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Background: Type 2 diabetes mellitus is a metabolic disease with irreversible organ damage. Although fasting plasma glucose and glycosylated hemoglobin are used for screening to identify individuals with type 2 DM, in certain scenarios there may be spurious results. Iron and ferritin have been implicated in the pathogenesis of type 2 DM. Materials And Methods: The study was a case control, observational study performed in a tertiary hospital in coastal Karnataka. It included 60 cases of type 2 diabetes mellitus fulfilling the inclusion criteria and 60 age, gender matched controls. Demographic details, comprehensive history, physical examination and relevant laboratory tests including fasting plasma glucose, serum ferritin and glycosylated hemoglobin were performed on both cases and controls. Results: There is a significant correlation between serum ferritin levels, duration of diabetes and glycosylated hemoglobin levels on performing Karl Pearson correlation, with t-test p value 0.000 (p<0.05) between cases and controls. Serum ferritin value of 187ng/mL can be used as cut off value to identify cases and controls with sensitivity of 98.3% and specificity of 100% (AUC-0.978). Conclusions: There is a significant positive linear association between serum ferritin levels, fasting plasma glucose, duration of diabetes and glycated hemoglobin and a cut off value of 187 ng/mL could potentially be used as a screening test apart from fasting glucose and glycosylated hemoglobin for identifying patients with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background: Patients with β-thalassemia major (TM) require lifelong blood transfusions, leading to iron overload, where active intervention is required. Aims and Objectives: The aim of the study was to evaluate real-world efficacy and safety of deferasirox (DFX) in TM patients at a tertiary care teaching hospital. Materials and Methods: A prospective observational study was conducted at thalassemia ward in a tertiary care teaching hospital in Gujarat for a period of 15 months from April 2021 to July 2022. A total of 100 patients were analyzed during the study period. Patient's demographic profile, laboratory investigation, and treatment details were analyzed using descriptive statistics. Statistical analysis was done through the statistical software GraphPad Prism 9.4.1 (681). Results: A total of 100 patients were included in the study. A serial significant decrease in median serum ferritin levels was observed in >13 years age group after initiation of DFX. A significant increase in the median dose of DFX was observed at 12 months in the age group of 2-≤13 years as compared to baseline (P < 0.05). Adverse reactions observed during the study were increased bilirubin level, increased alanine aminotransferase, and increased serum creatinine, rashes with itching, and arthralgia. Conclusion: A greater reduction in median serum ferritin levels was observed in the adult age group compared to pediatric patients. [ABSTRACT FROM AUTHOR]

Background and Objectives: A more restrictive blood donation criterion has been applied in Japan, with a maximum volume of whole blood (WB) donation of 400 mL, allowing twice a year for female donors and thrice a year for male donors. However, iron deficiency was as high as 20.5% among female donors prior to donation, increasing to 37.7% after blood donation. More than 20 years have passed since then, so we set out to investigate the present situation. Materials and Methods: A total of 2659 (male/female: 1496/1163) donors of 400 mL WB who gave informed consent to join the study were enrolled. Serum ferritin (sFer) of first‐time/reactivated (FT/RA) donors were compared with those of repeat donors, according to gender and age; those who returned for subsequent donations during the study period were also followed up. Results: About one‐third of FT/RA female donors had iron deficiency, possibly reflecting its high incidence among the general population. Interestingly, although sFer levels were low among pre‐menopausal FT/RA female donors, these values were not much different in repeat donors, whereas significant differences were observed between FT/RA and repeat donors among post‐menopausal females and in most age groups among males. As expected, donors with a normal initial sFer (≥26 ng/mL) recovered faster than those with a low initial sFer. Conclusion: Female donors, especially, have iron deficiency even before donation, and the rate increased compared to what was found previously. Measures to prevent iron deficiency of blood donors is required, and studies are going on in Japan. [ABSTRACT FROM AUTHOR]

Background: There is a lack of standardization of reference intervals (RIs) for ferritin across laboratories, particularly for postmenopausal women. Depending on the RI used, there can be more than a 4-fold difference in the upper limit of normal between laboratories, resulting in potential misinterpretation. Methods: This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over a 7-year period. Exclusion criteria were used to screen out individuals with conditions known to affect iron metabolism or raise ferritin as part of the acute phase response. Distributions were assessed using density and Q-Q plots, and age-banded cut-offs were determined. The non-parametric method was used to establish RIs for sex and age bands. Results: For females, 4 age bands were established (18–39, 40–49, 50–59 and 60+). For males, 2 bands were identified (18–39 and 40+). Performance against a validation dataset, followed by an expansive validation against an inclusive dataset, demonstrated the robustness of the derived RIs. Conclusion: This study addresses the inconsistency in serum ferritin RIs by presenting intervals based on demographic parameters. This approach can potentially enhance the accuracy of interpreting serum ferritin levels, assisting clinicians in identifying patients requiring further evaluation. [ABSTRACT FROM AUTHOR]

Type 2 diabetes mellitus (T2DM) is associated with chronic low-grade inflammation and altered iron metabolism, which may contribute to the development and progression of diabetic complications. This study aimed to investigate the correlation between C-reactive protein (CRP) and serum ferritin levels in T2DM patients and their association with glycemic control and diabetic complications. Methods: A total of 100 T2DM patients and 100 non-diabetic controls were included in this cross-sectional study. Serum levels of CRP and ferritin were measured, and their association with glycemic control (HbA1c) and the presence of diabetic complications (neuropathy, nephropathy, and retinopathy) was evaluated. Results: T2DM patients had significantly higher levels of CRP (6.82 ± 4.23 mg/L) and serum ferritin (241.7 ± 96.94 ng/mL) compared to non-diabetic controls (2.64 ± 1.87 mg/L and 199.02 ± 82.7 ng/mL, respectively) (p<0.001 and p=0.022, respectively). A significant positive correlation was found between CRP and serum ferritin levels in T2DM patients (r=0.45, p<0.001). Poor glycemic control (HbA1c ≥7%) and the presence of diabetic complications were associated with significantly higher levels of CRP and serum ferritin in T2DM patients (p<0.001 for all). Conclusion: T2DM patients have significantly higher levels of CRP and serum ferritin compared to non-diabetic controls, and these markers are positively correlated with each other. Poor glycemic control and the presence of diabetic complications are associated with higher levels of CRP and serum ferritin in T2DM patients. These findings suggest that inflammation and iron metabolism may play a role in the pathogenesis of T2DM and its complications. [ABSTRACT FROM AUTHOR]

Background: The prevalence of iron deficiency with or without anemia is still remains the common clinical problem worldwide. Iron deficiency with and without anemia may be more prevalent among migrants due to disadvantaged life conditions. The aim of this study was to estimate the prevalence of iron deficiency with and without anemia among immigrants in Al-Azrakeen area, Sana’a City. Subjects and Methods: Out of 2300 immigrant population in Al-Azrakeen area, 223 participants were randomly chosen, aged from 5 to 50 years (134 children and 89 adults). The study included measurement of hematological parameters and serum iron indices. All data were analyzed using SPSS version 26. Results: The prevalence of iron deficiency among the total immigrant population, adult and children was 21.5%, 19.1% and 23.1%, respectively. While the prevalence of IDA among total immigrants, adults and children was 6.7%, 4.5% and 8.2%, respectively. Statistically signifcant association was observed between iron deficiency anemia and age of immigrant adults (p=0.05). Conclusion: This study concludes that iron deficiency and iron deficiency anemia are prevalent among immigrants in Al-Azrakeen area, Sana’a City, Yemen. Children are at higher prevalence of developing iron deficiency with or without anemia.

The aim of this study was to investigate iron status and iron deficiency in incident continuous ambulatory peritoneal dialysis (CAPD) patients and identify influencing factors.

