Serum Ferritin Concentration Research Articles

Study on Changes of the Concentration of Some Indicators of the Serum Iron Test in Patients with Nephrotic Syndromein Vietnam

Background: In nephrotic syndrome (NS), the excessive and prolonged loss of protein in the urine reducesalbumin blood and leads to many other changes such as dyslipidemia, blood clotting disorders, and disordersof hematopoietic components. In NS, the more persistent and persistent decrease in albumin in the blood, themore apparent these disorders, including disorders of iron, transferrin and ferritin in serum. The objectivesof the study were to: Determine serum iron, transferrin and ferritin concentrations and Investigate therelationship between iron, transferrin and ferritin concentrations and serum albumin in NS patients.Methodology: Cross-sectional descriptive research method. Convenient and controlled sample selectionof 68 NS patients without kidney failure, aged 16 years and over, hospitalized for treatment at InternalDepartment of Hue University of Medicine and Pharmacy Hospital, Vietnam.Results: The average serum iron concentration is 8.9 µmol/L, of which at low level, the rate is 30.9%; In100% of cases, the serum transferrin concentration is lower than normal, the average concentration is 0.68mmol/L; the average elevation of ferritin in serum was 610.3 pmol/L, of which at high level accounted for67.6% (46 patients). Serum albumin concentrations are positively correlated with iron and transferrin, butnegatively with serum ferritin.Conclusion: In NS, the serum ferritin concentration is elevated and inversely correlated with the serum iron,transferrin, and albumin concentration.

Sustained Exposure to High Carbohydrate Availability Does Not Influence Iron-Regulatory Responses in Elite Endurance Athletes.

This study implemented a 2-week high carbohydrate (CHO) diet intended to maximize CHO oxidation rates and examined the iron-regulatory response to a 26-km race walking effort. Twenty international-level, male race walkers were assigned to either a novel high CHO diet (MAX = 10g/kg body mass CHO daily) inclusive of gut-training strategies, or a moderate CHO control diet (CON = 6g/kg body mass CHO daily) for a 2-week training period. The athletes completed a 26-km race walking test protocol before and after the dietary intervention. Venous blood samples were collected pre-, post-, and 3hr postexercise and measured for serum ferritin, interleukin-6, and hepcidin-25 concentrations. Similar decreases in serum ferritin (17-23%) occurred postintervention in MAX and CON. At the baseline, CON had a greater postexercise increase in interleukin-6 levels after 26km of walking (20.1-fold, 95% CI [9.2, 35.7]) compared with MAX (10.2-fold, 95% CI [3.7, 18.7]). A similar finding was evident for hepcidin levels 3hr postexercise (CON = 10.8-fold, 95% CI [4.8, 21.2]; MAX = 8.8-fold, 95% CI [3.9, 16.4]). Postintervention, there were no substantial differences in the interleukin-6 response (CON = 13.6-fold, 95% CI [9.2, 20.5]; MAX = 11.2-fold, 95% CI [6.5, 21.3]) or hepcidin levels (CON = 7.1-fold, 95% CI [2.1, 15.4]; MAX = 6.3-fold, 95% CI [1.8, 14.6]) between the dietary groups. Higher resting serum ferritin (p = .004) and hotter trial ambient temperatures (p = .014) were associated with greater hepcidin levels 3hr postexercise. Very high CHO diets employed by endurance athletes to increase CHO oxidation have little impact on iron regulation in elite athletes. It appears that variations in serum ferritin concentration and ambient temperature, rather than dietary CHO, are associated with increased hepcidin concentrations 3hr postexercise.

The Association between Serum Oxidative Stress Indexes and Pathogenesis of Parkinson's Disease in the Northwest of Iran.

