Mean Level Of Serum Ferritin Research Articles

Hemostatic assay in iron overloaded frequently transfused thalassemia patients.

Objective: To determine the hemostatic abnormalities in iron overloaded frequently transfused thalassemia patients. Study Design: Cross Sectional study. Setting: Departments of Pathology and Pediatric, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, Pakistan. Period: October 2022 to April 2023. Material & Methods: Was conducted on 112 patients using convenient sampling. The collected data was analyzed using SPSS version 25. Results: Total 112 thalassemia patients were included in the study, 62 were male and 50 of them were female. A normal PT value was recorded in 107 (95.5%), while 5 (4.5%) had prolonged PT, a normal APTT value was recorded in 98 (87.5%), while 14 (12.5%) patients had prolonged APTT, a normal BT value was recorded in 89 (79.5%), while 23 (20.5%) patients had prolonged BT, and a normal platelet count was recorded in 86 (76.7%), while 26 (23.2%) patients had thrombocytopenia with mean level of serum ferritin was (4169.08±2193.49) and the mean age of total study subjects was (11.7 ± 3.39). Conclusion: It was concluded that high serum ferritin levels resulted in disturbance of hemostatic profile of thalassemia patients.

Correlation of Magnesium Level with Cardiac and Hepatic Hemosiderosis Measured by T2*MRI Technique and Age in Patients with Thalassemia Major

Background: Given the association of hypomagnesemia with cardiac arrhythmia, the aim of this study was to investigate the relationship between serum magnesium levels with age and T2* magnetic resonance imaging (MRI) findings of the heart and liver in patients with thalassemia major (TM). 
 Materials and Methods: In a descriptive cross-sectional study, a total of 62 patients with β-thalassemia major aged 11-48 years were selected at the Amir-Kabir Hospital, Arak, Iran. Serum magnesium, ferritin, and iron levels of patients were measured, and the rate of cardiac and hepatic hemosiderosis of patients was extracted according to the routine T2*MRI method. 
 Results: The mean age of the patients at diagnosis was 32.6 years. The comparison of TM patients with and without hepatic/cardiac hemosiderosis demonstrated that mean levels of serum ferritin, serum iron, and age were significantly higher in TM patients with cardiac hemosiderosis than in hepatic/cardiac non-hemosiderosis (P < 0.05); however, there was no significant difference in mean levels of serum magnesium in TM patients with and without hepatic/cardiac hemosiderosis (P = 0.279). Interestingly, the correlation of age with serum magnesium levels in TM patients revealed a statistically significant and moderate inverse correlation (r = -0.56, P = 0.013).
 Conclusion: Hypomagnesemia may occur in a time-dependent manner. It is recommended that, in addition to cardiac and hepatic T2*MRI, serum magnesium levels be measured by using magnesium replacement if necessary.

Polymorphisms of haptoglobin modify the relationship between dietary iron and the risk of gestational iron-deficiency anemia.

To assess whether polymorphisms of haptoglobin (Hp) modify the relationship between dietary iron and the risk of gestational iron-deficiency anemia (IDA). This study analyzed 1430 singleton pregnant women aged 20 ~ ≤ 48years from the 2017-2019 National Nutrition and Health Survey of Pregnant Women in Taiwan. Sociodemographic, blood biochemical, Hp phenotype, and 24-h dietary recall data were collected. Erythropoiesis-related total prenatal supplementation was defined as the reported use of multivitamins and minerals, vitamin B complex, folate, and iron. Distributions of the Hp 1-1, Hp 2-1, and Hp 2-2 phenotypes were 13.6, 39.8, and 46.5%, respectively. Women with the Hp 1-1 phenotype had the lowest mean levels of serum ferritin (p-trend = 0.017), the highest prevalence of gestational ID (p-trend = 0.033) as well as the highest prevalence of gestational IDA (did not reach statistical differences, p-trend = 0.086). A gene-diet interaction on serum ferritin was observed between the Hp 1 and Hp 2 (2-1/2-2) alleles (p < 0.001). An adjusted multivariate logistic regression showed that compared to those with a normal blood iron status and who reported using erythropoiesis-related total prenatal supplements, those who did not had a 4.05-fold [odds ratio (OR) = 4.05 (95% confidence interval (CI) 2.63-6.24), p < 0.001] increased risk of gestational IDA. The corresponding ORs for carriers of the Hp 1 and Hp 2 alleles were 4.78 (95% CI 1.43-15.99) and 3.79 (95% CI 2.37-6.06), respectively. Pregnant women who are Hp 1 carriers are at increased risk for developing IDA if they do not meet the recommended dietary allowance for iron or use erythropoiesis-related prenatal supplements.