Background: ACOVID-19, caused by the novel coronavirus SARS-CoV-2, presents with varying severity, from mild symptoms to severe disease, including ARDS and multi-organ failure. Identifying early biochemical markers to predict the severity of COVID-19 is crucial for improving patient outcomes. Aims and Objectives: The study aimed to identify distinct patient groups with COVID-19 and healthy controls using cluster analysis of multiple biomarkers. Specifically, it sought to determine if early detected levels of ferritin, D-dimer, and C-reactive protein (CRP) are associated with the severity of COVID-19. Materials and Methods: Biochemical profiles of sixty patients with SARS-CoV-2 RNA-positive testing and thirty healthy controls were collected and analyzed. Two-dimensional automated hierarchy clustering was performed on all biomarkers. The study focused on alterations in the biochemistry markers ferritin, D-dimer, and CRP. Additionally, levels of inflammatory cytokines, particularly interleukin-6 and tumor necrosis factor-alpha, were measured. Results: Ferritin, D-dimer, and CRP levels were significantly higher in COVID-19 patients compared to the control group. Early detected levels of these biomarkers were associated with a higher incidence of severe COVID-19. Elevated levels of inflammatory cytokines, especially interleukin-6 and tumor necrosis factor-alpha, were also observed in COVID-19 patients, indicating the presence of a cytokine storm, which is a major cause of organ dysfunction and mortality in severe cases. Conclusion: Our findings suggest that elevated levels of ferritin, D-dimer, and CRP are indicative of severe COVID-19. Early detection of these biomarkers can help predict the severity of the infection and guide clinical management. The study also underscores the significant role of inflammatory cytokines in the pathogenesis of COVID-19, contributing to the understanding of the cytokine storm that leads to severe disease outcomes.

Background: According to a WHO report, the prevalence of anemia is the highest in children less than five years of age (40%) and pregnant women of the global population (37%). The prevalence of hypertensive disorders of pregnancy was 7.8% in India. 14% of maternal deaths are attributed to hypertensive disorders of pregnancy, according to a WHO report. Our study aimed to evaluate the variation of serum ferritin (SF) levels in four different groups: (1) normal pregnancy, (2) pregnancy with anemia, (3) pregnancy with hypertensive disorders, and (4) pregnancy with hypertensive disorders and anemia, to derive an association of SF in patients of anemia and hypertensive disorders of pregnancy. Methods: Thirty diagnosed cases of each predefined group of similar gestation were enrolled. A venous blood sample was collected from all subjects of all four groups for estimation of SF levels and hemoglobin levels. Results: SF level was found to be significantly around twofold higher in groups 3 and 4 with hypertensive disorders of pregnancy (60.6 ± 27.5 μg/dL and 54.4 ± 26 μg/dL, respectively) compared to normal pregnancy and pregnancy with anemia (31.3 ± 25 μg/dL and 23.3 ± 21.6 μg/dL, respectively). Hence, the Kruskal–Wallis test was conducted for four groups, and it was statistically significant. Conclusions: In our study, pregnant women with anemia had lower SF levels than normal pregnancy cases. However, in group 4 with hypertensive disorders of pregnancy with anemia SF levels were higher than group 2.

Abstract Background Feeding milk substitutes with low iron content or whole milk without iron supplementation is considered a major factor in developing iron-deficiency anemia in neonatal dairy calves. Young calves are often supplemented with iron dextran injections on the first day of life to prevent anemia. However, the effects of preventive treatment and the presence of disease on serum iron (Fe) concentrations, serum ferritin levels, and hematological blood parameters during the early neonatal stages have not been examined in detail. Therefore, we examined and evaluated the effects of iron dextran injections and health status on the development of hematocrit (Ht), red blood cells (RBC), hemoglobin concentration (Hb), erythrocyte indices (mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration), Fe, and serum ferritin concentrations in dairy calves within the first 10 days of life. The suitability of serum ferritin as a reliable indicator of anemia in very young calves was evaluated by correlating ferritin concentrations with known laboratory diagnostic parameters of anemia. Results Iron supplementation significantly increased Fe levels (P = 0.048) but did not affect serum ferritin levels in neonatal calves. Fe concentrations were significantly lower in diseased than healthy calves (P = 0.0417). Iron supplementation significantly affected the health status, as observed in Ht (Ptreat=0.0057; Phealth=0.0097), RBC (Ptreat=0.0342; Phealth=0.0243), and Hb (Ptreat=0.0170; Phealth=0.0168). Serum ferritin levels did not significantly correlate with Fe levels. Both groups showed marked differences in ferritin levels, with the highest levels measured on day 2. Fe concentrations showed weak negative correlations with Hb and Ht levels on day 3 (ρ=-0.45; P = 0.0034 and ρ=-0.045; P = 0.0032, respectively). RBC count showed strong positive correlations with Hb and Ht levels (ρ = 0.91 and ρ = 0.93; P

To explore and identify an optimal serum ferritin (SF) threshold level in diagnosing hemophagocytic lymphohistiocytosis (HLH) in Chinese children.

Background: Iron deficiency anaemia has been described as the commonest type of nutritional anaemia in infancy and childhood. The associated adverse health sequelae include permanent behavioural and cognitive impairments. Early detection and prompt treatment are necessary to prevent these complications. Aim: To determine the prevalence and socio-demographic distribution of iron deficiency anaemia among anaemic under five children in Enugu. Subjects and methods: Under-five children presenting at a tertiary hospital were consecutively enrolled and screened for iron deficiency anaemia using haematocrit and serum ferritin levels. Iron deficiency anaemia was defined as haematocrit level

BACKGROUND: Chronic spontaneous urticaria (CSU) is a common clinical condition presenting with wheals or along with angioedema. It has a complex pathogenesis having a considerable impact on quality of life. In patients with chronic spontaneous urticaria (CSU) exhibiting poor response to conventional treatments, the presence of hyposiderinemia suggests that oral iron therapy could potentially lead to resolution of the urticaria symptoms. OBJECTIVES: (1). To estimate serum ferritin levels in patients with CSU. (2) To assess the correlation between urticarial activity score, autologous serum skin test (ASST), and serum ferritin levels in CSU. MATERIALS AND METHODS: This prospective study enrolled 37 cases of clinically diagnosed CSU attending the dermatology outpatient department from December 2019 to November 2020 after Institutional Ethics Committee approval. ASST and serum ferritin level estimation were done on all patients. The severity of urticaria was calculated using the Urticaria Activity Score. Statistical analysis was done by frequency, standard deviation, and Chi-square test. RESULTS: Among ASST-positive patients, only 4 (19%) had low ferritin levels. No association was found between ASST and serum ferritin levels (P = 0.342). Mean serum ferritin levels in ASST-positive patients were high 91.34 ± 87.24 μg/L which was statistically significant compared to mean serum ferritin levels in ASST-negative patients 49.64 ± 46.91 μg/L. There was significant involvement of palms and soles in ASST-positive patients (P = 0.038). CONCLUSION: Although there was no significant correlation of serum ferritin levels with CSU, oral iron supplementation may be considered an add-on treatment in case of refractory urticaria.

