Serum Ferritin Concentration Research Articles

Peripheral Iron Metabolism is Associated with Leg Movements on Polysomnography but Not with the Severity of Restless Legs Syndrome or Its Impact on Patients.

PurposeThis study investigated the associations of peripheral iron status with different manifestations of restless legs syndrome (RLS), including leg movements (LMs) on polysomnography (PSG), disease severity, and impact on patients.Patients and MethodsIn this cross-sectional study, 108 patients with RLS were enrolled at Sir Run Run Shaw Hospital’s Center for Sleep Medicine. Demographic information, disease characteristics, RLS severity, and impact on patients were assessed through a semi-structured questionnaire. Peripheral iron indicators [serum ferritin, iron, and transferrin concentrations; unsaturated iron-binding capacity (UIBC) and total iron-binding capacity (TIBC); transferrin saturation (TSAT)] were measured following PSG to assess sleep stages, respiratory events, microarousals and LM parameters. Data from patients with and without ferritin concentration < 50 µg/L were compared in crude analyses, and Spearman correlations of other iron indicators with RLS data were examined. An ordinal logistic regression model was used to adjust for age, sex, body mass index, years of education, age at the time of RLS onset, prior treatment (yes/no), C-reactive protein (CRP)/hemoglobin level, total sleep time and apnea-hypopnea index.ResultsMultivariate analysis showed that periodic LMs during sleep (PLMS) and other LM parameters were significantly associated with a ferritin concentration < 50 µg/L, UIBC, TIBC, and serum transferrin concentration, but not serum iron or TSAT. By contrast, the severity and impact of RLS were not associated with a ferritin concentration < 50 µg/L or other peripheral iron indicators in the multivariate model.ConclusionIn this study, peripheral iron status was associated mainly with motor components (LMs on PSG) rather than sensory components (severity and impact of RLS) after adequately controlling for potential confounders, such as CRP and hemoglobin levels. Commonly used peripheral iron metabolism indicators may therefore not be ideal biomarkers of RLS severity or impact on patients.

Implication of asymptomatic and clinical Plasmodium falciparum infections on biomarkers of iron status among school-aged children in Malawi

BackgroundIron status is considered as a continuum from an iron deficiency with anaemia, without anaemia, varying amounts of stored iron to iron overload. The burden of Plasmodium falciparum infections is typically high among school-aged children (SAC). Nonetheless, SAC are often less likely to be covered by malaria interventions, making them a group with an untreated reservoir of parasite transmission. This study aimed to assess the effects of asymptomatic and clinical malaria infections on biochemical markers of iron status among SAC in Malawi.MethodsData from the 2015–2016 Malawi Micronutrient Survey (MNS) was used and multivariable logistic regression models using a generalized estimating equation to account for the complex cluster survey design were constructed. Blood samples of 684 children aged 5 to 14 years old were evaluated for clinical and asymptomatic malaria infections. Furthermore, blood samples were used to estimate haemoglobin (Hb), serum ferritin (SF) and, soluble transferrin receptors (sTfR) concentrations.ResultsOf the 684 SAC analysed, approximately 42% had asymptomatic malaria, while 41.0% had clinical malaria. Anaemia (low Hb levels), iron deficiency (low SF concentration), and functional iron deficiency (high sTfR levels) were found in 20%, 5%, and 30% of the children, respectively. School-aged children with asymptomatic malaria had increased odds of being anaemic (adjusted odds ratio [aOR]: 3.71, 95% confidence interval [CI]: 2.29–5.99) and increased levels of sTfR (aOR: 3.00, 95% CI 2.01–4.47). Similarly, SAC with clinical malaria had increased odds of being anaemic (aOR: 3.54, 95% CI 2.19–5.72) and increased levels of sTfR (aOR: 3.02, 95% CI 2.02–4.52).ConclusionsBoth asymptomatic and clinical malaria were independent risk factors for anaemia and functional iron deficiency (FID). The notion that asymptomatic and clinical malaria were associated with both anaemia and FID underscores the need for public health programmers to consider adding mass screening and treatment for malaria to existing school-based health programmes.

The Relationship Between Iron Status and Atherosclerotic Cardiovascular Disease Risk in Non-anemic Patients Without a History of Cardiovascular Diseases: A Cross-Sectional Study.