Background:Parkinson’s disease (PD) is a prevalent neurodegenerative disorder. Oxidative stress is a main modulator in the advancement of PD. This investigation aimed to evaluate the relations between serum trace elements, vitamin C, ferritin, transferrin, Nitrite Oxide (NOx) and Peroxynitrite (PrN) concentrations and clinical parameters in patients with PD.Methods:Serum concentrations of variables were measured in 75 PD patients and 75 healthy subjects from Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran between Feb 2016 and Sep 2018. Receiver Operating Characteristic (ROC) analysis was performed to examine incremental diagnostic value of vitamin C, NOx, and PrN in the study groups.Results:Mean serum NOx (35.81±5.16 vs. 11.27±3.59 mol/L, P<0.001) and PrN (15.78±4.23 vs. 9.62±4.57 mol/L, P= 0.004) were markedly higher in patient group versus healthy individuals. Significant differences were also observed in the serum levels of vitamin C (P<0.001), copper (Cu) (P<0.001), Iron (Fe) (P=0.003), and Zinc (Zn) (P<0.001) between patients with PD and healthy subjects. Nevertheless, the serum levels of Se (P=0.515), ferritin (P=0.103), and transferrin (P=0.372) were not statistically significant between the study groups. ROC analysis has revealed a diagnostic ability of serum vitamin C levels for PD with an area under ROC curve of ≥0.7 (P<0.05) and relatively high sensitivity and specificity.Conclusion:Serum levels of NOx and PrN are significantly higher in patients with PD. In additions, serum vitamin C levels have a diagnostic value as a biomarker. Further studies are required with larger sample size to provide more detailed information about the cognitive profile of participants and the outcome measures.

Impact of ferritin serum concentration on survival in children with acute leukemia: a long-term follow-up

Introduction: Nowadays, a significant number of children with acute leukemia can be cured. Iron overload, related to blood transfusions and its long-term complications, remains a problem. Elevated ferritin concentration is often observed in this group. The aim of this study was to evaluate the prognostic value of serum ferritin on long-term outcomes in children treated for acute leukemia. Material: We studied 71 patients treated for acute lymphoblastic (ALL) or myeloblastic (AML) leukemia between 2005 and 2011. Serum ferritin concentration, serum transaminases activity, lactic dehydrogenase and C-reactive protein levels (CRP) were analysed. Serum ferritin &gt;1,000 µg/L was considered to be a marker of iron overload. Results: Thirty-seven patients (52.1%) had iron overload. Ferritin serum concentration correlated with alanine aminotranferase activity ( p =0.001) and CRP concentration ( p =0.012). A total of 19 (26.76%) patients died during follow-up. Ferritin level was higher in patients with AML vs. ALL. There was a significant difference in long-term outcomes with respect to high ferritin concentrations, both in patients undergoing haematopoietic cell transplantation (HCT) and in the non-HCT group. Conclusions: In both groups, patients with higher ferritin concentrations had worse overall and event-free survivals and a higher relapse incidence. Ferritin concentration &gt;1,000 µg/L was the strongest determinant of long-term treatment outcome. Ferritin serum concentration &gt;1,000 µg/L is an adverse prognostic marker of survival in children with acute leukemia treated with chemotherapy with or without HCT.

The Association Between Ferritin and Vitamin D Levels in Premenopausal Fibroid Uterus Cases With Anemia.

ObjectiveThe present study aimed to evaluate the association between serum ferritin and vitamin D levels in fibroid uterus cases presenting with anemia.MethodsSixty premenopausal women with uterine fibroids (30 associated with anemia and 30 without anemia) were enrolled as cases and control. All participants were evaluated on the basis of a questionnaire, which included queries related to obstetric, medical, and sociodemographic history. Peripheral blood smear, complete blood count (CBC), hemoglobin (Hb), and serum ferritin concentration were measured by a fully automated analyzer, and 25(OH) vitamin D level was measured by enzyme-linked immunosorbent assay (ELISA).ResultsThere was a significant difference in ferritin levels between cases and control (p<0.001). The exposure to sunlight was moderate (one-hour exposure) in all subjects, eliminating the confounding effect of sunlight exposure influencing vitamin D levels. The median vitamin D level in cases was 5.0 ng/ml [interquartile range (IQR): 4.8], and that in control was 18.4 ng/ml (IQR: 7.9; p<0.001). A strong positive correlation of (r)=0.616 (p<0.001) was found between serum ferritin and vitamin D levels.ConclusionFibroid uterus cases with anemia are more prone to vitamin D deficiency as compared to cases without anemia. Vitamin D estimation in fibroid uterus cases presenting with anemia would be useful for better patient management.