\nObjectives: This study aimed to evaluate the distribution of genotypes and iron metabolism imbalance in transfusion-dependent thalassemia patients. Methods: Genotype analysis was conducted on 84 thalassemia patients requiring transfusion, and retrospective analysis of iron overload was performed on 48 transfusion-dependent patients. Results: Among the 84 thalassemia cases requiring transfusion, six mutations of α-thalassemia were identified, including --SEA, αCS, -α3.7, -α4.2, αQS, and αWS. Nine mutations of β-thalassemia were also found, with CD41-42 being the most common. Of the 48 transfusion-dependent patients, 40 (83.3%) had iron overload with serum ferritin (SF) levels above 1,000 ng/mL. The recent SF level was lower than 3 years ago, but the overall ferritin level remains elevated. Conclusions: β-thalassemia was the predominant type among transfusion-dependent thalassemia patients, with CD41-42/-28, CD41-42/IVS-II-654, and CD17/IVS-II-654 being the most common genotypes. Proper blood transfusion and iron chelation therapy are essential for managing transfusion-dependent thalassemia. While some patients show a reduction in SF levels after 3 years of treatment, there are still individuals who exhibit elevated levels necessitating ongoing management. This study is a retrospective research that investigates the genotype distribution and iron metabolic imbalance in thalassemia patients requiring blood transfusion. Eighty-four thalassemia patients needing transfusion were enrolled in the study and underwent genotype analysis. Among these patients, 56 were transfusion-dependent and 28 were non-transfusion-dependent. Of the 56 transfusion-dependent patients, 48 were observed for 3 years, and their iron overload status was analyzed in this study. Our research found that among the 84 thalassemia patients needing transfusion, there were six types of α-thalassemia deletions and nine types of β-thalassemia mutations. Among the 56 transfusion-dependent patients, three types of α-thalassemia genotypes and 15 types of β-thalassemia genotypes were identified. Among the 48 transfusion-dependent thalassemia patients observed for 3 years, 40 patients exhibited iron overload with SF levels exceeding 1,000 ng/mL. The recent SF levels were lower than those 3 years ago. Our study found that β-thalassemia is the most common type of transfusion-dependent thalassemia. Standard blood transfusion and iron chelation therapy are necessary for transfusion-dependent thalassemia patients. While some patients show a reduction in SF levels after 3 years of treatment, there are still individuals who exhibit elevated levels necessitating ongoing management. [ABSTRACT FROM AUTHOR]

Background: Feeding milk substitutes with low iron content or whole milk without iron supplementation is considered a major factor in developing iron-deficiency anemia in neonatal dairy calves. Young calves are often supplemented with iron dextran injections on the first day of life to prevent anemia. However, the effects of preventive treatment and the presence of disease on serum iron (Fe) concentrations, serum ferritin levels, and hematological blood parameters during the early neonatal stages have not been examined in detail. Therefore, we examined and evaluated the effects of iron dextran injections and health status on the development of hematocrit (Ht), red blood cells (RBC), hemoglobin concentration (Hb), erythrocyte indices (mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration), Fe, and serum ferritin concentrations in dairy calves within the first 10 days of life. The suitability of serum ferritin as a reliable indicator of anemia in very young calves was evaluated by correlating ferritin concentrations with known laboratory diagnostic parameters of anemia. Results: Iron supplementation significantly increased Fe levels (P = 0.048) but did not affect serum ferritin levels in neonatal calves. Fe concentrations were significantly lower in diseased than healthy calves (P = 0.0417). Iron supplementation significantly affected the health status, as observed in Ht (Ptreat=0.0057; Phealth=0.0097), RBC (Ptreat=0.0342; Phealth=0.0243), and Hb (Ptreat=0.0170; Phealth=0.0168). Serum ferritin levels did not significantly correlate with Fe levels. Both groups showed marked differences in ferritin levels, with the highest levels measured on day 2. Fe concentrations showed weak negative correlations with Hb and Ht levels on day 3 (ρ=-0.45; P = 0.0034 and ρ=-0.045; P = 0.0032, respectively). RBC count showed strong positive correlations with Hb and Ht levels (ρ = 0.91 and ρ = 0.93; P < 0.001). Conclusion: Iron dextran injections increased Fe concentrations but reduced Ht level, RBC count, and Hb level. The presence of diseases led to a reduction in Fe and higher values of Ht, RBC, and Hb in moderate disease than in severe disease. Due to physiological fluctuations during the first 3 days of life, serum ferritin level seems unuseful for evaluating iron storage before day 4 of life. [ABSTRACT FROM AUTHOR]

Background and Objectives Materials and Methods Results Conclusion In Japan, apheresis donation of plasma is allowed to a maximum of 24 times a year, and plateletpheresis are counted as two plasmapheresis donations. Diversion of the initial blood flow is conducted for all donations, and additionally, blood remaining in apheresis machine circuit is lost. Here, we aimed to investigate on the health impact of frequent apheresis donations, as measured by the serum ferritin (sFer).A total of 538 male apheresis donors and 538 age‐matched whole blood (WB) donors, who gave informed consent to join the study, were enrolled. sFer were compared, according to age. Another group of 19 apheresis donors were followed during four consecutive donations.About half (48%) of repeat male apheresis donors had iron deficiency (sFer < 26 ng/mL), compared with lower rates (13.9%) among male WB donors. It was evident in all age groups, except for teenagers, possibly because of the lower number of donations. Follow‐up of the 19 donors for 4 months revealed a progressive decrease in sFer.Blood remaining in the apheresis machine circuit and diversion of the initial blood flow have been implicated in iron deficiency for many years. Taking the present results, the manufacturer of apheresis equipment was requested to improve it to allow rinseback of the remaining blood, which was achieved only for plateletpheresis. Until further improvement, plasmapheresis frequency was reduced to 12 times a year. Additional measures, such as oral supplementation of iron, need to be considered. [ABSTRACT FROM AUTHOR]

Background: Diabetes Mellitus is a prevalent metabolic disorder influenced by genetic and environmental factors, with India facing a substantial rise in its diabetic population. Recent research has highlighted the association between elevated body iron levels and the onset of diabetes and its complications. This study aimed to explore the relationship between Serum Ferritin, HbA1c%, and Blood Glucose in patients with Type 2 Diabetes Mellitus. To evaluate the association between Serum Ferritin, HbA1c%, and Blood Glucose in patients with Type 2 Diabetes Mellitus. Material & Method: This cross-sectional study was conducted among patients with Type 2 Diabetes Mellitus attending the outpatient and inpatient departments of MNR Medical College & Hospital from June 2023 to January 2024. Patients meeting the inclusion criteria were enrolled, while those with specific exclusions were excluded. Detailed demographic and medical history data were collected, and blood samples were obtained for various biochemical analyses. Statistical analysis was performed using SPSS version 20. Results: The study included 100 patients, with no significant demographic differences between groups. Participants with diabetes exhibited significantly higher fasting and postprandial blood glucose levels, glycemic control, and LDL cholesterol compared to controls (p<0.05). Serum ferritin showed significant correlations with blood glucose (FBS=0.59, PPBS=0.69) and HbA1c (r=0.62). Conclusion: Elevated Serum Ferritin levels correlated significantly with higher Blood Glucose and HbA1c levels in patients with Type 2 Diabetes Mellitus, suggesting a potential role of iron metabolism in glycemic control. These findings underscore the importance of further investigation into the link between iron status and diabetes management. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the association of altered serum ferritin during pregnancy with chorioamnionitis and neonatal sepsis. Methods: This retrospective cohort study included 78,521 pregnant women who attended antenatal check-ups at maternal and child health centers in Fujian Province, China. Study lasted from January 2014 to January 2019. A total of 59,812 pregnant women were followed up. Patients with suspected infection before the delivery were selected and divided into the chorioamnionitis and non-chorioamnionitis groups according to placental pathology. Differences in late and early pregnancy serum ferritin between the two groups were compared. Multiple logistics regression was used to adjust for confounding factors and to analyze the association between serum ferritin changes and pregnancy outcomes. Importance of altered serum ferritin during pregnancy was assessed by receiver operating characteristic (ROC) curve and net reclassification index (NRI). Results: Clinical records of 8506 pregnant women were included in the study. there were 1010 (11.9%) cases of confirmed chorioamnionitis and 263 (3.1%) cases of neonatal sepsis. There was a significant difference in maternal serum ferritin changes between the groups with and without chorioamnionitis. No significant difference was detected in cases with or without neonatal sepsis. Multiple logistic regressions, corrected for confounding factors yielded similar conclusions. Maternal serum ferritin difference NRI 12.18% (p = 0.00014) was similar to the ROC results in predicting the occurrence of chorioamnionitis. Conclusion: Differential serum ferritin during pregnancy may predict chorioamnionitis but does not correlate well with neonatal sepsis. [ABSTRACT FROM AUTHOR]