Iron deficiency (ID) and iron status in non-anemic patients with atherosclerotic cardiovascular disease (ASCVD) risk without a history of cardiovascular diseases is still weakly explored. In this study, the authors evaluated the most common ID definitions in this group of patients. A total of 533 participants from the National Health and Nutrition Examination Survey (NHANES) were collected from 2005-2006, 2017-2018, and 2017-2020 records. Participants were divided according to their ASCVD risk score to the following groups: low (n=168, 32%), borderline (n=43, 8%), intermediate (n=200, 37%), and high (n=122, 23%). There was a higher prevalence of ID in low- and borderline-risk groups in contrast to intermediate- and high-risk groups. Higher serum ferritin concentrations were observed in groups with a greater ASCVD risk score. Transferrin saturation (TSAT) was comparable in all ASCVD categories. Lack of ID, defined by three different guidelines that are mainly based on serum ferritin levels, predisposed to a higher ASCVD risk category. Normal iron status, defined by these three guidelines, was positively associated with the male gender. The opposite association was observed for non-Hispanic Whites. The analyzed criteria of ID, based mostly on serum ferritin levels, demonstrated limited usefulness in patients with increased ASCVD risk. Further studies should be done to determine proper ID diagnostic criteria in non-anemic patients without a previous cardiovascular history with elevated ASCVD risk.

A comparative study of serum ferritin and thyroid stimulating hormone (TSH) levels in hypothyroid and euthyroid subjects

Thyroid hormones synthesized and released by the thyroid gland, have a vital role in regulating the metabolism of body. Synthesis of these thyroid hormones requires an iron containing enzyme Thyroid Peroxidase (TPO). Thus, iron inadequacy can affect the proper functioning of the TPO enzyme that further affect the thyroid hormone production. Serum ferritin, an index of iron store is present in almost all cells; however, it has been reported that an alteration in ferritin levels occurs in patients with thyroid disease. This study was conducted to determine serum ferritin and Thyroid Stimulating Hormone (TSH) levels in hypothyroid and euthyroid subjects and to compare the same.The retrospective study was carried out in Amrita Institute of Medical Sciences (AIMS), Kochi, which included 30 hypothyroid subjects as cases and 30 age and gender matched healthy controls. TSH, Thyroxine (T4) and serum ferritin levels of the study groups were collected and recorded.The mean TSH of hypothyroid patients was found to be higher (16.12±17.00) than that of euthyroid group (2.35± 1.08) whereas the mean value of T4 (1.01± 0.25) and ferritin (43.80 ± 75.44) were found to be reduced in patients with hypothyroidism compared to normal subjects. All the parameters were statistically significant with p value &amp;#60;0.05.The present study showed that hypothyroid subjects had significantly lower serum ferritin concentration than euthyroid subjects. Thus, serum ferritin measurement could be useful for the evaluation of thyroid diseases.

The Effects of Statin Treatment on Serum Ferritin Levels: A Systematic Review and Meta-Analysis.

Background: Statins are the most widely used drugs for decreasing elevated serum LDL-cholesterol (LDL-C) and thus for the prevention of atherosclerotic cardiovascular disease (ASCVD), but they have also some pleiotropic effects, including anti-inflammatory properties. Atherosclerosis is a low-grade inflammatory disease, and elevated ferritin is considered to be one of the markers of inflammation. Since the results of studies on the effects of statins on serum ferritin levels are conflicting, this meta-analysis was performed. Methods: A literature search was performed using major electronic databases (MEDLINE/PubMed, Scopus, Embase, and ISI Web of Science) from inception up to 5 March 2022 to find studies evaluating the effect of different statins on serum ferritin levels. The effect size was determined using weighted mean differences (WMDs) and the corresponding 95% confidence intervals (CIs). Results: The meta-analysis of nine studies (1611 patients) analyzing the effects of statins on serum ferritin levels that were included showed a significant decrease in circulating ferritin levels caused by statins. The results did not suggest any significant association between the changes in concentrations of serum ferritin and the duration of treatment with statins. Conclusions: Statin therapy decreases the circulating concentrations of ferritin, which might be beneficial for the prevention and/or progression of ASCVD. This effect might be explained by the anti-inflammatory effects and maybe some other pleiotropic effects of statins and not by their lipid-lowering effects.

Protein tyrosine phosphatase receptor type delta (PTPRD) gene in an animal model of restless legs syndrome.

