Disease in Intensive Care Units.

Recent years have seen a clear link established between elevated ferritin levels and COVID-19 prognosis. However, the impact of heightened ferritin levels on the prognosis of individuals with severe ischemic heart disease remains uncertain. We utilized the MIMIC IV database to identify a cohort of ischemic heart disease patients who underwent serum ferritin testing. We conducted regression analyses, employed the overlap propensity score weighting model, and utilized the restricted cubic splines model to comprehensively investigate the associations between serum ferritin levels and clinical outcomes. Our cohort included 1173 patients with diagnosed ischemic heart disease, categorized into high and low serum ferritin groups. After meticulous adjustment for confounding factors in a fully adjusted model, the hazard ratios (HRs) for 90-day and 1-year mortality were 1.63 (95% CI: 1.27-2.09) and 1.49 (95% CI: 1.19-1.86), respectively, in the high-ferritin group compared to the low-ferritin group. Subsequent analyses with propensity score weighting confirmed these results. Remarkably, restricted cubic spline analysis revealed an almost linear relationship between log-transformed serum ferritin levels and the risk of both 90-day and 1-year all-cause mortality. Moreover, incorporating ferritin into conventional severity of illness scores significantly improved the area under the curve for both 90-day and 1-year mortality. This study provides compelling evidence regarding the prognostic significance of serum ferritin in predicting 90-day and one-year mortality rates among patients diagnosed with ischemic heart disease.

Relationship between Iron Metabolic Parameters and Platelet Counts in Blood Donors

To investigate the correlation of iron metabolic parameters with platelet counts in blood donors. A total of 400 blood donors who met requirements of apheresis platelet donation were collected, and their hematological parameters were analyzed. The donors were divided into low ferritin group and normal group, the differences of hematological parameters between the two groups were compared, and the correlation of iron metabolic parameters and routine hematology parameters with platelet counts were analyzed. Whether male or female, low ferritin group had higher platelet counts than normal group (P < 0.01). Among the iron metabolic parameters, the platelet counts was negatively correlated with serum ferritin (SF), serum iron (SI), and transferrin saturation (TSAT) (r =-0.162, r =-0.153, r =-0.256), and positively correlated with total iron binding capacity (TIBC) and unsaturated iron binding capacity (UIBC) (r =0.219, r =0.294) in female blood donors. Platelet counts was also negatively correlated with SF, SI and TSAT (r =-0.188, r =-0.148, r =-0.224) and positively correlated with UIBC (r =0.220) in male blood donors. Among the routine hematology parameters, platelet counts was negatively correlated with mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and reticulocyte hemoglobin equivalent (Ret-He) in female blood donors (r =-0.236, r =-0.267, r =-0.213, r =-0.284). Platelet counts was also negatively correlated with MCH, MCHC and Ret-He in male blood donors (r =-0.184, r =-0.221, r =-0.209). In blood donors with low C-reactive protein level, the lower the iron store capacity, the lower the iron utilization, and the platelet counts tends to rise.

Evaluation of the Program for Giving Iron Tablets to Young Women

Background: Anemia due to iron deficiency is a prevalent health issue that affects many people, particularly women, from early childhood through adulthood. Bleeding can be a problem for pregnant women who have iron deficiency anemia, among other things, during pregnancy, labor, and the puerperium. Low birth weight, early birth, and problems of growth and development that result in stunting are some of the effects that anemic mothers experience while carrying their unborn children. Adolescent anemia continues up until the point at which the adolescent becomes pregnant. To treat iron-deficient anemia, the government is marketing blood replacement tablets. Pupose of study is to determine the effectiveness of iron tablets, the authors worked with the Klaten District Health Office to compare Hb and ferritin levels in pupils who had received blood tablets for 9 months versus kids who had not had blood tablets. Methods: This study used a cross-sectional research approach and is a case analysis study. The SMP Negeri I Jogonalan Klaten is the research location. Study do in June to September 2022. Respondents are 60 pupils from Klaten Public Middle School I, ages 11 to 14, participated in the survey. Of them, 30 female respondents had taken iron supplements for 9 months (40 weeks), while the remaining 30 served as controls and had not received blood supplements. After being told of the advantages of the study, participants who signed a written informed permission form and agreed to take part in it had their ferritin and hemoglobin levels checked. Results: When compared to the control group's ferritin value of 16.13% and Hb value of 6.45%, the treatment group's ferritin value was low (24.14%) and the Hb value was 10.34%. Conclusion: 20% of young women are still found to have anemia. Young women should be prevent anemia.