A Comparative Study of Serum Ferritin Levels Among Unfit and Fit Blood Donors.

Background:Cheap methodologies are being utilized by low-resource countries to determine blood donors' fitness. Important hematological biomarkers might have to be evaluated to enhance the use of these methods.Aims:The study evaluated the pattern of serum ferritin in 18–24 fit and unfit prospective blood donors (PDBs) and the prevalence of iron store deficiency.Settings and Design:This study was a cross-sectional, comparative study which was conducted at the blood donor clinic of the Lagos University Teaching Hospital.Materials and Methods:Blood samples were collected by venipuncture into sodium-ethylenediaminetetraacetic acid and plain bottles. The latter was centrifuged and used for ferritin determination via human ferritin enzyme-linked immunosorbent assay test kit, while the former was used for red cell indices analysis using an autoanalyzer.Statistical Analysis:Data were analyzed using SPSS version 20, values were presented as mean ± standard deviation, and P ≤ 0.05 was considered statistically significant.Results:A total of 263 PDB were recruited into the study consisting of 210 (79%) males and 53 (21%) females, with a mean age of 32.88 ± 8.22. Only 110 (41.8%) of the participants were considered fit, while 153 (58.2%) were unfit using copper sulfate specific gravity. There was no statistically significant difference (P = 0.301) in the mean level of serum ferritin in unfit blood donors (74.5 ± 90.8 μg/L) compared to that of the fit blood donors (61.5 ± 54.5 μg/L). The prevalence of iron store depletion among blood donors in Lagos state was 11.8% (31 of 263) with a higher proportion (7.6%) occurring among unfit donors. However, low levels of serum ferritin (<15 μg/L) were significantly associated with the occurrence of anemia (hemoglobin < 12.5 g/gl) among unit donors (19%; P = 0.05).Conclusion:Although serum ferritin depletion appears to be higher in the unfit blood donors, the use of serum ferritin as an index for the screening and determination of PDBs' fitness requires further evaluation.

Testicular function in patients with regular blood transfusion for thalassemia major

Abstract Background Regular blood transfusion and iron chelation therapy have improved the quality of life of patients with thalassemia and increased their longevity, but transfusion also increases the frequency of endocrine complications, possibly because of iron deposition in the pituitary gland or the gonads, or both. Objective To evaluate testicular function in patients with thalassemia major by basal hormonal study, and identify risk factors for dysfunction. Methods We performed a cross-sectional study of 28 patients with thalassemia major aged 11.7 ± 1.8 (8–14.9) years (15 in prepuberty, 13 in puberty with no delayed puberty) who had regular blood transfusions. A normal control group comprised 64 boys who were matched for age and Tanner genital stage. Results The mean level of serum ferritin in the previous year was 1,575 ± 642 ng/mL, and the onset of blood transfusion was at 3.8 ± 2.3 years and iron chelation therapy was 6.6 ± 2.8 years. The trend for anti-Müllerian hormone levels in patients and controls was similar with age, and although higher in the patients, particularly at Tanner stage II, was not significantly different. Testosterone levels were lower in the patients compared with controls; particularly at Tanner stages IV–V (290.88 vs. 537.4 ng/dL, P &lt; 0.05). Serum follicle-stimulating hormone and luteinizing hormone levels were not significantly different between the groups at any Tanner stage. Conclusion Patients who received regular blood transfusions had normal Sertoli cell function. Leydig cell dysfunction may occur, even though the patients had a normal pubertal onset.

Do Iron Chelators Affect Fertility in Thalassemic Men?

