scholarly journals Assessing the Association between Serum Ferritin, Transferrin Saturation, and C-Reactive Protein in Northern Territory Indigenous Australian Patients with High Serum Ferritin on Maintenance Haemodialysis

2017 ◽  
Vol 2017 ◽  
pp. 1-8
Author(s):  
Sandawana William Majoni ◽  
Paul D. Lawton ◽  
Federica Barzi ◽  
Alan Cass ◽  
Jaquelyne T. Hughes
Keyword(s):  
Serum Ferritin ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Northern Territory ◽  
High Serum ◽  
C Reactive Protein ◽  
Indigenous Australian ◽  
Maintenance Haemodialysis ◽  
Reactive Protein ◽  
Markers Of Inflammation

Objective. To determine the significance of high serum ferritin observed in Indigenous Australian patients on maintenance haemodialysis in the Northern Territory, we assessed the relationship between ferritin and transferrin saturation (TSAT) as measures of iron status and ferritin and C-reactive protein (CRP) as markers of inflammation. Methods. We performed a retrospective cohort analysis of data from adult patients (≥18 years) on maintenance haemodialysis (>3 months) from 2004 to 2011. Results. There were 1568 patients. The mean age was 53.9 (11.9) years. 1244 (79.3%) were Indigenous. 44.2% (n=693) were male. Indigenous patients were younger (mean age [52.3 (11.1) versus 57.4 (15.2), p<0.001]) and had higher CRP [14.7 mg/l (7–35) versus 5.9 mg/l (1.9–17.5), p<0.001], higher median serum ferritin [1069 µg/l (668–1522) versus 794.9 µg/l (558.5–1252.0), p<0.001], but similar transferrin saturation [26% (19–37) versus 28% (20–38), p=0.516]. We observed a small positive correlation between ferritin and TSAT (r2=0.11, p<0.001), no correlation between ferritin and CRP (r2 = 0.001, p<0.001), and positive association between high serum ferritin and TSAT (p<0.001), Indigenous ethnicity (p<0.001), urea reduction ratio (p=0.001), and gender (p<0.001) after adjustment in mixed regression analysis. Conclusion. Serum ferritin and TSAT may inadequately reflect iron status in this population. The high ferritin was poorly explained by inflammation.

scholarly journals THE ASSOCIATION BETWEEN LEVELS OF HEPCIDIN, IRON STATUS AND MICRO-INFLAMMATION MARKERS AMONG HAEMODIALYSIS

2019 ◽  
Author(s):  
Ebtesam Ahmad Mufadhal ◽  
Fairouz Kaid Al-Showafi ◽  
Hassan A. Al-Shamahy ◽  
Ebtesam Mhdi Al-zabidi
Keyword(s):  
Peer Review ◽  
Serum Iron ◽  
Iron Status ◽  
Control Group ◽  
Inflammation Markers ◽  
C Reactive Protein ◽  
Maintenance Haemodialysis ◽  
Reactive Protein ◽  
Serum Hepcidin ◽  
E Mail