Iron deficiency is the most common extraintestinal sign of colonic neoplasia, including colorectal cancer (CRC) and other lower gastrointestinal pathology. Both upper endoscopy and colonoscopy is usually recommended in the work‐up of patients with unexplained iron deficiency, particularly in men and postmenopausal women. As the incidence of early‐onset CRC (age <50 years) rises in the United States, there is an increasing need to identify risk predictors to aid in the early detection of CRC. It remains unknown if serum ferritin (SF), and what specific threshold, can be used as a marker to stratify those at risk for CRC and other lower gastrointestinal pathology. In this current review of the literature, we aimed to review guidelines for diagnostic workup of colonic neoplasia in the setting of iron deficiency and examine the association and specific thresholds of SF and risk of CRC by age. Some of the published findings are conflicting, and conclusions specific to younger patients are limited. Though further investigation is warranted, the cumulative findings suggest that SF, in addition to considering the clinical context and screening guidelines, may have potential utility in the assessment of colonic neoplasia. [ABSTRACT FROM AUTHOR]

Objective: To assess the effect of iron supplementation on symptoms in children with attention deficit hyperactivity disease (ADHD). Method: A prospective single arm intervention study was conducted on children aged 4–12 years, newly diagnosed with ADHD, attending the child development clinic in a tertiary centre in Northern India. A baseline hemogram and serum ferritin levels were assessed in all children. ADHD symptom severity was assessed with age-appropriate neuropsychometric questionnaires, and objective tests of attention at baseline and after six weeks of oral iron therapy. Results: Out of 32 participants, 23 were found to be ferritin sufficient (serum ferritin > 30 ng/mL) at enrolment. There was no difference in the median scores of neuropsychometric tests at the baseline of ferritin sufficient and ferritin deficient children. A statistically significant change in median scores of inattention and hyperactivity subscale on Conner's Rating Scale (P = 0.036) as well as significant improvement on tests of attention; Children's Color Trails Test (CCTT) (P = 0.006) were observed after six weeks of iron therapy in all children. Conclusion: The study showed promising results of iron supplementation in the treatment of ADHD symptoms in children. [ABSTRACT FROM AUTHOR]

Objectives: To determine the prevalence of Iron Deficiency (ID) in children without clinical pallor using serum ferritin and the new parameters, soluble transferrin receptor (sTfR) & the ratio of sTfR/log10 serum ferritin (sTfR-F index), as suggested by WHO. Also to assess whether these new parameters could individually predict the presence of ID. Methods: Consecutive 230 healthy children aged 9-11 y without clinical pallor underwent estimation of Hemoglobin (Hb), C-Reactive Protein (CRP), serum ferritin, sTfR, and sTfR-F index levels in their blood. The abilities of the sTfR and sTfR-F index in predicting ID were determined by comparing with the gold standard (normal CRP and less serum ferritin), plotting Receiver-operating characteristic (ROC) curve, and noting the area under the curve (AUC). Results: The blood reports of 114 boys and 106 girls (total = 220) were available for analysis. Overall, 57 (31 girls, 26 boys) children had ID; among children with low CRP, 45 had ID, as suggested by low serum ferritin levels. Among children with high CRP, 12 had evidence of ID as evidenced by elevated sTfR and/or sTfR-F index. The positive predictive values of both sTfR and sTfR-F were low (32.9% and 35.9%, respectively) than the negative predictive values (85.6% and 95.3%, respectively). Conclusions: The proportion of children identified to have ID using serum ferritin, sTfR, and sTfR-index was 25.9%. sTfR and/or sTfR-F index are unlikely to be ideal individual predictors of ID. [ABSTRACT FROM AUTHOR]

Background: According to a WHO report, the prevalence of anemia is the highest in children less than five years of age (40%) and pregnant women of the global population (37%). The prevalence of hypertensive disorders of pregnancy was 7.8% in India. 14% of maternal deaths are attributed to hypertensive disorders of pregnancy, according to a WHO report. Our study aimed to evaluate the variation of serum ferritin (SF) levels in four different groups: (1) normal pregnancy, (2) pregnancy with anemia, (3) pregnancy with hypertensive disorders, and (4) pregnancy with hypertensive disorders and anemia, to derive an association of SF in patients of anemia and hypertensive disorders of pregnancy. Methods: Thirty diagnosed cases of each predefined group of similar gestation were enrolled. A venous blood sample was collected from all subjects of all four groups for estimation of SF levels and hemoglobin levels. Results: SF level was found to be significantly around twofold higher in groups 3 and 4 with hypertensive disorders of pregnancy (60.6 ± 27.5 µg/dL and 54.4 ± 26 µg/dL, respectively) compared to normal pregnancy and pregnancy with anemia (31.3 ± 25 µg/dL and 23.3 ± 21.6 µg/dL, respectively). Hence, the Kruskal-Wallis test was conducted for four groups, and it was statistically significant. Conclusions: In our study, pregnant women with anemia had lower SF levels than normal pregnancy cases. However, in group 4 with hypertensive disorders of pregnancy with anemia SF levels were higher than group 2. [ABSTRACT FROM AUTHOR]

Data on iron overload status and change thresholds that can predict mortality in patients with transfusion-dependent β-thalassemia (TDT) are limited. This was a retrospective cohort study of 912 TDT patients followed for up to 10 years at treatment centers in Italy (median age 32 years, 51.6% female). The crude mortality rate was 2.9%. Following best-predictive threshold identification through receiver operating characteristic curve analyses, data from multivariate Cox-regression models showed that patients with Period Average Serum Ferritin (SF) > 2145 vs ≤ 2145 ng/mL were 7.1-fold (P < 0.001) or with Absolute Change SF > 1330 vs ≤ 1330 ng/mL increase were 21.5-fold (P < 0.001) more likely to die from any cause. Patients with Period Average Liver Iron Concentration (LIC) > 8 vs ≤ 8 mg/g were 20.2-fold (P < 0.001) or with Absolute Change LIC > 1.4 vs ≤ 1.4 mg/g increase were 27.6-fold (P < 0.001) more likely to die from any cause. Patients with Index (first) cardiac T2* (cT2*) < 27 vs ≥ 27 ms were 8.6-fold (P < 0.001) more likely to die from any cause. Similarly, results at varying thresholds were identified for death from cardiovascular disease. These findings should support decisions on iron chelation therapy by establishing treatment targets, including safe iron levels and clinically meaningful changes over time. [ABSTRACT FROM AUTHOR]

Background: The increased iron level aids the formation of many of oxygen-reactive compounds via Haber-Weiss and Fenton reactions. These compounds participate in the metal regulation of the redox reaction and can affect many organs, erythrocytes and endocrine glands causing disturbances in the function of these organs. Iron chelating therapy is required to detoxify iron's toxic effects to avoid oxidative injury. Objective: This research aims to determine the relationship between oxidative status and serum ferritin in major β- thalassemic patients treated by iron chelating agents ( deferasirox and deferoxamine). Methods: It is a cross-sectional study, 55 known cases of β-thalassemic patients receiving chelating agents therapy under follow-up participated in the study, their ages ranged between 3-20 years, divided into two groups, group one consisted of 30 patients, 14 male and 16 female, received oral agent deferasirox, Group two consisted of 25 patients, 11 male and 14 female, on Deferoxamine therapy. Total antioxidant capacity (TAOC), serum Malondialdehyde (MDA), haemoglobin and serum ferritin were measured in the studied groups. Results: the TAOC in the patients group on Deferoxamine, is significantly higher than in the Defrasirox group (34.5±13.2; 29.8±11.8 u/ml) respectively, while MDA is higher in Defrasirox than in patients in the deferoxamine group (8.6±5.4; 5.8 ±4.4 nmol/ml) respectively. A non-significant variation in serum ferritin levels and haemoglobin between the 2 groups was found. A considerable affirmative correlation, between TAOC and serum ferritin, and a non–considerable affirmative correlation between MDA and serum ferritin. Conclusion: A considerable affirmative correlation, between TAOC and serum ferritin, and anon – considerable affirmative correlation between MDA and serum ferritin when comparing the results of all patients as one group, were found. [ABSTRACT FROM AUTHOR]