Aim To evaluate the effect of iron chelator drugs on testicular volume, semen parameters and serum FSH, LH, and Testosterone concentrations in 62 young male patients with major and intermedia thalassemia. Methods Sixty two young male patients with major and intermedia thalassemia, aged 18-41 years who had different iron chelator drug using status were evaluated. Results At the time of the study their serum ferritin levels ranged from 182-11053 ng/mL (mean 2067 ng/mL). The mean volume of patients’ ejaculate was 2.3 cc. The mean concentration of sperm was 61.04 million per milliliter. The mean size of right testis was 11.4 cc and the mean size of left testis was 11.7 cc. Hypogonadism and hypothyroidism was seen in 22.6% and 17.7% of patients, respectively. The mean level of FSH was 3.7 mIU/ml, LH was 4.6 mIU/ml and Testosterone was 4.8 ng/dl. The mean level of serum ferritin was 2067 ng/dl. Conclusion This study suggests that in thalassemic men, concentrations of serum Testosterone, LH, FSH has significant correlation with sperm parameters and testicular volume but iron chelators mostly do not impact the elements of fertility in these patients. Keywords: Thalassemia major; Thalassemia intermedia; Spermatogenesis; Puberty; Testicular volume; Gonadal hormones; Iron chelators

Metabolic syndrome and serum ferritin level in postmenopausal women in urban cities in Enugu State, Nigeria

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Physiological and biochemical changes that alter the general health of women are seen in menopause which include increase in adiposity and elevated serum ferritin. There is a dearth of information on the prevalence and common risk factors of MS and their association with iron stores of the body among postmenopausal women (POMW) in Enugu. Hence, this study was carried out to determine the prevalence of metabolic syndrome, the most prevalent components of metabolic syndrome and its relationship with serum ferritin level in postmenopausal women in Enugu, Nigeria.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The study was a cross sectional study, carried out from February to August 2013 among two hundred and twenty four (224) apparently healthy postmenopausal women aged 40 to 83 years. Metabolic syndrome was defined using National Cholesterol Education Programme, Adult Treatment Panel III criteria. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The most frequent components of metabolic syndrome (MS) seen among the subjects were high waist circumference (WC) (70.1%), high blood pressure (66.5%) and low high density lipoprotein cholesterol (25.4%). The prevalence of metabolic syndrome among the women was 29.0% while the mean level of serum ferritin of subjects with metabolic syndrome showed no significant (p &amp;gt;0.05) difference when compared to subjects without MS.&lt;/p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The most frequent cluster of the risk factor of MS in the population studied was high WC, high blood pressure and low high density lipoprotein cholesterol (HDL). Although serum ferritin is slightly associated with FPG and WHR, it may not be used as diagnostic tool for MS in the group studied.

The Effects of Nutrition, Exercise, and a Praying Program on Reducing Iron Overload in Patients With Beta-Thalassemia Major: A Randomized Clinical Trial.

BackgroundExcessive iron accumulation in the visceral organs creates problems for patients with beta-thalassemia major. Despite chelation therapy, mortality rate from the complications of this disease is still quite high.ObjectivesThis study aimed to investigate the effectiveness of nutrition, exercise, and a praying program at reducing iron overload in patients with beta-thalassemia major.Patients and MethodsThis randomized clinical trial assessed the effect of the designed care program on iron overload. The study was conducted in 38 patients with beta-thalassemia major who ranged in age from 15 - 35 years and had been referred to the largest center for thalassemic patients in Shiraz. The patients were randomly assigned to an intervention (n = 18) and a control (n = 20) group. Blood samples were collected from the participants before and two months after the intervention. Then, the data were statistically analyzed using chi-square, Fisher’s exact test, Mann-Whitney U-test, Wilcoxon, independent samples t-test, and paired samples t-test.ResultsThe results showed that the mean level of serum ferritin significantly decreased in the intervention group two months after beginning the intervention. Also, the mean level of serum iron decreased in the intervention group, but the difference was not statistically significant.ConclusionsThe planned educational program could be used to reduce iron overload and ultimately improve the patients’ health status.