The pathophysiology of the restless legs syndrome (RLS) is related to dopaminergic dysfunction, reduced iron and variations in gene expression, such as the protein tyrosine phosphatase receptor type delta gene (PTPRD). Animal models could be key to achieving a mechanistic understanding of RLS and to facilitate efficient platforms for evaluating new therapeutics. Thus, the aim of this study was to evaluate the expression of PTPRD, of genes and proteins associated with RLS, the sleep patterns and the cardiovascular parameters in an animal model of RLS (spontaneously hypertensive rat [SHR]). Rats were divided into two groups: (i) Wistar-Kyoto and (ii) SHR. Cardiovascular parameters were assessed by tail plethysmography. Polysomnography was used to analyse the sleep pattern (24 h). For the PTPRD analyses, quantitative polymerase chain reaction (qPCR) and indirect enzyme-linked immunosorbent assay (ELISA) techniques were used. To evaluate the tyrosine hydroxylase enzyme, dopamine transporter (DAT) and type 2 dopaminergic receptor, qPCR and Western Blotting techniques were used. For the quantification of iron, ferritin and transferrin, the ELISA method was used. SHRs had higher blood pressure, alterations in sleep pattern, lower expression of protein content of PTPRD, lower expression of DAT, and lower serum concentrations of ferritin. These data suggest that the behavioural, physiological, and molecular changes observed in SHRs provide a useful animal model of RLS, reinforcing the importance of this strain as an animal model of this sleep disorder.

Association Between Serum Ferritin Concentration and Risk of Adverse Maternal and Fetal Pregnancy Outcomes: A Retrospective Cohort Study.

ObjectiveThis study evaluated the associations of serum ferritin (SF) concentration during pregnancy with the risk of adverse maternal and fetal pregnancy outcomes.MethodsWe conducted a retrospective study of 2327 pregnant women from 2015 to 2020 in Guangdong, China. SF concentrations were measured at 16–18th and 28–32th week of gestation. Logistic regression models were applied to estimate the association between SF concentration and the risk of adverse pregnancy outcomes.ResultsAfter multivariable adjustment, the odds ratio (OR) of the highest quartile of SF concentration at 16–18th week of gestation was 1.43 (95% confidence interval [CI]: 1.09, 1.89) for gestational diabetes mellitus (GDM) and 1.79 (95% CI: 1.15, 2.79) for small for gestational age (SGA) when compared with the lowest quartile. At 28–32th week of gestation compared with the lowest quartile, women with SF in the highest quartile had an increased risk of SGA (OR: 1.62; 95% CI: 1.01, 2.62). Moreover, the lowest quartile of SF concentration decreased risk of SGA by 90% (95% CI: 0.01, 0.80) when compared with the highest quartile among pregnancy women with GDM.ConclusionElevated SF concentrations increased the risk of GDM and SGA during pregnancy. Maintaining an appropriately low level of maternal SF at 28–32th week of gestation in women with GDM could reduce the risk of SGA.

Exercise-induced Hemolysis And Iron Regulation In Response To Mechanical Stress

Hepcidin, a liver derived hormone, plays a role in iron regulation due to decreases in iron absorption and/or iron recycling. Exercise-induced hepcidin secretion is thought to be augmented by increased interleukin-6 (IL-6) and hemolysis (i.e., disruption of red blood cells). However, it is difficult to comprehend the contributions of hemolysis during exercise for hepcidin secretion. PURPOSE: To investigate the impact of exercise-induced hemolysis by a drop jump with concomitant repetitions of mechanical stress on hepcidin response. METHODS: Ten healthy males attended in this study [means ± SD, age: 24 ± 3 yrs, height: 170.6 ± 5.8 cm, body weight: 64.4 ± 7.2 kg]. Participants conducted two trials on different days, consisting of drop jump exercise to induce mechanical stress (DJ trial) or without exercise (CON trial). DJ trial consists of 100 bouts of drop jump from a 60 cm box, and each jump was conducted with their maximal effort. Blood samples were collected before trials, immediately, 1 h, 2 h and 3 h after completion of trials. The timing of blood sampling in CON trial was matched with DJ trial. A p value less than 0.05 was considered statistically significant. RESULTS: Baseline serum ferritin concentration did not significantly differ between DJ (73.1 ± 42.8 ng/mL) and CON trials (65.2 ± 31.6 ng/mL, p = 0.135). Serum iron and myoglobin concentration significantly increased and serum haptoglobin concentrations significantly decreased post-exercise in DJ trial (p < 0.05). Plasma IL-6 concentration did not increase in either trial (p > 0.05). Serum hepcidin concentration significantly increased 3 h after both trials (p < 0.05); however, the relative increase in serum hepcidin concentrations did not differ significantly between DJ and CON trials (77.4 ± 70.6% vs. 39.1 ± 51.5%, p = 0.184). CONCLUSIONS: Hemolysis was occurred following the drop jump exercise, while post-exercise IL-6 and hepcidin elevations were not different between the trials. Mechanical stress-induced hemolysis may not be sufficient to induce hepcidin elevation without IL-6 changes.