Background: Maternal serum ferritin is being explored as a potential predictor for Intrauterine Growth Restriction (IUGR). Early detection of IUGR is crucial for improving perinatal outcomes and reducing associated mortality and morbidity. Objective: To evaluate the role of elevated maternal serum ferritin in predicting the risk of developing IUGR. Patients and Methods: A prospective case-control study was conducted at Al-Batool Teaching Hospital, Diyala, involving 51 pregnant women divided into two groups based on pregnancy status. Demographic data, obstetric history, and risk factors for IUGR were collected through a questionnaire, and blood samples were taken to measure hemoglobin and serum ferritin levels. Results: The study found that the mean serum ferritin level was significantly higher in the patient group (209.89±50.95 ng/ml) compared to the control group (66.91±37.49 ng/ml), with a p-value of <0.001. The mean birth weight was significantly lower in the patient group (1873.81±425.62 g) compared to the control group (3078.67±415.56 g), also with a p-value of <0.001. There were no significant differences in age and hemoglobin levels between the two groups. Conclusion: Elevated maternal serum ferritin levels may suggest an increased risk of IUGR, emphasizing the need for further research to validate its role as a predictive marker. [ABSTRACT FROM AUTHOR]

Research into the pulmonary function of patients with transfusion-dependent thalassemia (TDT) is limited, with existing studies presenting conflicting results. We carried out a retrospective study involving 140 patients with TDT. The mean patient age was 8.7 ± 3.2 years, with a median serum ferritin (SF) level of 3791.4 ng/ml (IQR: 2424.1–5733.3 ng/ml). Pulmonary function abnormalities were detected in 46.43 % (65 out of 140) of patients, primarily manifesting as diffusion dysfunction (26.43 %), followed by ventilatory dysfunction (5.0 %), and mixed pulmonary dysfunction (15.0 %). A serum ferritin level above 2500 ng/ml significantly correlated with the occurrence of these abnormalities(OR = 3.187, 95%CI:1.312–7.741, P = 0.010), while higher hemoglobin concentrations demonstrated a protective effect (OR = 0.966, 95%CI: 0.943–0.989, P = 0.004). Our study highlights diffusion dysfunction as the most prevalent type of pulmonary function abnormalities in TDT patients. Furthermore, it establishes a correlation between elevated serum ferritin levels and pulmonary dysfunction.

AimThis study aims to assess the dose–response impact of iron load on systemic and hepatic metabolic disorders including metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD).MethodsSerum ferritin (SF) and dietary iron intake were selected to represent the indicators of iron load in the general population. PubMed, EMBASE and Web of Science databases were searched for epidemiological studies assessing the impact of SF/dietary iron intake on MetS/NAFLD occurrence. All literature was published before September 1st, 2023 with no language restrictions.ResultsFifteen and 11 papers were collected with a focus on connections between SF and MetS/NAFLD, respectively. Eight papers focusing on dietary iron and MetS were included in the following meta-analysis. For the impact of SF on MetS, the pooled odds ratio (OR) of MetS was 1.88 (95% CI: 1.58–2.24) for the highest versus lowest SF categories. In males, the OR was 1.15 (95% CI: 1.10–1.21) per incremental increase in SF of 50 μg/L, while for females, each 50 μg/L increase in SF was associated with a 1.50-fold higher risk of MetS (95% CI: 1.15–1.94). For connections between SF and NAFLD, we found higher SF levels were observed in NAFLD patients compared to the control group [standardized mean difference (SMD) 0.71; 95% CI: 0.27–1.15], NASH patients against control group (SMD1.05; 95% CI:0.44–1.66), NASH patients against the NAFLD group (SMD 0.6; 95% CI: 0.31–1.00), each 50 μg/L increase in SF was associated with a 1.08-fold higher risk of NAFLD (95% CI: 1.07–1.10). For the impact of dietary iron on MetS, Pooled OR of MetS was 1.34 (95% CI: 1.10–1.63) for the highest versus lowest dietary iron categories.ConclusionElevated SF levels is a linear relation between the incidence of MetS/NAFLD. In addition, there is a positive association between dietary iron intake and metabolic syndrome. The association between serum ferritin and metabolic syndrome may be confounded by body mass index and C-reactive protein levels.

Abstract Background and aims Evidence from prospective cohort studies on the relationship between metabolic dysfunction-associated steatotic liver disease (MASLD) and longitudinal changes in serum ferritin (SF) still limited. This study aimed to investigate the associations of SF baselines and trajectories with new-onset MASLD and to present a MASLD discriminant model. Methods A total of 1895 participants who attended health examinations at least three times in a hospital in Dalian City between 2015 and 2022 were included. The main outcome was the incidence of MASLD. The associations between SF baselines and trajectories with the risk of MASLD were analyzed by Cox proportional hazards regression, restricted cubic spline (RCS) analysis and time-dependent receiver operating characteristic (ROC) curve analysis. In addition, a MASLD discrimination model was established using logistic regression analyses. Results Among the 1895 participants, 492 developed MASLD during follow-up. Kaplan-Meier analysis indicated that participants in the low-stable trajectory group had a longer MASLD-free time compared with participants in other groups. Compared with those in the low-stable trajectory group, the adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for the risk of new-onset MASLD in the medium-high, high-stable and high-high trajectory groups were 1.54(1.18-2.00), 1.77(1.35–2.32) and 1.55(1.07–2.26), respectively (P trend < 0.001). The results were robust in subgroup and sensitivity analyses. Multivariate Cox proportional regression showed that SF was an independent risk factor of MASLD (HR = 1.002, 95%CI: 1.000-1.003, P = 0.003). The restricted cubic spline demonstrated a nonlinear relationship between SF and the risk of MASLD. The 8-variable model had high discriminative performance, good accuracy and clinical effectiveness. The ROC curve results showed that AUC was greater than that of the FLI, HSI and ZJU models (all P

AIM:To establish a nomogram model to predict the effect of serum ferritin on diabetic retinopathy and evaluate the model.METHODS:A total of 21 variables, including ferritin, were screened by univariate and multivariate regression analysis to determine the risk factors of diabetic retinopathy. A nomogram prediction model was established for evaluation and calibration.RESULTS:Ferritin, duration of diabetes, hemoglobin, urine microalbumin, regularity of medication and body mass index were included in the nomogram model. The consistency index of the prediction model with serum ferritin was 0.813(95%CI: 0.748-0.879). The calibration curves of internal and external verification showed good performance, and the probability of the threshold suggested by the decision curve was in the range 10% to 90%. The model had a high net profit value.CONCLUSIONS:Serum ferritin is an important risk factor for diabetic retinopathy. A new nomogram model, which includes body mass index, duration of diabetes, ferritin, hemoglobin, urine microalbumin and regularity of medication, has a high predictive accuracy and could provide early prediction for clinicians.

id="st1" To measure the effect of doxycycline on inflammatory marker [IL-6, TNF-α, ferritin and C reactive protein (CRP)] levels in patients with dengue infection. id="st2" A single-centre, open-label, parallel-group randomized controlled trial was done in PGIMER Chandigarh from June 2021 to October 2022. Patients were randomized using a simple randomization process into two groups: the doxycycline treatment group (n=35) and the control group (n=34). Patients in the treatment group were given oral doxycycline 100 mg twice daily for five days along with standard treatment, whereas patients in the control group received only standard treatment. The objective was to measure the effect of doxycycline on inflammatory markers in dengue infection. id="st3" On comparative analysis at day 5, there was a statistically significant reduction in the median values of ferritin and CRP in cases compared to the control group (ferritin: P=0.006 and CRP: P=0.006). No significant reduction was noted in the levels of IL-6 and TNF-α. id="st4" Doxycycline treatment led to a reduction of inflammatory markers in dengue infection.