Restless Legs Syndrome: Associated Risk Factors in Hemodialysis Patients

Background:Restless legs syndrome (RLS) may be associated with increased morbidity and mortality among end-stage renal disease (ESRD) patients; however, it is a disorder that is neglected in dialysis centers.Objectives:The goal of this study was to investigate the clinical factors associated with RLS among ESRD patients.Patients and Methods:This cross-sectional study was conducted on ESRD patients undergoing maintenance hemodialysis (HD) in three HD centers in Ahvaz city in Southwest Iran. Blood samples were obtained prior to a dialysis session to check the routine laboratory test results and assess the adequacy of dialysis. The presence of RLS was assessed by using the international RLS study group (IRLSSG) diagnostic criteria. The IRLSSG rating scale was also used to evaluate the severity of the RLS symptoms.Results:Of the 139 HD patients enrolled in this study, 60 were female (43.2%) and 79 were male (56.8%), with a mean age of 51.82 ± 13.31 years. The prevalence of RLS was 15.8% (22 patients), with 50% of them (11 patients) having severe or very severe symptoms. There was a significant relationship between RLS and longer durations of dialysis (P < 0.001). The mean level of serum ferritin was lower in patients without RLS, but it was not significant (P = 0.065). No significant differences were found according to age, gender, dialysis shifts, and hemoglobin (Hb) level among patients with and without RLS.Conclusions:We conclude that a significant percentage of ESRD patients undergoing maintenance HD have severe or very severe RLS symptoms. The presence of RLS is associated to longer durations of dialysis.

English

INTRODUCTION: Despite lot of researches in the field of stroke, accurate prognostication of an acute attack is difficult. Several prognostic factors like site of infarction, size of infarct, size of the vessel involved, Glasgow coma scale, level of cerebral edema, intracranial tension have been found significant in cerebral infarction. Similarly in cases of cerebral hemorrhage, CT calculated volume of hematoma, GCS, site of hemorrhage etc. are important. One of the prognostic indicators which has gained great clinical interest in recent times is the level of serum ferritin. Initially considered only as a stress response to stroke, serum ferritin now is under research as a prognostic indicator. AIMS AND OBJECTIVES: To correlate the levels of serum ferritin with early neurological deterioration and prognosis in patients of acute stroke. MATERIAL AND METHODS: A total of 50 patients of cerebrovascular accident presenting within 48hrs of symptom onset were included in the study and diagnosis of stroke was confirmed by CT scan. In vitro quantitative determination of ferritin in human serum was done within 48 hours of presentation by electro chemiluminescence immunoassay ECLIA in Elecsys and cobas e immunoassay analyser. Neurological assessment was done by Canadian stroke scale. INCLUSION CRITERIA: patients above 18 yrs. of age of both sexes with CT scan confirmed diagnosis of stroke presenting within 48 hrs of symptom onset EXCLUSION CRITERIA: Patient not fulfilling inclusion criteria and with history of recent infection or inflammation in the previous month, with history of malignancy and with anemia. RESULTS: level of serum ferritin has direct correlation with worse prognosis in patients of stroke. The mean level of serum ferritin in the group of clinically improved (87.01) was much lesser compared to the group clinically deteriorated or died (458.7) among patients of ischemic stroke. Similarly in hemorrhagic stroke it was 96.4 in improved group compared to 463.91 in deteriorated. Both the differences were statistically significant (p<0.001) in both types of stroke. CONCLUSION: elevated serum ferritin is strongly associated with early neurological deterioration in patients of stroke and is a definite prognostic marker of acute stroke, ischemic or hemorrhagic an elevated serum ferritin (A marker of iron stores) herald more intensive management protocols and care for the patient as it can predict early neurological deterioration. Iron chelation therapy in acute stroke seems to be a strong theoretical possibility and further studies are required to investigate its role in treatment of stroke.

Correlation between serum bilirubin and serum ferritin Level in thalassaemia patients