Effects of ferric ammonium citrate on iron accumulation, bone turnover and bone density in ovariectomized rat models with osteoporosis.

To analyze the effect of ferric ammonium citrate on iron accumulation, bone turnover and bone density in ovariectomized rat models with osteoporosis, 40 female SD rats were randomized into four groups, that were, sham-operated, model, low and high-dose ferric ammonium citrate groups (i.e. low and high-dose groups) respectively, each of them had ten rats. Except for the sham-operated group, bilateral ovariectomy was performed in the other groups to establish models with osteoporosis; one week after the operation, those in the low and high-dose groups were given 90 mg/kg and 180 mg/kg ferric ammonium citrate, respectively. Those in the other two groups received isodose saline for nine weeks, with the frequency of twice per week. The changes in bone tissue morphology, serum ferritin concentration, tibial iron content, serum osteocalcin, carboxyl terminal peptide (β - CTX), bone density, bone volume fraction and trabecular thickness were compared. Results showed that the rats in the low and high-dose groups contained a higher concentration of serum ferritin and tibial iron content compared to the other groups (P < 0.05). In contrast to the model group, the bone trabeculae in the low and high-dose groups were sparse in morphology and increased in spacing. It was obvious that the rats contained more osteocalcin and β - CTX in the model group, the low and high-dose groups versus the sham-operated group (P < 0.05), and those had more β - CTX in the high-dose group versus the model group and the low-dose group (P < 0.05). The bone density, bone volume fraction and trabecular thickness of the rats in the model group, the low and high-dose groups showed lower versus the sham-operated group (P < 0.05); those in the low and high-dose groups significantly presented lower bone density and bone volume fraction versus the model group (P < 0.05). Iron accumulation can aggravate osteoporosis in ovariectomized rats, and its mechanism may be associated with accelerating bone turnover, promoting bone absorption, reducing bone density and sparsely trabecular structure. Therefore, it is particularly important to understand iron accumulation in postmenopausal osteoporosis patients.

Assessing whether serum ceruloplasmin promotes non-alcoholic steatohepatitis via regulating iron metabolism.

Non-alcoholic steatohepatitis (NASH) is a progressive form of non-alcoholic fatty liver disease (NAFLD). The diagnostic gold standard for detecting NASH still relies upon an invasive pathological biopsy. There is, therefore, a need to identify non-invasive diagnostic markers. Oxidative stress mediates fatty liver progression to NASH. Imbalanced iron metabolism produces many reactive oxygen species (ROS). Ceruloplasmin is associated with oxidase and iron metabolism-related activities. The current study aimed to determine whether there was a correlation between ceruloplasmin levels and NASH and whether such a relationship may be associated with altered iron metabolism in NASH patients. A total of 135 NAFLD patients were enrolled in this study. A pathological biopsy confirmed that 60 of those patients had NAFLD activity scores (NAS) 5, while the remaining 75 had NAS<5. Receiver operating characteristic (ROC) curves confirmed that serum ceruloplasmin and ferritin levels were predictors of NAS 5 and NAS<5, with area under the curve (AUC) values of 0.80 and 0.81, respectively. The serum ceruloplasmin levels in NAS 5 patients were significantly lower than those in NAS<5 patients (p< 0.001). Serum ceruloplasmin levels were also negatively correlated with ferritin levels. Lower serum ceruloplasmin levels were associated with more severe histopathological findings. Low serum ceruloplasmin and high serum ferritin are correlated with NASH. A high concentration of serum ferritin is a viable clinical biomarker of NASH, and low serum ceruloplasmin may participate in the occurrence of NASH by regulating iron load, which can be used as a non-invasive diagnostic marker of NASH.