The same outcome of cancer patients treated with radiotherapy or chemoradiotherapy regardless COVID-19 status.

e18866 Background: COVID-19 has spread all over the world and infects people including cancer patients. The aim of this study is to explore the influence of COVID-19 infection on various cancer patients in China. Methods: A total of 167 cancer patients receiving radiotherapy or chemoradiotherapy from July 2022 to February 2023 were included in this study. Tumor types included lung, breast, esophageal, nasopharyngeal, cervical, pancreatic, thymus, rectal, bladder, testicular cancers, and glioblastoma, etc. The patients were divided into three groups: no COVID-19 infection during the therapy cycle (group A, n = 52), therapy beginning at least 10 days after the first positive COVID-19 tests (group B, n = 43), and therapy beginning less than 10 days after the first positive COVID-19 tests (group C, n = 72). The COVID-19 variants in this study were BA5.5.6, BA.5.2, and BF.7. Results: Some infection-related parameters were increased in COVID-19 positive cancer patients, such as SAA (group A vs group B, p= 0.0006; group A vs group C, p= 0.0004), hsCRP (group A vs group B, p= 0.0043; group A vs group C, p= 0.0144), ferritin (group A vs group B, p= 0.0417; group A vs group C, p= 0.0319) and PA (group A vs group C, p= 0.011), yet IL-6 and PCT were of no difference among three groups. Similarly, the serum markers for the myocardial and hepatic lesions, such as LDH (group A vs group B, p= 0.0064; group A vs group C, p= 0.0369), HBDH (group A vs group B, p= 0.0116; group A vs group C, p= 0.0414), and CHE (group A vs group B, p= 0.0303; group A vs group C, p= 0.0256), were raised in both group B and group C, but AST, CK, CK-MB, ADA, GGT, cTnT, and proBNP showed no difference between COVID-19 positive and negative cancer patients. The cancer patients receiving radiotherapy or chemoradiotherapy showed no differences in the lowest WBC, Hgb, platelets, NLR (Neutrophil to Lymphocyte Ratio), and lymphocyte subtype counts among three groups. Nevertheless, the leukopenia was apparent in group C (group A vs group C, p= 0.0031; group B vs group C, p= 0.0194), and no obvious difference between group A and group B. Finally, the dropout rates in three groups were nearly the same (group A, 4/52; group B, 6/43; group C, 6/72), and the causes of treatment interruption varied, including pneumonia, deep venous thrombosis, mucosal damage, headache, diarrhea, agranulocytosis, esophageal fistula, etc. Moreover, the completion rate of treatment was not affected by the radiation dose or antitumor drugs in COVID-19 infected cancer patients. Conclusions: This study found that COVID-19 infection did not change the completion rate of radiotherapy or chemoradiotherapy in cancer patients, although some hematological and serum parameters altered during the treatment and infection. In contrast to NCCN guidelines, cancer patients positive for COVID-19 could be treated safely by radiotherapy or chemoradiotherapy.

Prognostic Value of Serum Ferritin for Patients with Severe Fever with Thrombocytopenia Syndrome: A Single-Center Retrospective Cohort Study.

This article aims to evaluate the prognostic value of ferritin in patients with severe fever with thrombocytopenia syndrome (SFTS). Patients with SFTS diagnosed at the Infection Department of Wuhan Union Medical College Hospital from July 2018 to November 2021 were included. The best cutoff value was determined by receiver-operating characteristic (ROC) curve. The survival curve was analyzed by Kaplan-Meier method and compared among different serum ferritin subgroups by log-rank test. Cox regression model was used to evaluate the effect of prognosis on overall survival (OS). A total of 229 patients with febrile thrombocytopenia syndrome were enrolled. There were 42 fatal cases, with a fatality rate of 18.3%. The best critical value of serum ferritin was 16.775mg/l. With increasing serum ferritin level, the cumulative mortality increased significantly (log-rank, P < 0.001). Cox univariate regression analysis and adjusted confounding factors such as age, viral load, liver and kidney function and blood coagulation function showed that, compared with the low ferritin group, the high ferritin group demonstrated poorer OS. The serum ferritin level before treatment can be considered a valuable index for predicting the prognosis of patients with SFTS.