The Aim of the study was determine the relationship between the pres- ence of Helicobacter pylori infection and the level of S. ferritin using Im- munofluorescence assay method. Methods The study was conducted between (November) 2023 and (February) 2024, where the study was conducted on (100) patients both males 58% and females 42% in the city of Samawah, Iraq, suffering from symptoms of H. pylori. Results showed that 81 patients were confirmed to be infected with H. pylori 54.32% male and 45.67% female. The study also showed that 74.07% of the patients with H. pylori infection suffered from a ferritin deficiency anemia the levels of S. ferritin was between 2.77 - 18.85 ng/ml for male and 0.5 - 12.79 ng/ml for female, and 25.92% of patients they have H. pylori infection but with normal levels of S. ferritin 34.11 - 218.73 ng/ml for male and 22.61 – 81.57 ng/ml for female. This decrease in S. ferritin levels is due Upper Gastrointestinal Bleeding which is due to necrosis and ulceration of the wall lining the upper part of the digestive system by H.pylori. Other 19 patients had no bacterial infection identified in their serum their levels of S. Ferritin was 30.63 – 310.25 ng/ml for male and 15.01 – 124.14 ng/ml for female therefore, this levels within the normal rang.

Introduction: It is well known that preterm birth (PTB) contributes to perinatal mortality and long-term morbidity. Elevated serum ferritin levels have been frequently reported in PTB compared to term births; however, most studies had blood samples taken during the peripartum period. We aim to evaluate the relationship between antenatal serum ferritin levels and PTB. Methods: A retrospective study of pregnant women delivered at our hospital between January 2013 and December 2020 was conducted. Demographic data, medical history, gestation, and blood ferritin results were retrieved from the hospital and laboratory information system. Patients with maternal serum ferritin measured antenatally who were not documented to have chronic diseases, infection, iron disorders, multiple gestations, and uterine or cervical anomalies were included in the analysis. We compared the preterm and term groups' ferritin levels and other risk factors. Results: Among 202 recruited women, 27 (14.4%) had spontaneous PTB. Most ferritin measurements (80%) were taken during the third trimester. There was no significant difference in the median ferritin levels between PTBs (15.81µg/L, IQR 10.09 - 32.41 µg/L) and term births (16.11µg/L, IQR 9.09 - 34.38 µg/L), P=0.801. However, ferritin levels in the second trimester nearly doubled that in the first trimester in the PTB group. PTB was associated with more cases of preeclampsia (P=0.003), a history of antepartum haemorrhage (p=0.040) and premature rupture of membrane status (P<0.001). Conclusion: Despite the elevation of ferritin levels in the second trimester, there is no significant association between maternal antenatal ferritin levels and PTB. [ABSTRACT FROM AUTHOR]

Background and Objectives: The administration of iron to premature newborns is a common intervention aimed at preventing iron deficiency (ID). However, there is no consensus on the optimal timing and dosage for iron supplementation in this population. This study evaluates the effects and potential adverse outcomes of administering iron on the 7th and 21st days of life in premature infants. Materials and Methods: This research was conducted on 108 premature neonates at the "Louis Turcanu" Children's Emergency Clinical Hospital in Timisoara, Romania. The study population was divided into a control group of 48 newborns who did not receive iron supplementation and an intervention group of 60 newborns who did. The analysis utilized univariate and multivariate regression to examine binary outcomes. Results: The findings indicate that iron supplementation significantly increased the risk of anemia during the premature period at 21 days of life, as demonstrated by both univariate and multivariate regression analyses, with an odds ratio (OR) of 2.40 (95% CI, 1.01–5.68) and an adjusted odds ratio (AOR) of 2.75 (95% CI, 1.06–7.11), respectively. Contrary to expectations, iron supplementation did not significantly alter the risk of abnormal serum ferritin or iron levels at 21 days of life, according to the univariate analysis (p = 0.380 and p = 0.526, respectively). Conclusions: The observed increase in the risk of anemia without a corresponding improvement in the serum ferritin or iron levels suggests the need for further investigation into alternative strategies for iron supplementation in premature newborns. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 attributed to severe acute respiratory syndrome has been implicated with life threatening opportunistic infections like mucormycosis. COVID-19 is a hyperferritinemic syndrome and emerging data project the role of iron in the susceptibility and pathogenesis of mucormycosis but whether high ferritin is an indicator of severity of mucormycosis is debated. The study aimed to determine the relationship between serum ferritin levels and the extent of involvement of COVID-19 associated mucormycosis. A hospital based observational study was conducted with a sample size of 70. All biopsy confirmed cases of COVID-19 associated mucormycosis were included. Retrospective data from hospital records prepared at the time of patient admission were retrieved. The imaging data was used to determine the extent of disease involvement and serum ferritin values were analysed. During the study period 40 patients had mild extent mucormycosis and 30 had severe extent. A statistically significant difference was seen in levels of serum ferritin between mild extent mucormycosis and severe extent involvement (p < 0.01). COVID-19 associated Mucormycosis patients tend to have higher serum ferritin values especially in severe extent disease and with active COVID-19 infection along with diabetes mellitus as a potent aggravating factor. [ABSTRACT FROM AUTHOR]

Objective: To measure the effect of doxycycline on inflammatory marker [IL-6, TNF-α, ferritin and C reactive protein (CRP)] levels in patients with dengue infection. Methods: A single-centre, open-label, parallel-group randomized controlled trial was done in PGIMER Chandigarh from June 2021 to October 2022. Patients were randomized using a simple randomization process into two groups: the doxycycline treatment group (n=35) and the control group (n=34). Patients in the treatment group were given oral doxycycline 100 mg twice daily for five days along with standard treatment, whereas patients in the control group received only standard treatment. The objective was to measure the effect of doxycycline on inflammatory markers in dengue infection. Results: On comparative analysis at day 5, there was a statistically significant reduction in the median values of ferritin and CRP in cases compared to the control group (ferritin: P=0.006 and CRP: P=0.006). No significant reduction was noted in the levels of IL-6 and TNF-α. Conclusions: Doxycycline treatment led to a reduction of inflammatory markers in dengue infection. [ABSTRACT FROM AUTHOR]

To investigate the correlation between serum ferritin (SF) and bone turnover markers in type 2 diabetes mellitus (T2DM) patients with non-alcoholic fatty liver disease (NAFLD). Seven hundred and forty-two people with T2DM were selected. Serum bone turnover markers: osteocalcin (OC), type I procollagen N-terminal peptide (PINP), β-I type collagen carboxy-terminal peptide (β-CTx), and 25-hydroxyvitamin D3 (25-[OH]-D) levels were detected. High SF (HF) was defined as the indicated SF levels above 400 ng/mL in males and more than 150 ng/mL in females. Patients were divided into four groups: T2DM+normal SF (non-HF); T2DM+high SF (HF); T2DM+NAFLD+non-HF; andT2DM+NAFLD+HF. Relationships between SF and bone turnover markers were analyzed. Compared with the T2DM+non-HF group, β-CTx levels were higher in the T2DM+HFgroup. Compared with the T2DM+NAFLD+non-HF group, β-CTx levels were increased and 25-(OH)-D levels decreased in the T2DM+NAFLD+HF group (all p < 0.05). SF was positively correlated with β-CTx [β = 0.074; 95% CI (0.003, 0.205)] and negatively correlated with 25-(OH)-D [β=-0.108; 95%CI (−0.006, −0.001)]. Compared with the T2DM+non-HF group, an independent positive correlation was found between β-CTx and SF in the T2DM+NAFLD+HF group [OR = 1.002; 95% CI (1.001, 1.004)]. Among males, SF was positively correlatedwith β-CTx [β = 0.114; 95% CI (0.031, 0.266)]. SF was negatively correlated with 25-(OH)-D levels in both male and female patients [β=-0.124; 95% CI (0.007,0.001) and β=-0.168; 95% CI (−0.012, −0.002)]. Among those >50 years of age and postmenopausal females, SF was negatively correlated with 25-(OH)-D levels [β=-0.117; 95% CI (−0.007, −0.001) and β=-0.003; 95% CI (−0.013, −0.003)]. SF level was positively correlated with β-CTx in T2DM patients with NAFLD, which may promote bone resorption and increase the risk of bone loss. [ABSTRACT FROM AUTHOR]