Importance of Iron Absorption in Human Health: An Overview

Iron is one of the essential elements required for human health, as it plays a vital role in a number of metabolic, growth, and developmental processes, including erythropoiesis, DNA synthesis, electron transport, and others. Iron deficiency is a concern in both developing and developed (industrialized) countries, and, in particular, young women are highly vulnerable. This review investigates the dietary and genetic determinants of iron metabolism in the human body and a possible solution to combat iron deficiency by exploring various targets. Hence, this review mainly focuses on the assessment of dietary and genetic factors affecting the iron bioavailability and homeostasis and collates the available information from 2000 to till date from the Pubmed database. The dietary factors, including ascorbic acid, an important factor in animal protein foods (meat, fish, and poultry), enhance iron absorption whereas the phytic acid, soy protein, calcium, and polyphenols have been reported to inhibit iron absorption. However, the effects of these dietary factors on iron absorption do not necessarily translate into an association with iron status and iron stores (serum ferritin concentration). Moreover, the genetic factors influence the absorption of iron involving HFE, TFR2, FPN1, and HAMP in humans. Further research is needed to determine optimal dietary recommendations for both the prevention and treatment of iron deficiency.

Hepcidin response to three consecutive days of endurance training in hypoxia.

The purpose of this study was to determine the effects of 3 consecutive days of endurance training in hypoxia on hepcidin responses. Nine active healthy males completed two trials, consisting of 3 consecutive days of endurance training in either hypoxia [fraction of inspired oxygen (FiO2): 14.5%) or normoxia (FiO2: 20.9%). On days 1-3, participants performed one 90min session of endurance training per day, consisting of high-intensity endurance interval exercise [10 × 4min of pedaling at 80% of maximal oxygen uptake ([Formula: see text]O2max) with 2min of active rest at 30% of [Formula: see text]O2max] followed by 30min of continuous exercise at 60% of [Formula: see text]O2max. Venous blood samples were collected prior to exercise each day during the experimental period (days 1-4) to determine serum hepcidin, iron, ferritin, haptoglobin, and ketone body concentrations. Serum iron (p < 0.0001), ferritin (p = 0.005) and ketone body (p < 0.0001) concentrations increased significantly in both trials on days 2-4 compared with day 1, with no significant differences between trials. No significant changes in serum haptoglobin concentrations were observed throughout the experimental period in either trial. Serum hepcidin concentrations also increased significantly on days 2-4 compared with day 1 in both trials (p = 0.004), with no significant differences observed between trials. 3 consecutive days of endurance training in hypoxia did not affect hepcidin concentrations compared with endurance training in normoxia.

Serum Ferritin Concentration in the Early Third Trimester of Pregnancy and Risk of Preterm Birth and Low Birth Weight Based on Gestational Age

Objective: Although serum ferritin is considered the best measure of total body iron, with low levels indicating iron deficiency, recent studies have shown that high levels are associated with gestational diabetes, premature birth, and low birth weight. This study aimed to analyze the association between serum ferritin levels in the third trimester of pregnancy and low birth weight and preterm birth.Methods: This study included pregnant women who delivered a single fetus at Kangwon National University Hospital between January 2009 and December 2013 and in whom serum ferritin levels were measured between 28 and 34 weeks of gestation. The association between serum ferritin levels measured in the early third trimester of pregnancy and preterm birth and low birth weight infants was analyzed.Results: A total of 1,079 women fulfilled the study criteria and had their serum ferritin level measured during the third trimester (28–33.9 weeks of gestation) and later delivered at Kangwon National University Hospital. Comparison of the group with serum ferritin levels above the 75th percentile and those below the 25th percentile at the beginning of the third trimester revealed that the incidence of preterm births (&lt;34 weeks of gestation, &lt;37 weeks of gestation) and low birth weight were significantly higher in the group with serum ferritin levels above the 75th percentile than those below the 25th percentile (p&lt;0.05). When variable factors were controlled through multiple regression analysis, the group whose serum ferritin levels were above the 75th percentile at 30–31.9 weeks of gestation had the highest risk of preterm birth before 34 weeks of gestation (adjusted odds ratio [OR], 7.85; 95% confidence interval [CI], 1.32–29.9) and low birth weight (adjusted OR, 6.49; 95% CI, 2.10–20.0).Conclusion: In this study, when serum ferritin was high in the third trimester of pregnancy, it was significantly increased with preterm birth (&lt;34 and 37 weeks) and low birth weight. In particular, when serum ferritin levels were high at 30–31.9 weeks of gestation, the risk of premature birth before 34 weeks and low birth weight was statistically highest.