Thalassaemia is the most common hereditary disorder in the world including Bangladesh. Beta thalassaemia major and Hb-E thalassaemia both are common in our country. Iron overload causes most of the mortality and morbidity associate with thalassaemia. To assess the iron over load and liver function a cross sectional comparative study was carried out in the Department of Biochemistry, Dhaka Medical College, Dhaka in collaboration with Thalassaemia Center and Department of Pathology, Dhaka Shishu Hospital, Dhaka during the period of July 2006 to June 2007. The study was carried out with the patients who visited regularly in Dhaka Shishu Hospital Thalassaemia Centre (DSHTC) and had multiple transfusions (more than five) and age more than 2 years. To compare the state of liver function with normal healthy individuals' normal healthy persons were also included. Total 70 subjects were included in this study. The study subjects were distributed into two groups, the group - A (cases, n=40) and group - B (healthy controls, n=30). According to the major types of thalassaemia present in our country, group -A again divided into two, group - AI ?-thalassaemia major (n=12) and group - AII of Hemoglobin E ?-thalassaemia (n=28). The mean of serum Bilirubin in group - A and group - B were (2.04 ±0.70) mg/dl and (0.67±0.15) mg/dl respectively. Group - A had higher serum bilirubin than group -B in p value &lt;0.001.The mean level of serum bilirubin in group - AI was (1.70±0.70)mg/dl and the mean of bilirubin in group AII was (2.18±0.66) mg/dl. Group -AI had lower serum bilirubin than group AII in p value &lt;0.05. Pearson's correlation between serum bilirubin and serum ferritin had r value -0.26 was statistically not significant. Mean level of serum ferritin in the total was (2729.40 ± 1935.87) ng/ml, minimum level was 304 ng/ml and maximum was 7256ng/ml. Mean level of serum ferritin in the patients of ? - thalassaemia major was (4098.67 ± 1598.63) ng/ml, minimum level was 1212ng/ml and maximum was 7560ng/ml. Mean level of serum ferritin in the patients of HbE ? - thalassaemia was (2232.57± 1598.63) ng/ml, minimum level was 304ng/ml and maximum was 630ng/ml. Group AI had higher level of serum ferritin than group AII in p value &lt;0.05.In conclusion, iron over load and jaundice are common finding of thalassaemia. In this present study serum ferritin and serum bilirubin parameter of iron over load and jaundice are correlated. But no statistical correlation was found between these two parameters. DOI: http://dx.doi.org/10.3329/bjmb.v4i2.13769 Bangladesh J Med Biochem 2011; 4(2): 6-12

Prognostic Significance of Elevated Serum Ferritin Before Chemotherapy in Patients with Non-Hodgkin's Lymphoma

AbstractAbstract 5099 Background:Elevated ferritin level before stem cell transplantation was documented an adverse prognostic factor for patients undergoing hematopoietic stem cell transplantation for hematologic malignancies. Until now, there have been reported few studies which suggested high serum ferritin level were associated with worse outcomes for lymphoma. The purpose of this study was to find the significance of high levels of serum ferritin for predicting survival outcome in patients with non-Hodgkin's lymphoma (NHL). Methods:A total of 267 patients who newly diagnosed and received an chemotherapy at the Kosin University Gospel Hospital, Busan, South Korea between September 1999 and April 2012 were enrolled retrospectively in the current study. Pretreatment serum ferritin was measured within 2 weeks before the beginning of first line chemotherapy. The enrolled diseases included diffuse large B cell lymphoma (DLBL, n=163, 61. 0%), T cell lymphoma (TCL, n=48, 18. 0%) and other lymphoma (n=56, 21. 0%) including mantle cell lymphoma, marzinal zone B cell lymphoma, follicular lymphoma, small lymphocytic lymphoma and burkitt's lymphoma. In this study, patients with Hodgkin's disease and with undergoing chemotherapy 3 cycles or less than 3 cycles were excluded. Results:The median age of patients was 56 years (range, 14–84 years) and the mean level of serum ferritin at pre-treatment was 257. 79 ng/ml (range: 1. 70–6562. 00). In univariate anaylsis, factors associated with prolonged progression free survival (PFS) were LDH (p < 0. 001, 65. 8% in less than normal limit vs 39. 3% in more than normal limit), stage (p=0. 003, 64. 3% in less than stage III vs 46. 1% in stage III or more than), CRP (p = 0. 001, 58. 8% in less than 5mg/dL vs 27. 0% in 5mg/dL or more than), beta2-microglobulin (p < 0. 001, 59. 2% in less than 3. 5mg/L vs 29. 4% in 3. 5 mg/L or more than), and serum ferritin (p < 0. 001, 59. 2% in less than 500 ng/ml vs 22. 1% in 500 ng/ml or more than). Factors associated with prolonged overall survival (OS) were age (p < 0. 001, 61. 5% in less than 60 years vs 38. 4% in 60 years or more than), LDH (p < 0. 001, 70. 9% in less than normal limit vs 30. 0% in more than normal limit), ECOG performance status (p < 0. 001, 72. 8% in less than 2 scores vs 41. 9% in 2 scores or more than), stage(p=0. 005, 63. 4% in less than stage III vs 42. 1% in stage III or more than), Bulky mass (p = 0. 001, 57. 4% in tumor diameter less than 10cm vs 33. 5% in 10cm or more than), CRP (p = 0. 001, 60. 4% in less than 5mg/dL vs 27. 0% in 5mg/dL or more than), beta2-microglobulin (p < 0. 001, 59. 3% in less than 3. 5 mg/L vs 16. 3% in 3. 5 mg/L or more than), absolute lymphocyte count (p < 0. 001, 32. 2% in less than 1. 0 × 103/uL vs 59. 2% in 1. 0 × 103/uL or more than) and serum ferritin (p < 0. 001, 56. 9% in less than 500 ng/ml vs 23. 6% in 500 ng/ml or more than). In multivariate analysis, high level of LDH (RR (relative risk) = 0. 561, 95%CI: 0. 035–0. 890, P=0. 014), high level of beta2-microglobulin (RR= 0. 491, 95%CI: 0. 274–0. 880, P=0. 017) and high levels of serum ferritin (RR= 0. 557, 95%CI: 0. 311–0. 997, P=0. 049) were significant independent prognostic factors for PFS and high level of LDH (RR= 0. 418, 95%CI: 0. 269–0. 650, P < 0. 001), poor performance status (RR= 0. 467, 95%CI: 0. 295–0. 741, P=0. 001), high level of beta2-microglobulin (RR= 0. 461, 95%CI: 0. 278–0. 764, P=0. 003), and high levels of serum ferritin (RR= 0. 562, 95%CI: 0. 329–0. 958, P=0. 034) were significant independent prognostic factors for OS. Conclusions:High serum ferritin level of 500 ng/ml or more than 500 ng/ml may prognostic factor for survival outcomes including high LDH level, poor performance status, and high level of beta2-microglobulin in NHL. However, further studies are needed to confirm prognostic value of serum ferritn. Disclosures:No relevant conflicts of interest to declare.