Electrophysiological properties and heart rate variability of patients with thalassemia major in Jakarta, Indonesia.

Beta thalassemia major (TM) is a common hereditary disease in Indonesia. Iron overload due to regular transfusion may induce myocardial iron deposition leading to electrophysiological dysfunction and functional disorders of the heart. Ventricular arrhythmia is one of the most common causes of sudden cardiac death in thalassemia patients. This cross-sectional study of 62 TM patients aged 10-32 years in Cipto Mangunkusumo General Hospital was done to assess their electrophysiological properties and heart rate variability, including 24- hour Holter monitoring, signal averaged electrocardiogram (SAECG) for detection of ventricular late potential (VLP), and determination of heart rate variability (HRV). We also assessed their 12-lead ECG parameters, such as P wave, QRS complex, QT/ QTc interval, QRS dispersion, and QT/ QTc dispersion. Iron overload was defined by T2-star magnetic resonance (MR-T2*) values of less than 20 ms or ferritin level greater than 2500 ng/mL. Subjects were grouped accordingly. There were significant differences of QTc dispersion (p = 0.026) and deceleration capacity (p = 0.007) between MR-T2* groups. Multivariate analysis showed an inverse correlation between QTc dispersion and MR-T2* values. There was a proportional correlation between heart rate deceleration capacity in the low MR-T2* group (p = 0.058) and the high ferritin group (p = 0.007). No VLPs were detectable in any patients. In conclusion, prolonged QTc dispersion and decreased heart rate deceleration capacity were significantly correlated with greater odds of iron overload among patients with Thalassemia major.

Ferritin, transferrin, and transferrin receptor in relation to metabolic obesity phenotypes: Findings from the China Health and Nutrition Survey.

BackgroundThis study aimed to explore the relationship between iron markers and metabolic obesity phenotypes and the role of age.MethodsData were from the China Health and Nutrition Survey 2009. Metabolic obesity phenotypes included metabolically healthy with normal weight (MHNW), metabolically unhealthy with normal weight (MUNW), metabolically healthy with overweight/obesity (MHO), and metabolically unhealthy with overweight/obesity (MUO). Iron markers including ferritin, transferrin, and soluble transferrin receptor were calculated as Log and quartered. The linear regression and multinomial logistic regression were used to explore the association of iron markers with age and metabolic obesity phenotypes, respectively.ResultsFerritin was linearly related with age, with β (95% confidence interval, CI) of 0.029 (0.027 to 0.032) and -0.005 (-0.007 to -0.002) for women and men. Transferrin was negatively associated with age in both men and women (β < -0.011). Furthermore, compared with participants in the quartile 1 ferritin group, those in the quartile 4 had increased odds of MUNW, MHO, and MUO, with odds ratio and 95% confidence interval (OR, 95% CI) of 3.06 (2.20 to 4.25), 1.66 (1.35 to 2.05), and 5.27 (4.17 to 6.66). Transferrin showed similar relationships with MUNW, MUO, and MHO; whereas transferrin receptor showed no significance. We also found joint associations of ferritin and transferrin with MUNW, MUO, and MHO. The interactive effect of ferritin and transferrin on MUO was significant (P = 0.015).ConclusionIncreased ferritin and transferrin were associated with MUNW, MHO, and MUO. Age should be considered when investigating iron.

Evaluating the value of superoxide dismutase in anti-MDA5-positive dermatomyositis associated with interstitial lung disease.

This study aimed to investigate the relationship between serum superoxide dismutase (SOD) and interstitial lung disease (ILD) among patients with anti-melanoma differentiation-associated gene 5 antibody (MDA5)-positive DM. In this retrospective study, serum SOD of 90 health check-ups were tested in our hospital. A total of 94 hospitalized patients with anti-MDA5-positive DM had ILD. Their serum SOD, serum ferritin and autoantibody levels were determined and lung high-resolution CT was performed. The serum SOD level was significantly lower in the anti-MDA5-positive DM group compared with the control group. The SOD level was significantly lower in patients positive for both anti-MDA5 antibodies and anti-Ro-52 antibodies than in those positive for only anti-MDA5 antibodies before treatment. The SOD level was significantly lower in the higher serum ferritin group compared with the lower serum ferritin group before treatment. After treatment, the serum SOD level decreased in patients with exacerbation of ILD, while it increased in those with alleviated ILD. The SOD level was significantly lower in the death group than in the survival group before treatment. In patients with anti-MDA5-positive DM, the low SOD level before treatment indicated the presence of oxidative stress in the disease; the serum SOD level was affected by anti-Ro-52 antibodies and ferritin; there is a close relationship between serum SOD level and ILD among patients with anti-MDA5-positive DM, suggesting that SOD might serve as an effective indicator to evaluate the changes in ILD in these patients; and the low SOD level is an important indicator of poor prognosis in these patients, which deserves attention from rheumatologists.