Iron therapy in pregnant women with iron deficiency anemia: a meta-analysis

Background: Pregnancy significantly increases the need for iron. The prevalence of anemia in pregnant women is high, affecting 41.8% of all pregnant women worldwide. In patients with low tolerance to oral iron, it is recommended to start them on parenteral iron therapy but with variable degree of efficacy. Hence this meta-analysis was done with the following aim. This study aimed to assess the efficacy of various iron preparations in pregnant women with iron deficiency anemia (IDA).Methods: Randomised controlled trials (RCTs) (available as full free text) which included iron therapy in pregnant women with iron deficiency anemia were retrieved from electronic databases viz. PubMed, Google scholar and IndMed, with specific search terms. Qualities of RCTs were assessed using JADAD score and four RCTs with high score were included for analysis using RevMan 5.3 software. Outcome measures were change in hemoglobin levels and serum ferritin concentration after one month of therapy.Results: In the four RCTs included, a total of 267 patients were treated with oral iron and 267 patients were treated with parenteral iron therapy. Change in the hemoglobin levels between the 2 groups had a standard mean difference of 0.73, 95% CI (-0.05-1.52), with the p-value of 0.07. To assess the change in the serum ferritin concentration a total of 188 patients in oral iron and 197 patients in parenteral iron therapy were included. There was a standard mean difference of 0.88, 95% CI (0.60-1.66), with a p value of&lt;0.00001.Conclusions: In the present meta-analysis we found that oral and parenteral iron therapy showed similar efficacy in improving the hemoglobin level in pregnant women.

Renal and dietary factors associated with hypertension in a setting of disadvantage in rural India.

Using a case-control design, we determined risk factors associated with hypertension in a disadvantaged rural population in southern India. Three hundred adults with hypertension and 300 age- and sex-matched controls were extensively phenotyped. Underweight (29%, body mass index < 18.0 kg m-2), chronic kidney disease (25%, estimated glomerular filtration rate <60 ml min-1 1.73 m-2) and anemia (82%) were highly prevalent. The ratio of sodium to potassium excretion was high (8.2). In multivariable conditional logistic regression of continuous variables dichotomized by their median value, hypertension was independently associated with greater abdominal adiposity as assessed by waist-hip ratio [odds ratio (95% confidence interval), 1.89 (1.21-2.97)], lesser protein intake as assessed by 24 h urea excretion [0.39 (0.24-0.65)], and lesser plasma renin activity [0.54 (0.35-0.84)]. Hypertension tended to be independently associated with lesser serum potassium concentration [0.66 (0.44-1.01), P = 0.06]. Furthermore, those with hypertension reported less frequent intake of vegetables and urinary sodium-potassium ratio correlated positively with serum sodium-potassium ratio (r = 0.18). Hypertension was also independently associated with lesser blood hemoglobin concentration [0.48 (0.26-0.88)]. Blood hemoglobin concentration was positively associated with serum iron (r = 0.41) and ferritin (r = 0.25) concentration and negatively associated with total iron binding capacity (r = -0.17), reflecting iron-deficiency anemia. Our findings indicate potential roles for deficient intake of potassium and protein, and iron-deficiency anemia, in the pathophysiology of hypertension in a setting of disadvantage in rural India. Imbalanced intake of potassium and sodium may be driven partly by deficient intake of vegetables or fruit.

Iatrogenic Iron Promotes Neurodegeneration and Activates Self-Protection of Neural Cells against Exogenous Iron Attacks.