Iron Balance in Regular Blood Donors

Background: Numerous reports have shown that iron stores decrease in blood donors after donation. As we need healthy donors, it is essential to test hemoglobin and ferritin levels for preventing reduced of iron stores in donors. Methods: This study was conducted on 235 healthy men. The donors were divided into three groups: group I) control group with no donation; group II) case group 1 with two donations within 1 year; group III) case group 2 with three donations within 1 year. Results: The mean level of hemoglobin was 15.9 and 14.7 g/dl in the control group and in the case group, respectively (p < 0.0000). The mean level of serum ferritin in group I, II and III, was 108, 56 and 26 mg/l, respectively (p < 0.0000). When studying various stages of iron deficiency in donors, it could be shown that 58% of group III donors but only 1% of control group donors had a negative iron balance. Moreover, iron deficiency anemia was observed in 20% of group III donors. Conclusion: Just measuring the hemoglobin level is not sufficient for selecting donors. In addition, testing of the ferritin level and iron supplementation are recommended in regular donors with more than one donation per year.

Comparative study of serum ferritin levels after oral supplementation with ferrous sulphate and carbonyl iron in mild iron deficiency anemia in pregnancy

Iron supplementation is almost universally recommended during pregnancy to correct or prevent iron deficiency. Iron status can be assessed prepartum by estimating blood hemoglobin concentration, serum iron, serum total iron binding capacity (TIBC) and serum ferritin. This study attempts to know the therapeutic efficacy of the drugs, ferrous sulphate and carbonyl iron, in improving the iron stores to meet the increased demand during pregnancy. A comparative study was done in two groups of 36 pregnant women each. One group was supplemented with ferrous sulphate and the other group with carbonyl iron. The biochemical parameters assessing iron status, serum ferritin, serum iron and serum TIBC along with hemoglobin concentration were estimated before and after supplementation in both groups. Though not statistically significant, an increase was seen in the mean levels of serum ferritin in pregnant women who were supplemented with carbonyl iron compared to those who were supplemented with ferrous sulphate. Therefore, carbonyl iron can be preferred over ferrous sulphate in treating iron deficiency anemia in pregnancy, with added advantages of lesser side effects and shorter duration of therapy, which has been established in earlier studies. © 2010 International Formulae Group. All rights reserved.Keywords: Serum iron, serum TIBC, hemoglobin concentration.