Determination of the concentration of serum ferritin, D-dimer, CRP and IL-6 in patients who affected with COVID-19

Background; SARS-CoV-2, the novel corona virus that originated in Wuhan, China in late December is a positive single stranded RNA virus. COVID-19, a disease caused by the SARS-CoV-2 is characterized by symptoms such as fever, sore throat, dry cough, loss of sense of taste and smell etc. The symptoms may range from asymptomatic, mild, moderate, severe and critical. The virus enters through its spike protein (S) to the ACE2 receptors. The aim of the study is to evaluation of ferritin, D-dimer, CRP and IL-6 in patients who affected with COVID-19. Patients and methods; A cross-sectional conducted in many Hospitals in Baghdad. This study conducted between January to June 2022 on patients infected with the Corona virus. A total of sixty subjects were participated in the present study. Thirty patients of both sexes, with different ages and in the severity infection with the Corona virus, divided into two groups. Results; There were significant elevations in the concentration of serum ferritin and D dimer of COVID-19 patients, as compared with control healthy subjects. Also, there is significant elevation in the concentration of serum CRP of patients with COVID-19, as compare with control healthy subjects.

Association between non-anemic iron deficiency in early pregnancy and perinatal mental health: A retrospective pilot study.

Postpartum anemia and iron deficiency are reportedly involved in postpartum depression, but the association between perinatal depression and iron deficiency with or without anemia is poorly documented. This pilot study retrospectively investigated the relationship between non-anemic iron deficiency (NAID) in early pregnancy and perinatal depressive symptoms. This study included 31 non-anemic women among patients who received perinatal care with preserved residual serum from routine antenatal checkups in Kyoto University Hospital. All participants gave informed consent for research. The ferritin concentration in their preserved serum was measured. The hemoglobin (Hb) and ferritin in early pregnancy, as well as the Edinburgh Postpartum Depression Scale (EPDS) at mid-pregnancy and 1 month after childbirth were analyzed. Iron deficiency was defined as a serum ferritin concentration < 30 ng/mL. Based on the ferritin level in early pregnancy, 13 women (41.9%) had NAID, whereas 18 were normal. The mean Hb and ferritin were 12.7 ± 0.6g/dL and 18.5 ± 5.8ng/mL in the NAID group and 12.8 ± 0.9g/dL and 74.7 ± 39.2ng/mL in the normal group, respectively. The median EPDS scores at mid-pregnancy and 1 month postpartum, respectively, were 2.0 (2.0-3.3) and 5.0 (4.0-6.6) in the NAID group and 4.5 (2.3-7.3) and 4.5 (2.3-5.7) in the normal group. EPDS scores increased significantly from mid-pregnancy to 1month postpartum in the NAID group only. NAID in early pregnancy was highly prevalent and was suggested to reduce resilience to depression during the perinatal period.

Beyond hemoglobin: uncovering iron deficiency and iron deficiency anemia using serum ferritin concentration among pregnant women in eastern Ethiopia: a community-based study

BackgroundAlthough the high burden of anemia among pregnant women in low-resource settings like Ethiopia is well documented, evidence is scarce on the underlying causes using biochemical tests. Therefore, this study assessed the iron status and factors associated with iron deficiency (ID) using serum ferritin concentration among pregnant women in Haramaya district, eastern Ethiopia.MethodsA community-based cross-sectional study was conducted among randomly selected pregnant women in Haramaya district, eastern Ethiopia. The serum ferritin (SF) concentration was measured in the National Biochemical Laboratory of Ethiopia on a fully automated Cobas e411 (German, Japan Cobas 4000 analyzer series) immunoassay analyzer using the electro-chemiluminescence (ECL) method and standard procedures. A log-binomial regression analysis identified variables associated with iron deficiency, and defined as serum ferritin concentration < 15 μg/L (per the World Health Organization recommendation in developing countries). An adjusted risk ratio (aRR), and a 95% confidence interval (CI), were used to report associations. Finally, the p-value < 0.05 was the cut-off point for the significant association.ResultsA total of 446 pregnant women with a mean age of 24.78 (+ 5.20) were included in the study. A total of 236 (52.91%; 95% CI: 48.16–57.63) had iron deficiency. The overall prevalence of anemia and iron deficiency anemia (IDA) was 45.96% (95% CI: 41.32–50.71) and 28.03% (95% CI: 21.27–32.44), respectively. The risk of iron deficiency was more likely among women with low dietary diversity (aRR = 1.36; 95% CI = 1.07–1.72) and those who skipped meals (aRR = 1.29; 95% CI = 1.05–1.57), but less among women who had antenatal care (aRR = 0.73 (95% CI = 0.61–0.88).ConclusionMore than half of the pregnant women in eastern Ethiopia had iron deficiency. Improving dietary diversity, meal frequency, and prenatal follow-up is essential to improve the high burden of ID and the adverse effect on pregnant women and the fetus. Moreover, a prospective study comparing maternal and perinatal outcomes among these spectra—iron depletion, ID, and IDA—is crucial for understanding their impact on maternal and perinatal mortality and morbidity.