Background and Aims: Hemoglobin A1c (HbA1c) is widely used for assessment of glycemic status and diagnosis of diabetes. HbA1c levels are influenced by age, ethnicity, and conditions that alter the red cell turnover or survival. We aimed to assess the effect of iron deficiency anemia (IDA) on HbA1c levels among adult diabetic and nondiabetic patients and correlate HbA1c with iron profile. Materials and Methods: A cross-sectional study was carried out among 150 patients, of whom 50 were diagnosed diabetics with IDA, 50 were nondiabetics with IDA, and 50 were controls. They were investigated for hemogram, renal function test, HbA1c, and iron profile. Results: Mean HbA1c value among controls was 5.03 ± 0.34%, among diabetics with IDA was 8.69 ± 0.92%, and among nondiabetics with IDA was 5.87 ± 0.76% and this difference was statistically significant. Total iron binding capacity (TIBC) was 332.54 ± 58.32 µg/dL among controls, 420.63 ± 119.03 µg/dL among nondiabetics with IDA, and 495.88 ± 126.79 µg/dL among diabetics with IDA. Pearson's correlation coefficient of HbA1c with serum ferritin was -0.444, with serum iron was -0.357, and with TIBC was 0.476. Conclusion: HbA1c levels are elevated in diabetes with IDA. HBA1c is negatively correlated with serum iron and ferritin and positively correlated with TIBC. [ABSTRACT FROM AUTHOR]

Hemochromatosis represents clinically one of the most important genetic storage diseases of the liver caused by iron overload, which is to be differentiated from hepatic iron overload due to excessive iron release from erythrocytes in patients with genetic hemolytic disorders. This disorder is under recent mechanistic discussion regarding ferroptosis, reactive oxygen species (ROS), the gut microbiome, and alcohol abuse as a risk factor, which are all topics of this review article. Triggered by released intracellular free iron from ferritin via the autophagic process of ferritinophagy, ferroptosis is involved in hemochromatosis as a specific form of iron-dependent regulated cell death. This develops in the course of mitochondrial injury associated with additional iron accumulation, followed by excessive production of ROS and lipid peroxidation. A low fecal iron content during therapeutic iron depletion reduces colonic inflammation and oxidative stress. In clinical terms, iron is an essential trace element required for human health. Humans cannot synthesize iron and must take it up from iron-containing foods and beverages. Under physiological conditions, healthy individuals allow for iron homeostasis by restricting the extent of intestinal iron depending on realistic demand, avoiding uptake of iron in excess. For this condition, the human body has no chance to adequately compensate through removal. In patients with hemochromatosis, the molecular finetuning of intestinal iron uptake is set off due to mutations in the high-FE2+ (HFE) genes that lead to a lack of hepcidin or resistance on the part of ferroportin to hepcidin binding. This is the major mechanism for the increased iron stores in the body. Hepcidin is a liver-derived peptide, which impairs the release of iron from enterocytes and macrophages by interacting with ferroportin. As a result, iron accumulates in various organs including the liver, which is severely injured and causes the clinically important hemochromatosis. This diagnosis is difficult to establish due to uncharacteristic features. Among these are asthenia, joint pain, arthritis, chondrocalcinosis, diabetes mellitus, hypopituitarism, hypogonadotropic hypogonadism, and cardiopathy. Diagnosis is initially suspected by increased serum levels of ferritin, a non-specific parameter also elevated in inflammatory diseases that must be excluded to be on the safer diagnostic side. Diagnosis is facilitated if ferritin is combined with elevated fasting transferrin saturation, genetic testing, and family screening. Various diagnostic attempts were published as algorithms. However, none of these were based on evidence or quantitative results derived from scored key features as opposed to other known complex diseases. Among these are autoimmune hepatitis (AIH) or drug-induced liver injury (DILI). For both diseases, the scored diagnostic algorithms are used in line with artificial intelligence (AI) principles to ascertain the diagnosis. The first-line therapy of hemochromatosis involves regular and life-long phlebotomy to remove iron from the blood, which improves the prognosis and may prevent the development of end-stage liver disease such as cirrhosis and hepatocellular carcinoma. Liver transplantation is rarely performed, confined to acute liver failure. In conclusion, ferroptosis, ROS, the gut microbiome, and concomitant alcohol abuse play a major contributing role in the development and clinical course of genetic hemochromatosis, which requires early diagnosis and therapy initiation through phlebotomy as a first-line treatment. [ABSTRACT FROM AUTHOR]

Introduction: Tea consumption with meals affects iron absorption, increasing the risk of iron deficiency. Our study investigated the association between tea consumption patterns and serum ferritin levels among women of childbearing age (WCA) in Nandi County, Kenya. Methods: We conducted a cross-sectional analytical study among 160 WCA selected using a systematic random sampling technique from Kapsabet Ward. Information on tea consumption practices was gathered using a researcher-administered questionnaire, and serum ferritin and C-reactive protein were measured. We assessed associations between tea consumption and iron status of respondents by multivariable regression analysis, adjusting for potential confounders, including parasitic infections and recent severe blood losses. Results: The prevalence of anaemia and iron deficiency among the study participants were 86.2% and 45%, respectively. Majority (90.6%) of the respondents consumed tea or coffee, with an infusion time of more than 5 min (60.0%) and a moderate tea strength (64.1%), within 1 h before or after meals. Iron deficiency was associated the number of teacups consumed (adjusted odds ratio = 7.282, 95% CI = 3.580–14.812). Conclusion: High tea consumption is positively associated with iron deficiency among WCA. Lower tea infusion strength, shorter tea infusion duration, and a lower number of teacups overall consumed, as well as consuming tea 1 h before or after meals instead of with meals, may be recommended for better outcomes in iron status among WCA. [ABSTRACT FROM AUTHOR]

Hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory syndrome with high mortality rate. The response to induction therapy is an important factor affecting survival. The purpose is to investigate laboratory predictors for induction response in adult patients with HLH, which are convenient, practical, and timeliness. Clinical data from January 2017 to December 2020 was retrospectively analyzed, and 269 patients were included. Patients were divided into remission and non-remission groups according to their induction response, 177 in the remission group, and 92 in the non-remission group. We reviewed general characteristics and analyzed the predictive value of serum ferritin, triglycerides, alanine aminotransferase (ALT), and blood cells before and 1–4 weeks after induction therapy for induction response by univariate analysis, ROC curves, etc. There was a correlation between serum ferritin, ALT, leukocytes, neutrophils, hemoglobin, platelets, and induction response (P < 0.05). Serum ferritin and platelets 1–4 weeks after induction therapy, respectively, might be a good predictor for induction response in adults with HLH, with AUC values close to or greater than 0.7. We established a new clinical model of the ferritin/platelet ratio. The results showed that the ferritin/platelet ratio at 1–4 weeks after induction therapy might be a practical index for predicting induction response, which significantly improved the area under the ROC curve (AUC > 0.75). Patients with a ferritin/platelet ratio > 16.08 at 2 weeks after induction therapy may have a relatively poor induction response. Ferritin/platelet ratio after induction therapy can be a good predictor for induction response in adult patients with HLH. [ABSTRACT FROM AUTHOR]