Metal implants are used worldwide, with millions of nails, plates, and fixtures grafted during orthopedic surgeries. Iron is the most common element of these metal implants. As time passes, implants can be corroded and iron can be released. Ionized iron permeates the surrounding tissues and enters circulation; importantly, iron ions pass through the blood–brain barrier. Can iron from implants represent a risk factor for neurological diseases? This remains an unanswered question. In this study, we discovered that patients with metal implants delivered through orthopedic surgeries have higher incidence of Parkinson’s disease or ischemic stroke compared to patients who underwent similar surgeries but did not have implants. Concentration of serum iron and ferritin was increased in subjects with metal implants. In experiments in vivo, we found that injection of iron dextran selectively decreased the presence of divalent metal transporter 1 (DMT1) in neurons through increasing the expression of Ndfip1, which degrades DMT1 and does not exist in glial cells. At the same time, excess of iron increased expression of DMT1 in astrocytes and microglial cells and triggered reactive astrogliosis and microgliosis. Facing the attack of excess iron, glial cells act as neuroprotectors to accumulate more extracellular iron by upregulating DMT1, whereas neurons limit iron uptake through increasing DMT1 degradation. Cerebral accumulation of iron in animals is associated with impaired cognition, locomotion, and mood. Excess iron from surgical implants thus can affect neural cells and may be regarded as a risk factor for neurodegeneration.

Levels of major and trace metals in the scalp hair of Crohn's disease patients: correlations among transition metals.

Concentrations of 16 metals in the scalp hair of maleCrohn's disease (CD) patients (n = 28) were compared to those of male control subjects (n = 25). The majority of patients (n = 20) took an anti-inflammatory agent (mesalazine), and several patients underwent colectomy. A low concentration of serum ferritin was observed in approximately 50% of CD patients due to Fe-deficiency anemia. The concentrations of Fe, Cr, and Co in the hair of CD patients were significantly higher than those ofcontrol subjects, and particularly high concentrations were found in CD patients with low serum ferritin. Significant correlations were found among the concentrations of Fe, Cr, and Co in the hair of CD patients, but not in control subjects. In agreement with previous reports, a significant negative correlation was found between ferritin and transferrin concentrations in serum, although the available data in this study was limited (n = 8). Transferrin not only binds to Fe3+ but also to Cr3+ and Co3+, and the amount of transferrin is increased in Fe-deficiency anemia. Thus, the majority of the Fe3+, Cr3+, and Co3+ in the serum of CD patients is likely to bind to transferrin, which may be associated with the higher concentrations of those metals, as well as the significant correlations among those metals in the scalp hair of CD patients. In addition, colectomy may alter the intestinal absorption rate of some metals, while mesalazine may increase the concentrations of Mn and some metals in the scalp hair by chelate formation.

Association of High Serum Ferritin Level in Early Pregnancy with Development of Gestational Diabetes Mellitus- A Prospective Observational Study

Introduction: Gestational Diabetes Mellitus (GDM) has a negative impact on maternal and perinatal outcome and several long-term complications. The evidence from different experimental studies have shown that high serum ferritin concentration can lead to pancreatic β-cell dysfunction and impaired glucose metabolism leading to GDM. Aim: To determine the association of increased serum ferritin level in first trimester and GDM in course of pregnancy. Materials and Methods: A prospective observational study was conducted in 204 women in Institute of Post Graduate Medical Education and Research and SSKM Hospital, West Bengal, India, during the period from January 2015 to December 2015. The blood samples were collected and screened for GDM by Oral Glucose Tolerance Test (OGTT) at the beginning of the study and then assayed for serum ferritin level who were screened negative. The women were divided into four groups by quartiles of serum ferritin levels (Q1 to Q4). Then they were followed-up with OGTT at 24-28 weeks and again at 32-34 weeks. Statistical analysis was done by using paired t-test, Chi-square test and Fisher’s- exact test. Results: The participants had an average serum ferritin concentration of 77.44 ng/mL. GDM prevalence within each serum ferritin quartile was 7.84%, 11.76%, 19.61% and 23.53% respectively (p-value=0.016). The odds ratio for GDM in the ferritin Q2-Q4 was 1.57 (CI=0.41-5.92), 2.87 (CI=0.84-9.83) and 3.62 (CI=1.08-12.11) compared with Q1, respectively. In addition, primigravida and women with high Haemoglobin (Hb) level (&gt;13 gm%) have an increased risk of developing GDM. Conclusion: Elevated serum ferritin level is associated with increased incidence of GDM irrespective of other risk factors. Iron supplementation should therefore be individualised based on serum ferritin in early pregnancy to minimise the risk of GDM.