Clinical utility of reticulocyte hemoglobin equivalent in patients with heart failure

Anemia and iron deficiency (ID) are common in patients with heart failure (HF) and intravenous (IV) administration of iron to patients hospitalized for decompensated HF with ID improves outcome. The diagnosis of ID in routine practice is based on serum ferritin and transferrin saturation (TSAT) but both have limitations; alternatives should be considered. Reticulocyte hemoglobin equivalent (Ret-He) reflects iron content in reticulocytes but its clinical utility in patients with HF remains uncertain. We prospectively enrolled 142 patients hospitalized for decompensated HF. Sixty five percent had ID as defined in current international guidelines. Ret-He was directly correlated with serum iron and ferritin concentrations and with TSAT. There was a poor relationship between quartile of Ret-He and HF hospitalization or death but increases or decreases in Ret-He between admission and discharge were associated with a worse outcome. The clinical utility of Ret-He for identifying ID and predicting response to IV iron and prognosis for patients with HF requires further investigation.

RETROSPECTIVE ANALYSIS OF THE RELATIONSHIP BETWEEN SERUM FERRITIN LEVELS, INSULIN RESISTANCE, METABOLIC SYNDROME, AND NUTRITIONAL STATUS IN OBESE INDIVIDUALS

Bu çalışmada, obez bireylerin beslenme durumlarının serum ferritin değerleri, insülin direnci ve metabolik sendrom ile ilişkisi bakımından retrospektif olarak incelenmesi amaçlanmıştır. Araştırmanın örneklemini Özel 19 Mayıs Hastanesi Beslenme ve Diyet polikliniğine 1 Ocak 2020’den itibaren başvurmuş 210 obez birey oluşturmaktadır. Bu bireylerin antropometrik ölçümleri, biyokimyasal bulguları, genel sağlık durumları ve beslenme durumları hasta dosyalarından kaydedilmiştir. Çalışmaya dahil edilen bireyler serum ferritin değerlerine göre; ferritin düzeyi ˂14,52 ng/mL ise kuartil 1 (Q1), 14,52-35,49 ng/mL ise Q2, 35,49-70,68 ng/mL ise Q3, ˃70,68 ng/mL ise Q4 olarak 4 gruba ayrılmıştır. Bireylerin beden kütle indeksi (kg/ m2) ferritin kuartillerine göre incelendiğinde Q2’de en yüksek beden kütle indeksi (32,5±6,4 kg/m2) gözlenmiştir (p˃0,05). Bel çevresi ölçümlerinde en yüksek bel çevresi ortalaması Q4’te olup (114,85±15,09 cm), kuartiller arasındaki fark anlamlı bulunmamıştır (p˃0.05). Bireylerin serum HOMA-IR ortalama değerleri en yüksek Q4’de (4,10±5,05) bulunmaktadır. HOMA-IR düzeyleri ferritin kuartiline göre istatistiksel açıdan önemli bulunmuştur (p˂0.05) Trigliserit değerleri Q4’te (169,43±93,40); HDL değerleri Q2’de (58,68±11,69); LDL değerleri ise Q4’te (127,21±35,15) en yüksek bulunmuştur. (˂0.05) Bireylerin ferritin quartillerine göre beslenme durumlarına bakıldığında protein tüketiminin en yüksek Q4’te olduğu (112,1±29,8 g/gün), karbonhidrat tüketiminin ise en yüksek Q1’de (395,2±83,6 g/gün) olduğu görülmüştür (p˂0.05). Obez bireylerin protein tüketimleri (g/gün) ile serum ferritin düzeyleri arasında pozitif yönlü orta kuvvetli bir ilişki tespit edilmiştir (r:0,506, p:0,000). Sonuç olarak yüksek serum ferritin konsantrasyonları yüksek trigliserit, yüksek LDL, yüksek HOMA, AST ve ALT değerleri ve daha düşük HDL değerleri ile ilişkilendirilmiştir. Obez bireylerde serum ferritinin yüksek olması insülin direnci ve metabolik sendrom için risk faktörü olabileceği belirlenmiştir. Bu risk faktörlerinden korunmak için obez bireylere yaşam tarzı değişikliği önerilmelidir.