Status of Thyroid Function and Iron Overload in Adolescents and Young Adults with Beta- Thalassemia Major Treated with Deferoxamine in Jordan

Thyroid dysfunction is one of the most frequently reported complications of chronic blood transfusion therapy in patients with beta-thalassemia major (BTM). However, the occurrence of thyroid dysfunction and its possible association with iron overload in BTM patients is still under debate. Therefore, this study aimed to investigate the status of thyroid functions and iron overload in adolescent and young adult patients with BTM in Jordan population. Thirty six BTM patients aged 12-28 years and matched controls were included in this study. All patients have been receiving frequent blood transfusion to maintain pretransfusion hemoglobin concentration above 10 g dl -1 and deferoxamine at a dose of 45 mg kg −1 day −1 (8 h, 5-7 days/week) by subcutaneous infusion. Blood samples were drawn from patients and controls. The status of thyroid functions and iron overload was evaluated by measurements of serum free thyroxine (FT4), triiodothyronine (FT3), thyrotropin (TSH) and serum ferritin level. A number of some hematological and biochemical parameters were also measured. It was found that hematocrit, serum ferritin, hemoglobin, FT3 and zinc, copper mean values were significantly higher in the patients than in the controls (P < 0.05). On other hand, leukocyte, FT4 and TSH mean values were similar to that of the controls. In addition, our data also indicated that all of the above examined parameters were not significantly affected by the patient's age and gender. Deferoxamine approach for removing excess iron from our BTM patient did not normalize the values of serum ferritin, copper and zinc, suggesting poor compliance with deferoxamine chelation therapy. Thus, we recommend the use of a combination of deferoxamine and deferiprone to reduce the risk of excess of iron in our patients. Furthermore, thyroid dysfunction appears to be a rare complication, because our patients showed normal mean levels for serum TSH and FT4. However, high mean levels of serum ferritin, zinc, copper might be seen as potential risk factors for initiation and development of thyroid dysfunctions and other diseases. Therefore, further studies must be carried out at yearly intervals with large sample number, to detect subclinical thyroid dysfunction cases. Keywords—beta-thalassemia major, deferoxamine, iron overload, triiodothyronine, zinc.

Ferritina sérica e coronariopatia obstrutiva: correlação angiográfica

To verify the possible association between the levels of serum ferritin and the degree of obstructive coronary artery disease. 115 patients with coronary arteriography and concomitant evaluation of serum ferritin were studied. The adopted cut-off values were 80 ng/ml for women and 120 ng/ml for men. The mean ferritin levels for males and females were 133.9 +/- 133.8 ng/ml and 214.6 +/- 217.2 ng/ml, respectively (p=0.047). It was observed that 44.1% of the women had normal serum ferritin levels in comparison to 30.9% of the men (p=0.254). In the patients without obstructive coronary artery disease or with less severe obstructions (group A) the serum ferritin level was 222.3 +/- 325 ng/ml. On the other hand, for those with moderate (group B) and severe obstructions (group C) the levels were 145.6+-83.7 ng/ml and 188.9 +/- 150.6 ng/ml, respectively. There was no correlation between the degree of coronary artery disease and the mean level of serum ferritin. Regarding the cut-off value, the number of women with serum ferritin level > 80 ng/ml in groups B+C or only C was significantly higher than the number of women in group A (ODDS RATIO 9.71 with 95%CI from 1.63 to 57.72). For males there was no significant difference between the number of cases above or below the cut-off values (ODDS RATIO 0.92 with 95%CI from 0.28 to 2.95). It was verified that women with serum ferritin levels > 80 ng/mL presented more severe obstructive coronary artery disease than women with lower levels. In men, the serum ferritin level was not a predictor element of the degree of obstruction.