Iron, coronary artery calcification, and mortality in patients undergoing hemodialysis

Objective A high coronary artery calcification score (CACS) may be associated with high mortality in patients undergoing hemodialysis (HD). Recently, effects of iron on vascular smooth muscle cell calcification have been described. We aimed to investigate the relationships between iron, CACS, and mortality in HD patients. Methods We studied 173 consecutive patients who were undergoing maintenance HD. Laboratory data and Agatston’s CACS were obtained at baseline for two groups of patients: those with CACS ≥400 (n = 109) and those with CACS <400 (n = 64). Logistic regression analyses for CACS ≥400 and Cox proportional hazard analyses for mortality were conducted. Results The median (interquartile range) age and duration of dialysis of the participants were 67 (60–75) years and 73 (37–138) months, respectively. Serum iron (Fe) and transferrin saturation (TSAT) levels were significantly lower in participants with CACS ≥400 than in those with CACS <400, although the serum ferritin concentration did not differ between the groups. TSAT ≥21% was significantly associated with CACS ≥400 (odds ratio 0.46, p<0.05). TSAT ≥17%, Fe ≥63 µg/dL, and ferritin ≥200 ng/mL appear to protect against 5-year all-cause mortality in HD patients, independent of conventional risk factors of all-cause mortality (p < 0.05). Conclusion We have identified associations between iron, CACS, and mortality in HD patients. Lower TSAT was found to be an independent predictor of CACS ≥400, and iron deficiency (low TSAT, iron, or ferritin) was a significant predictor of 5-year all-cause mortality in HD patients.

Quantitative Assessment of Interleukin-6 and Ferritin Levels and its Clinical Correlation among COVID-19 Patients

Introduction: COVID-19 pandemic has emerged as a global challenge threatening human life worldwide. Early recognition of severe forms of COVID-19 infection is critically essential for timely triaging of COVID-19 patients. Biochemical Parameters correlating clinically with the severity of COVID-19 infection amidst testing of Peripheral Oxygen Saturation (SpO2) levels can serve in timely management of severe COVID-19 infections. Aim: To estimate the concentrations of proinflammatory cytokine serum Interleukin-6 (IL-6) and serum ferritin levels and to clinically correlate these markers with COVID-19 disease severity. Materials and Methods: A cross-sectional single center study conducted in a Tertiary care Hospital and Research Center from July 2020 to September 2020, 113 COVID-19 positive patients confirmed by Real Time-Polymerase Chain Reaction (RT-PCR) were included, Serum IL-6 and Serum Ferritin levels were measured in the patient’s blood sample using standard Enzyme linked immunosorbent assay and Vitros ECi Immunodiagnostics respectively. Data obtained was statistically analysed using SPSS Software version 22. Results: Of the 113 COVID-19 infected patients, 53 were included in Group A, 27 patients in Group B and 33 patients in Group C. Mean±SD of Serum IL-6 levels were 10.92±2.65, 40.05±11.66 and 120.92±40.96 (p&lt;0.001) and Serum Ferritin levels 368.21±374.85, 309.15±291.58, and 433.45±376.13, respectively. Conclusion: IL-6 correlated significantly with disease severity of COVID-19 infection and can be judiciously used for stratification and management of COVID-19 infected patients. Serum Ferritin concentration were found to be high in severe cases of COVID-19 infections and did not show any significant variation compared with Mild to Moderate COVID-19 infection.