Identification of Serum Ferritin-Specific Nanobodies and Development towards a Diagnostic Immunoassay.

Serum ferritin (SF) is an iron-rich protein tightly connected with iron homeostasis, and the variations are frequently observed in diseased states, including iron-deficiency anemia, inflammation, liver disease, and tumors, which renders SF level an indicator of potential malignancies in clinical practice. Nanobodies (Nbs) have been widely explored and developed into theranostic reagents. Surprisingly, no reports stated the identification of anti-SF Nbs, nor the potential of such Nbs as a diagnostic tool. In this study, we generated SF-specific Nbs and provided novel clinical diagnostic approaches to develop an immunoassay. An immune library was constructed after immunizing an alpaca with SF, and five Nbs specifically targeting human SF were retrieved. The obtained Nbs exhibited robust properties including high stability, affinity, and specificity. Then, an ELISA-based test using a heterologous Nb-pair was developed. The calibration curve demonstrated a linear range of SF between 9.0 to 1100 ng/mL, and a limit of detection (LOD) of 1.01 ng/mL. The detecting recovery and coefficient variation (CV) were determined by spiking different concentrations of SF into the serum sample, to verify the successful application of our selected Nbs for SF monitoring. In general, this study generated SF-specific Nbs and demonstrated their potential as diagnostic immunoassay tools.

Iron Metabolism Markers in Patients with Tuberculosis Combined with HIV Infection

Background. Changes of iron metabolism in patients with tuberculosis combined with HIV infection is an important task of phthisiology, since, on the one hand, iron deficiency can have a negative effect on the course of the tuberculous process. On the other hand, compensation for iron deficiency may be creating an iron overload situation, promoting replication of M. tuberculosis. Aims to study in a comparative aspect, changes in iron metabolism markers in patients with tuberculosis combined with HIV infection and without it. Methods. The study included 284 tuberculosis patients who were divided into 2 groups. The first group included 141 patients with tuberculosis combined with HIV (TB/HIV group). The comparison group consisted of 143 tuberculosis patients without HIV (TB group). The assessment of the bodys iron supply was carried out in terms of the concentration of serum iron, transferrin (TF), and ferritin (FT). The study was conducted separately in men and women, since the indicators of iron metabolism in healthy men and women differ significantly. Results. It was found that in men with TB/HIV patients, the decrease in serum iron less than the lower limit of the norm took place in 47.6%, and in the TB group in 27.3% of cases (p 0.01). The concentration of TF in the blood serum in the group of TB/HIV patients in men decreased in 69.9%, and in the group of TB patients in 31.2% of cases (p 0.01). The level of FT in the TB/HIV group increased in 19.4%, and in the TB group in 8.3% of cases (p 0.05). In women, a decrease in iron levels in the group of TB/HIV patients was observed in 39.5%, and in the TB group only in 2.2% of cases (p 0.01), a decrease in the level of TF was observed in 55.2% and 24.3% (p 0.01). A decrease in ferritin levels below 15 ng/ml was observed in 15.7% of women with TB/HIV and in 10.6% of TB patients. A negative relationship was found between iron content and CRP levels. Conclusion. The results of studied made it possible to conclude that in all cases the decrease in iron was caused not by a true deficiency of iron, but by its redistribution in the body. At the same time, a small number of women with tuberculosis combined with HIV infection and tuberculosis without HIV infection showed a significant decrease in ferritin levels, which indicated that they had a true iron deficiency.