Lower serum ferritin levels and higher inattentiveness in attention deficit hyperactivity disorder in a case–control study

Introduction: Attention deficit hyperactivity disorder (ADHD) has hyperactivity, impulsivity, and inattentiveness. Brain iron stores influence dopamine synthesis and behavior. Serum ferritin is a marker for iron stores. Few studies are there on serum ferritin levels in ADHD, and the results showed either way as low or equal to controls. Contradictory results were observed in two published Indian studies, hence the need for the study. Aims and Objectives: The objectives of this study were to compare serum ferritin and hematological indexes between children with ADHD and normal controls and also to compare ADHD subscales in two of ADHD groups divided on a cutoff serum value of below 15 ng/ml (World Health Organization criteria). Materials and Methods: Children with ADHD without comorbidities were compared with controls at a child and adolescent psychiatry unit, Hyderabad, India, after ethics committee approval. The assessments included Conners' Parent Rating Scale (CPRS)-Revised (S), serum ferritin, and hematological indexes. Results: Two-three children with ADHD and 38 normal children as controls participated. The mean (standard deviation [SD]) of serum ferritin levels in the ADHD group 28.26 (16.46) and controls 23.06 (18.88) was not statistically significant. Significantly higher mean values (14.60) on cognitive/inattention subscale was noticed In below (15 ng/ml) serum ferritin level group compared to the mean (11.50) in above (15 ng/ml) serum ferritin group. Negative nonsignificant correlation (r = −0.366) between cognitive-inattention subscale of ADHD and serum ferritin levels was noticed. Conclusions: Iron-deficiency state showed higher inattentiveness on CPRS subscale than noniron-deficiency state. There is a weak negative correlation between serum ferritin and inattentiveness.

Prognostic value of von-Willebrand factor in patients with liver cirrhosis and its relation to other prognostic indicators.

BACKGROUNDVon-Willebrand factor (vWF) disposes certain prognostic value in patients with liver cirrhosis, but its relation to other prognostic indicators has not been fully investigated. AIMTo analyze the relation between vWF and other prognostic indicators in cirrhotic patients and to evaluate its prognostic value for mortality. METHODSThis analytic prospective study was carried out in a tertiary center and initially enrolled 71 patients with liver cirrhosis and portal hypertension. It analyzed the relation between vWF and the stage of the disease and several inflammatory and prognostic indicators. The prospective analysis, performed on a sample of 63 patients, evaluated the association between the selected variables [vWF, Model for End-stage Liver Disease (MELD) score, C-reactive protein (CRP), ferritin, vitamin D, activated partial thromboplastin time, thrombin time, D-dimer concentration] and the survival time as well as their predictive value in terms of 3-mo, 6-mo and 1-year mortality.RESULTSvWF was significantly higher in patients with higher Child-Turcotte-Pugh class (P = 0.0045), MELD group (P = 0.0057), ferritin group (P = 0.0278), and D-dimer concentration (P = 0.0232). vWF significantly correlated with D-dimer concentration, ferritin, CRP, International Normalized Ratio, and MELD, Child-Turcotte-Pugh, Sequential Organ Failure Assessment, and CLIF-consortium organ failure (CLIF-C OF) scores. vWF, MELD score, and CRP were significantly associated with death and were significant predictors of 3-mo, 6-mo, and 1-year mortality. Each vWF unit significantly increased the probability for 3-mo mortality by 1.005 times (P = 0.008), for 6-mo mortality by 1.006 times (P = 0.005), and for 1-year mortality by 1.007 times (P = 0.002). There was no significant difference between the diagnostic performance of vWF and MELD score and also between vWF and CRP regarding the 3-mo, 6-mo, and 1-year mortality.CONCLUSIONIn patients with liver cirrhosis, vWF is significantly related to other prognostic indicators and is a significant predictor of 3-mo, 6-mo, and 1-year mortality similar to MELD score and CRP.