The iron chelator deferoxamine decreases myeloma cell survival

ObjectiveThis study evaluated serum ferritin (SF) levels and investigated their relationships with various clinical markers in patients with multiple myeloma (MM). Furthermore, the effects and molecular mechanism of deferoxamine (DFO) in myeloma cells were studied.MethodsClinical data from 84 patients with MM were collected to evaluate SF content and its relationship with several important clinical parameters. MM1S and MM1R myeloma cells were chosen to investigate the effects of iron and DFO on cell survival and apoptosis.ResultsIncreased SF levels were detected in newly diagnosed patients, especially those with stage III disease or the κ isotype. SF content was positively correlated with β2-microglobulin, interleukin-6, and lactate dehydrogenase expression. Furthermore, patients with progressive or relapsed disease had higher SF levels. Importantly, iron chelation with DFO efficiently inhibited myeloma cell survival and accelerated apoptosis by regulating apoptosis-related genes.ConclusionsThe importance of SF for MM was highlighted. Additionally, it is suggested that DFO may be a good therapeutic option for MM.

The serum ferritin levels and liver iron concentrations in patients with alpha-thalassemia: is there a good correlation?

ABSTRACT Introduction Liver iron overload is common in patients with thalassemia. In patients with beta-thalassemia, the correlation between serum ferritin and liver iron concentration is well established. The correlation between serum ferritin levels and liver iron concentrations in patients with alpha-thalassemia remains limited. Methods This is a cross-sectional study in patients with alpha-thalassemia aged ≥ 18 years old at Srinagarind Hospital, Khon Kaen University, Thailand. Liver iron concentration (LIC) was evaluated by the MRI-T2* technique. Linear logistic regression analysis was used to determine the correlation between serum ferritin levels and liver iron concentrations. Results One hundred and thirty-one of the MRI-T2* measurements from 65 patients with alpha-thalassemia were evaluated. Patients with non-deletional alpha-thalassemia had higher LIC compared to patients with deletional alpha-thalassemia. The serum ferritin levels were relatively low at the same levels of LIC in patients with non-deletional alpha-thalassemia compared to deletional alpha-thalassemia. Conclusions The correlation of serum ferritin levels and LIC was modest and different among alpha-thalassemia genotypes. A different serum ferritin threshold is needed to guide iron chelation therapy in patients with alpha-thalassemia. Evaluation of liver iron concentration is necessary for patients with alpha-thalassemia, especially in patients with non-deletional alpha-thalassemia.

Study Iron Homeostasis of Infected and Non-Infected Iraqi Camels with Trypanosomiasis

Trypanosomiasis is one of the common parasitic diseases, which infects the dromedary camels and decreases the numbers of these animals in Iraq. To get the best knowledge of the changes of iron status in camels infected with trypanosomiasis, in an attempt to take advantage of these variables as markers for infection, we designed this study. The current study conducted in blood sample collection from155 dromedary camels, 33 were infected (21.29%), according to the status of infection with Trypanosoma evansi that depends on blood smear examination as a golden test. Results denote significant differences of infection ratio by sex and age, from total of 132 male tested, 29 (21.96%) infected, distributed into 12 (%41.37) of age ≤ 2 years and 17 (58.62) of ≥ 2 years. From 23 female tested, 4 (17.39%) were infected at age ≤ 2 years. Furthermore, the results of this study demonstrated significant (p˂0.05) decrease in total serum iron, transferrin saturation, ferritin, whereas increased in total iron binding capacity and unsaturated iron binding capacity in the infected male and female camels with different age. Analyzed data of iron status parameters denoted that the cutoff point test between sensitivity (97) and specificity (100) for serum iron is (≤67.26), for transferrin saturation is (≤17.23) between the sensitivity and specificity (100) and (≥378.66), for total iron binding capacity between the sensitivity and specificity (93.9 and 96.7) respectively. Also, the cutoff point test between the sensitivity (100) and specificity (96.7) for unsaturated iron binding capacity is (≥301.27) and ferritin concentration has a cutoff point is (≤ 249.88) for the sensitivity (100) and specificity (99.2). It could be concluded from what was stated in the results of the current study, that the measurement of the concentration of serum ferritin could be considered as a good marker for the T. evansi infection

To establish the role of serum ferritin as a prognostic marker in patients of stroke