Serum Ferritin: As a Biomarker in Diagnosis of Dengue Fever

Background: Major public health risk was ‘Dengue infection’ initial discovery is critical to improving the existence in serious infection of dengue. Our objective in this study was to investigate the serum ferritin level to suppose biomarker in the diagnosis of dengue fever. Method: An observational and prospective study was conducted in the Hayatabad Medical Complex and it included one hundred nineteen cases related to dengue was diagnosed by using NSI Test antigen or serology test related to specific dengue that internment “ELISA”. At the time of diagnosis, serum ferritin was measured. Monitoring the clinical and platelets counts was done on daily bases, it also classified into two groups such as non-severe and severe groups by allowing WHO criteria in 2009. Result: Five out of 119 cases of dengue were severe, dengue patients had lower platelets when they are in severe condition, count the number of platelets (p less than 0.0001); Ferritin level almost high (p=0.02) and the value of hospital longer time period (p less than 0.0001) mostly in severe group as compare to non-severe group of dengue. Platelets count had negative value with age factor almost Positive correlations with ferritin levels (p=0.08 or r= 0.16) and a longer hospital stay (r= -0.427 and p 0.0001) were also found (r= 0.26, p= 0.004). These values indicate the severe risk of dengue infection/ disease. Negative value of serum ferritin that are related to the value of platelets (r=0.51 and p&lt; 0.001). On day 4 of clinical infections, an elevated value of ferritin is seen in severe cases. Conclusion: In Clinical practice, a biomarker for determining the severity of dengue infection is increased serum ferritin concentrations. Keywords: Biomarkers, Serum ferritin, Severity, Dengue infection, Predicators

Association of biomarkers and severity of COVID-19: A crosssectional study.

Introduction COVID- 19 is a disease that has claimed the lives of many people. However, alterations in labo-ratory profiles in the city of Tacna have not been accurately established in association with its severity to support diagnosis and treatment. Objective To determine biomarkers related to the severity of COVID- 19 in patients treated at the social security hospital in Tacna during 2020. Methods We performed an observational, cross- sectional, and analytical study that included 308 patients with COVID- 19 from the social security hospital in Tacna, Peru, during the "first wave" of the pandemic (from July to August 2020). Immunological, hematological, arterial gas, hemostasis, and biochemical markers were collected. Patients were categorized into mild, moderate, and severe based on the clinical criteria found on clinical records. Correlation strength was per-formed according to Spearman's Rho coefficient. The performance of the biomarkers associat-ed with severity was analyzed with the Receiver Operating Characteristic curve. Results Regarding hematological markers there was a positive correlation with monocyte count (correla-tion coefficient: 0.841; area under the curve 97.0%; p < 0.05) and a negative correlation with lymphocyte count (correlation coefficient: -0.622; area under the curve 82.7%; p < 0.05). Regarding biochemical markers, arterial gases and hemostasis, no significant correlations were found. In immunological markers, we found positive correlation with ferritin (correlation coef-ficient: 0.805; area under the curve 94.0%; p < 0.05), and C- reactive protein (correlation coeffi-cient: 0.587; area under the curve 87.4%; p < 0.05). Conclusions The biomarkers that can be considered as parameters associated with the severity of COVID- 19 are the absolute blood count of monocytes and serum ferritin concentration.

Adequate Dietary Intake and Vitamin D Supplementation: A Study of Their Relative Importance in Determining Serum Vitamin D and Ferritin Concentrations during Pregnancy.

Vitamin D is essential for human health. However, it is not clear if vitamin D supplementation is necessary for all pregnant women. This study examines the relative importance of dietary patterns and vitamin D supplementation frequency in determining serum 25-hydroxyvitamin D (25(OH)D) and ferritin concentrations among pregnant women in Hong Kong, China. A total of 572 healthy women were recruited from antenatal clinics at 25–35 weeks pregnant. Participants completed an electronic version of the food frequency questionnaire and a web questionnaire on supplement use. Their blood samples were tested for serum 25(OH)D and ferritin. The associations of dietary patterns and vitamin D supplementation frequency with serum 25(OH)D and ferritin concentrations were analyzed using moderated hierarchical regression. Two dietary patterns were identified. The adequate dietary intake was characterized by the high probability of meeting recommended daily food group servings, whereas the inadequate dietary intake was characterized by inadequate consumption of vegetables, fruits, meat, fish, and eggs, or alternatives. The association between adequate dietary intake and serum ferritin concentrations was independent of vitamin D supplementation frequency (β = 0.05, p = 0.035), but dietary patterns interacted with vitamin D supplementation frequency to determine serum 25(OH)D concentrations (β = −13.22, p = 0.014). The current study presents evidence on the relative importance of dietary patterns and vitamin D supplementation in maintaining sufficient vitamin D and iron in pregnancy. Antenatal nutrition counselling services should be provided to pregnant women who show signs of inadequate dietary intake.