Hemochromatosis and Iron-Overload Screening in a Racially Diverse Population

Iron overload and hemochromatosis are common, treatable conditions. HFE genotypes, levels of serum ferritin, transferrin saturation values, and self-reported medical history were studied in a multiethnic primary care population. Participants were recruited from primary care practices and blood-drawing laboratories. Blood samples were tested for transferrin saturation, serum ferritin, and C282Y and H63D mutations of the HFE gene. Before genetic screening, participants were asked whether they had a history of medical conditions related to iron overload. Of the 99,711 participants, 299 were homozygous for the C282Y mutation. The estimated prevalence of C282Y homozygotes was higher in non-Hispanic whites (0.44 percent) than in Native Americans (0.11 percent), Hispanics (0.027 percent), blacks (0.014 percent), Pacific Islanders (0.012 percent), or Asians (0.000039 percent). Among participants who were homozygous for the C282Y mutation but in whom iron overload had not been diagnosed (227 participants), serum ferritin levels were greater than 300 mug per liter in 78 of 89 men (88 percent) and greater than 200 microg per liter in 79 of 138 women (57 percent). Pacific Islanders and Asians had the highest geometric mean levels of serum ferritin and mean transferrin saturation despite having the lowest prevalence of C282Y homozygotes. There were 364 participants in whom iron overload had not been diagnosed (29 C282Y homozygotes) who had a serum ferritin level greater than 1000 microg per liter. Among men, C282Y homozygotes and compound heterozygotes were more likely to report a history of liver disease than were participants without HFE mutations. The C282Y mutation is most common in whites, and most C282Y homozygotes have elevations in serum ferritin levels and transferrin saturation. The C282Y mutation does not account for high mean serum ferritin levels and transferrin saturation values in nonwhites.

Iron Supplementation to Improve Endurance in Iron-Depleted, Nonanemic Women

Iron Supplementation to Improve Endurance in Iron-Depleted, Nonanemic Women

Cardiovascular risk factors in non-insulin-dependent diabetics compared to non-diabetic controls: a population-based survey among Asians in Singapore

Cardiovascular risk factors were compared between 126 people with non-insulin-dependent diabetes mellitus (NIDDM) and 530 non-diabetics (controls), in a random sample of people (Chinese, Malays, and Asian Indians) aged 40–69 years from the general population of Singapore. Data were adjusted for age and ethnicity. For both genders, people with NIDDM had higher mean body mass indices, waist-hip ratios and abdominal diameters. They also had a higher prevalence of hypertension, higher mean levels of fasting serum triglyceride, slightly lower mean levels of serum high-density-lipoprotein cholesterol, and higher mean levels of plasma plasminogen activator inhibitor-1 and tissue plasminogen activator (antigen). These factors are components of syndrome X (metabolic syndrome) and increase the risk of atherosclerosis and thrombosis. In contrast, there were no important differences for cigarette smoking, serum total and low-density-lipoprotein cholesterol, serum apolipoproteins A1 and B, plasma factor VIIc and plasma prothrombin fragment 1+2. Females with NIDDM, but not males, had a higher mean serum fibrinogen level than non-diabetics, which could explain why NIDDM has a greater cardiovascular effect in females than males. Serum lipoprotein(a) concentrations were lower in people with NIDDM. Mean levels of serum ferritin, a pro-oxidant, were higher in people with NIDDM than controls, but there were no important differences for plasma vitamins A, C and E, and serum selenium, which are anti-oxidants.

High levels of serum ferritin in elderly patients with non-insulin-dependent diabetes mellitus

We studied concentrations of serum ferritin, glycosylated ferritin, and non-glycosylated ferritin in elderly patients with diabetes. The subjects were 111 people who were at least 60 years old: 54 healthy controls, 14 diabetic patients without retinopathy, and 43 diabetic patients with retinopathy. The mean levels of ferritin, glycosylated ferritin, and non-glycosylated ferritin in serum were significantly higher in the patients with retinopathy than in healthy controls. The mean percent glycosylated ferritin did not differ between patients with retinopathy and healthy controls. The mean levels of serum ferritin, glycosylated ferritin, and non-glycosylated ferritin, and the percent glycosylated ferritin did not differ significantly between patients without retinopathy and health controls. None of these values differed between subjects with macroangiopathy and those without macroangiopathy, in both groups of patients. In patients with diabetes, none of the values measured was significantly related to fasting plasma glucose, HbA1c, or the duration of diabetes. These results suggest that diabetic microangiopathy is associated with abnormally high levels of ferritin in serum.