Introduction: Stroke is the second leading cause of death worldwide. The incidence of cerebrovascular diseases increases with age. 1 Accurate prognostication of stroke patients is difficult many times. Materials and Methods: A total of 100 stroke patients who presented to R.N.T. Medical College Udaipur Rajasthan were enrolled from February 2016 to October 2016 and their serum ferritin was measured and correlated with early neurological deterioration in patients of acute stroke. Results: Total 100 patients were included, the age ranged from 22-90 years and the age group with the maximum number of patients was 61-70 years. 62 patients were in ischemic and 38 were in hemmoraghic groups. In ischemic group the mean serum ferritin level was 89.540 in clinically improvement patients and 341.345 in those deteriorated. In hemorrhagic group the mean serum ferritin level was 86.838 in clinically improvement patients and 355.759 in those deteriorated. Conclusion: The patients with stroke with increased serum ferritin concentrations have a higher risk of poor clinical outcome, hemorrhagic transformation, and brain edema than patients with low ferritin values. Keywords: Serum ferritin, Ischemic stroke, Hemorrhagic transformation.

Iron metabolism parameters and inflammatory status in patients with diabetes mellitus and dyslipidemia

Background:Investigating the inflammatory status and iron metabolism in patients with impaired carbohydrate metabolism seems quite relevant, while only few studies are devoted to the relationship between metabolic parameters, including lipid profile, inflammatory status indicators and the state of ferrokinetics in diabetes mellitus types 1 and 2 in a comparative aspect.Aims: To establish the direction of changes in the inflammatory status and the state of ferrokinetics in patients with type 1 and type 2 diabetes mellitus depending on lipid metabolism disorders.Materials and methods: The study included 48 patients with type 1 diabetes, 81 patients with type 2 diabetes; 11 people with obesity without impaired carbohydrate metabolism made up the comparison group, 17 healthy volunteers - the control group. Low-grade inflammation was assessed by the levels of high-sensitive C-reactive protein (CRP), tumor necrosisfactor-а (TNF-а), ferritin, and erythrocyte sedimentation rate (ESR). The state of iron metabolism was evaluated by the main hematological parameters (hemoglobin, red blood cell count, hematocrit), serum iron concentrations, transferrin, ferritin and hepcidin concentrations. In all patients lipid metabolism parameters, glycated hemoglobin, and microalbuminuria were measured.Results:Patients with type 1 and type 2 diabetes mellitus had significantly higher inflammatory markers concentrations-TNF-а, ESR, and CRP - in relation to obese patients without impaired carbohydrate metabolism and those in the control group. The highest production of TNF-а was observed in patients with type 1 diabetes mellitus (15.28 [12.41-24.41] pg/ml), whereas CRP (7.00 [3.00-11.85] ng/ml) and ESR (18.00 [9.00-27.00] mm/h) were higher in patients with type 2 diabetes. In the structure of the examined individuals with diabetes mellitus (regardless of its type), dyslipidemia type IIb in comparison with less atherogenic type IIa dyslipidemia was characterized by a higher production of CRP (6.9 [3.00-12.35] and 3.00 [1.80-8.70] ng/ml, respectively), ESR (20.00 [10.00-30.00] and 15.00 [5.00-24.50] mm/h, respectively) and ferritin (114.80 [48.90-196.45] and 50.90 [19.58-114.10] ng/ml, respectively). Compared to iron deficiency anemia, anemia of chronic diseases in diabetes mellitus patients was more often accompanied by dyslipidemia llb (χ2=2.743; p=0.098) and was characterized by a higher content of atherogenic fractions of cholesterol.Conclusions: Patients with type 2 diabetes mellitus and a more atherogenic dyslipidemia profile (type IIb) have a phenotype of the local inflammatory mesenchymal reaction of the liver with an increase in acute-phase proteins predominantly of hepatic origin (CRP, ferritin), whereas individuals suffering from type 1 diabetes and less atherogenic lipid profile (type IIa) have a phenotype of an autoimmune, genetically determined inflammatory response. It has been established that anemia of chronic diseases developing in the background of diabetes mellitus is associated with a more atherogenic lipid profile, compared with iron deficiency anemia.