Effects of iron deficiency on left ventricular functions in young women regardless of anemia: A speckle tracking echocardiography study.

Iron deficiency is one of the most common metabolic disorders worldwide and affects multiple organs and systems including the cardiovascular (CV) system. Iron deficiency can cause structural and functional changes in the myocardium. The aim of the study is to evaluate left ventricular (LV) functions in patients with low ferritin levels without anemia by two-dimensional "speckle tracking" echocardiography (2D STE). We studied 90 participants (all female) that were divided into two groups according to ferritin levels (49 patients with ferritin levels <30 ng/mL, 41 age-matched controls with >30 ng/mL). Patients with anemia (hemoglobin level <12 g/dL), known CV disease, diabetes mellitus, low ejection fraction (<55%), active infection, high ferritin levels (>200 ng/mL) were excluded. All patients were evaluated by transthoracic echocardiography. In addition to conventional echocardiographic parameters and Doppler measurements, LV global longitudinal strain (GLS) and strain rate (GLSR) were obtained by 2D STE. Mean ferritin level was 18.96 ± 7.29 ng/mL in low ferritin group, and was 61.22 ± 26.14 ng/mL in control group. There were no significant differences according to conventional and Doppler echocardiographic parameters between the groups. LV GLS and GLSR values were significantly lower in low ferritin group comparing with control group (17.31% ± 1.56 and 18.96% ± 1.53, p < 0.001; 0.64 ± 0.13 1/s and 0.81 ± 0.13 1/s, p < 0.001, respectively). There was a significant positive correlation between ferritin levels and LV GLS and GLSR values in study group (r = 0.482, p < 0.001; r = 0.387, p < 0.001, respectively). Ferritin level was also detected as an independent risk factor for GLS value < -18% in logistic regression analysis. In ROC curve analysis, the area under the curve for predicting GLS < -18% was 0.801 (p < 0.001, 95% CI 0.70-0.89) and the threshold of ferritin value was 28.5 ng/mL (sensitivity 76.1%, specificity 77.3%). Low ferritin levels can cause subclinical LV systolic dysfunction in patients without anemia. STE provides detailed information about LV functions. With larger studies, these patients should be followed more closely and considered for iron replacement treatment before developing anemia.

Effects of Daily Iron Supplementation on Motor Development and Brain Connectivity in Preterm Infants: A Diffusion Magnetic Resonance Study.

Objectives: The aim of the study is to demonstrate the characteristic of motor development and MRI changes of related brain regions in preterm infants with different iron statuses and to determine whether the daily iron supplementation can promote motor development for preterm in early infancy.Methods: The 63 preterm infants were grouped into non-anemia with higher serum ferritin (NA-HF) group and anemia with lower serum ferritin (A-LF) group according to their lowest serum Hb level in the neonatal period as well as the sFer at 3 months old. Forty-nine participants underwent MRI scans and Infant Neurological International Battery (INFANIB) at their 3 months. At 6 months of corrected age, these infants received the assessment of Peabody Developmental Motor Scales (PDMS) after 2 mg/kg/day iron supplementation.Results: In total, 19 preterm infants were assigned to the NA-HF group while 44 preterm infants to the A-LF groups. The serum ferritin (sFer) level of the infants in A-LF group was lower than that in NA-HF group (44.0 ± 2.8 mg/L vs. 65.1 ± 2.8 mg/L, p < 0.05) and was with poorer scores of INFANIB (66.8 ± 0.9 vs. 64.4 ± 0.6, p < 0.05) at 3 months old. The structural connectivity between cerebellum and ipsilateral thalamus in the NA-HF group was significantly stronger than that in the A-LF group (n = 17, 109.76 ± 23.8 vs. n = 32, 70.4 ± 6.6, p < 0.05). The decreased brain structural connectivity was positively associated with the scores of PDMS (r = 0.347, p < 0.05). After 6 months of routine iron supplementation, no difference in Hb, MCV, MCHC, RDW, and sFer was detected between A-LF and NA-HF groups as well as the motor scores of PDMS-2 assessments.Conclusion: Iron status at early postnatal period of preterm infant is related to motor development and the enrichment of brain structural connectivity. The decrease in brain structural connectivity is related to the motor delay. After supplying 2 mg/kg of iron per day for 6 months, the differences in the iron status and motor ability between the A-LF and NA-HF groups were eliminated.