Background & Objective: The aim of the current study was comparison of the effectiveness of intravenous iron sucrose versus oral ferrous fumarate for the treatment of iron deficiency anemia during pregnancy. Materials & Methods: This is a prospective randomized clinical trial enrolling 100 pregnant women with iron deficiency anemia who visited the Al-diwaniya Educational Hospital for maternity and children from October 2022 to July 2023 whose ferritin level was less than 15 ng/ml and Hb level was between 70-10.9g/L. They were treated with either intravenous iron sucrose or oral ferrous fumarate for four weeks. Formerly, patients were allocated into two groups. The patients in the group I received ferrous fumarate pills, each enclosed with elemental Iron 100 mg. Group II got 100 ml of 0.9% NaCl containing a dose of iron sucrose dissolved in it and calculated by a specific equation. After four weeks, serum ferritin and hemoglobin levels were assessed, and the adverse effects were also monitored. Results: Comparing hemoglobin levels produces a substantial pre- and post-treatment difference (P=0.001). Serum Ferritin Level harvest significant differences pre- and posttreatment (P=0.001). The post-treatment comparison of the two groups showed a significant difference in each group (P= 0.001). Conclusion: Maternal iron reserves are more effectively increased by intravenous ferrous sucrose than by oral ferrous fumarate. [ABSTRACT FROM AUTHOR]

Background: Maternal serum ferritin is being explored as a potential predictor for Intrauterine Growth Restriction (IUGR). Early detection of IUGR is crucial for improving perinatal outcomes and reducing associated mortality and morbidity. Objective: To evaluate the role of elevated maternal serum ferritin in predicting the risk of developing IUGR. Patients and Methods: A prospective case-control study was conducted at Al-Batool Teaching Hospital, Diyala, involving 51 pregnant women divided into two groups based on pregnancy status. Demographic data, obstetric history, and risk factors for IUGR were collected through a questionnaire, and blood samples were taken to measure hemoglobin and serum ferritin levels. Results: The study found that the mean serum ferritin level was significantly higher in the patient group (209.89±50.95 ng/ml) compared to the control group (66.91±37.49 ng/ml), with a p-value of

BackgroundSerum ferritin (SF) is clinically found to be elevated in many disease conditions, and our research examines serum ferritin in patients with acute kidney injury (AKI) and its implication on the risk of short-term mortality in AKI.MethodsData were extracted from the Medical Information Mart for Intensive Care IV 2.2 (MIMIC-IV 2.2) database. Adult patients with AKI who had serum ferritin tested on the first day of ICU admission were included. The primary outcome was 28-day mortality. Kaplan–Meier survival curves and Cox proportional hazards models were used to test the relationship between SF and clinical outcomes. Subgroup analyses based on the Cox model were further conducted.ResultsKaplan–Meier survival curves showed that a higher SF value was significantly associated with an enhanced risk of 28-day mortality, 90-day mortality, ICU mortality and hospital mortality (log-rank test: p 0.05).ConclusionHigh level of SF is an independent prognostic predictor of 28-day mortality in patients with AKI.

Iron-deficiency anemia (IDA) is a global health concern, and its widespread prevalence and multifaceted impact on various populations, particularly in developing countries, underscore the urgency for efficient diagnostic and management strategies. While traditional diagnostic methods such as ferritin and transferrin saturation are fundamental, their limitations in sensitivity and specificity lead to challenges in the early detection and effective management of IDA. This review provides a comprehensive analysis of IDA, focusing on the evolution of diagnostic methods culminating in the utilization of reticulocyte hemoglobin content (CHr) as a critical biomarker. The core of this review is the detailed examination of CHr as a biomarker. Its emergence has been pivotal due to its superior sensitivity and specificity in identifying iron deficiency and monitoring therapy efficacy. The review discusses the comparative advantages of CHr over conventional methods, including its ability to detect IDA at an earlier stage and its utility in varied demographic groups, such as children and pregnant women. Future research directions are proposed, including integration of CHr into routine clinical practice, cost-effectiveness analysis, and technological advancements for enhanced measurement and accessibility. In conclusion, CHr holds significant potential for revolutionizing IDA management, paving the way for more precise and personalized medical interventions, thereby improving patient outcomes in diverse populations.

Abstract Background Iron deficiency (ID) is often associated with other comorbidities in older patients and is a factor of morbimortality. However, the prevalence of ID remains poorly documented in this population. Methods The CARENFER PA study was a French multicenter cross-sectional study whose objective was to evaluate ID in patients (> 75 years) admitted to a geriatric unit. The primary endpoint was the ID prevalence defined as: serum ferritin

Abstract Background Anemia is strongly associated with late-life depression (LLD), however, few studies have investigated the relationship between anemia and suicide attempts in LLD patients. It is still challenging to predict suicide risk in patients with depression. Therefore, there is growing interest in potential biomarkers of depressive disorders and suicidal behavior, which may play a significant role in the early diagnosis and treatment of depression. This study aimed to compare serum ferritin, folate, vitamin B12, and erythrocyte parameter levels in patients with LLD with those in healthy older adults, and the relationship between serum ferritin, folate, vitamin B12, and suicide attempts in patients. Methods Serum ferritin, folate, vitamin B12, and erythrocyte parameter levels were measured in 66 hospitalized LLD patients (30 without suicide attempt, 36 with suicide attempt) and 47 healthy individuals. All participants were surveyed for basic conditions and suicide attempts, and depression was assessed in LLD patients. Results Serum ferritin, folate, vitamin B12, red blood cell count, hemoglobin, hematocrit, mean platelet volume and plateletcrit levels were significantly lower in LLD patients compared with healthy older adults (P

Xing Li, Zhuyuan Zhang, Wen Cai, Xuexin Zhou, Yan Zhang, Cailiang Wu, Xianming Xu, Hao Wu Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of ChinaCorrespondence: Hao Wu; Xianming Xu, Email zhuwy2007@126.com; xuxm11@163.comBackground: The relationship of iron deficiency and thyroid hormone has been researched a lot among pregnant or other healthy population. However, invisible iron deficiency, namely shortage of serum ferritin (sFer) level, has been barely investigated among Chinese pregnant women. This study aimed to explore the effects of sFer status on thyroid function and pregnancy outcomes in a population-based upper first-class hospital.Methods: A total of 781 singleton pregnant women of gestation in Shanghai General Hospital took part in this retrospective cohort study. The participants were divided into four groups by quartiles of serum ferritin levels (Q1– 4). Binary logistic regressions were used to examine the strength of association between the different traits and the serum ferritin (sFer) quartiles separately, where Q1 (lowest ferritin quartile) was taken as the base reference. One-way ANOVA was adopted to compare the averages of the different variables across sFer quartiles. Categorical measures were compared by Fisher exact test or chi-square test.Results: As the sFer concentration rises, incidence of premature birth (15.8%vs 12.3% vs 9.20% vs 6.20% p = 0.016) as well as threatened miscarriage (14.8% vs 7.2% vs 8.70% vs 6.70% p = 0.021) presented a downward trend. Compared with the other sFer group, subjects of the low sFer group were older, more often to be found to have lower serum γT3 and FT4 levels in early pregnancy but not in middle pregnancy.Conclusion: sFer concentration in the first trimester can affect thyroid function. The correction of invisible iron deficiency with inadequate sFer status prior to pregnancy or during early pregnancy is imperative, not only to prevent anemia, but also for maintaining optimum thyroid function and normal fetal development. For clinicians, sFer status of pregnant women should be attached great importance apart from attention to iron level.Keywords: serum ferritin, thyroid hormone, subclinical hypothyroidism, thyroid-stimulating hormone, pregnant women