Hepcidin is a polypeptide that regulates iron homeostasis and could serve as an indicator of functional iron deficiency in patients with end-stage renal disease (ESRD); this may also aid in the assessment of patient's response to erythropoietin (EPO). Erythropoietin is a cytokine glycoprotein secreted by the kidney in response to cellular hypoxia; it stimulates the production of red blood cells (erythrocytes) in the bone marrow. The present study was aimed to investigate serum levels of hepcidin, iron status and inflammation markers such as C-reactive protein (CRP) in patients with ESRD on maintenance HD and to observe the correlation of serum hepcidin with conventional iron and inflammatory markers. A total of 59 patients on maintenance HD were enrolled; 29 age and sex-matched healthy subjects were included as controls. Laboratory tests including complete blood count, creatinine, urea, albumin, BUN, serum hepcidin, serum ferritin, serum iron and CRP were performed. The serum hepcidin levels was measured by a competitive enzyme-linked immunosorbent assay (C-ELISA). Serum hepcidin levels were significantly higher in patients with ESRD than in the control group (63.7±47.4 ng/mL: 11.5± 26.3 ng/mL respectively P<0.001). The hemoglobin and serum iron levels in the patient group were significantly lower than in the control group. Higher feritine levels were found in hemodialysis patients (448.5±710 ng/mL): ( 98.3±83 ng/mL) of controls (P =0.01). A positive and significant correlation was observed between the values of serum hepcidin and CRP.  Serum hepcidin and high-sensitivity C-reactive protein levels were significantly higher in maintenance haemodialysis patients (case=21.2±28.6 mg/L:control=2.9±2.7 mg/L, P=0.001). In conclusion, higher hepcidin levels are found in ESRD patients and serum hepcidin levels are associated with iron status and micro-inflammation (defined as hsCRP < 6mg/l, in maintenance haemodialysis patients). Also, our findings suggest that hepcidin might play a role in the pathophysiology of anemia associated with chronic diseases as ESRD. As well as, ELISA method for measuring serum hepcidin should facilitate the routine measurement of hepcidin in clinical practice. Peer Review History: UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication st0ge: 8.5/10 Reviewer(s) detail: Name: Hebatallah Ahmed Mohamed Moustafa Affiliation: Heliopolis University Cairo, Egypt E-mail: [email protected]   Name: Dr. Heba M. Abd El-Azim  Affiliation: Damanhour University, Egypt E-mail: [email protected] Comments of reviewer(s):

High Transferrin Saturation Is Associated with Lower Monocytic Ferritin Heavy Chain Expression in Sickle Cell Anemia Patients

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4058-4058
Author(s):  
Kleber Yotsumoto Fertrin ◽  
Carolina Lanaro ◽  
Carla Fernanda Franco-Penteado ◽  
Dulcinéia Martins Albuquerque ◽  
Betania Lucena Hatzlhofer ◽  
...  
Keyword(s):  
Iron Overload ◽  
Sickle Cell ◽  
Serum Ferritin ◽  
Iron Metabolism ◽  
Sickle Cell Anemia ◽  
Transferrin Saturation ◽  
C Reactive Protein ◽  
Iron Storage ◽  
Reactive Protein ◽  
Ferroxidase Activity

Abstract The pathophysiology of sickle cell anemia (SCA) involves hemolysis, vaso-occlusion and a chronic inflammatory state. Iron overload secondary to blood transfusions is a frequent complication in these patients, but cannot be adequately estimated by serum ferritin levels, because ferritin is also an acute phase reactant. Although excess iron elevates both ferritin levels and transferrin saturation (TSAT) in SCA patients, there is notorious discrepancy between these parameters. Ferritin is composed of heavy (FHC) and light chains (FLC), and ferroxidase activity by FHC is an important cytoprotective mechanism against redox-iron, a product of heme breakdown and largely present in overt iron overload. Previous studies have shown that overexpression of FHC in sickle cell mice prevented free hemoglobin-induced vaso-occlusion. Since ferritin is also highly expressed in circulating monocytes, and these cells have been shown to interact with other cellular types in the sickle cell vaso-occlusive process, we aimed to characterize ferritin chains in monocytes and investigate the relationship with biomarkers of iron metabolism, inflammation and hemolysis. Peripheral blood monocytes from sixteen adult sickle cell anemia patients in steady state were isolated using a double Ficoll-Percoll density gradient to separate monocytes from neutrophils and lymphocytes. FHC, FLC, TLR4 (toll-like receptor 4), and SLC40A1(ferroportin) gene expressions were determined by RT-qPCR. Blood samples were also collected to determine serum ferritin, iron, and TSAT, and plasma levels of lactate dehydrogenase, soluble transferrin receptor, erythropoietin, and C reactive protein. We found that the expression of TLR4, a receptor known to be activated by heme, correlated with FLC, but not FHC expression. Higher TLR4 expression was also associated with higher serum iron, but not with ferritin, TSAT, or LDH. Interestingly, we did not find a correlation between C reactive protein levels and ferritin in this group of patients. As expected, the expressions of both ferritin chains were correlated with each other (P=0.027, r=0.55), but we found the strongest correlation between FHC and TSAT (P=0.0008, r=-0.652). Patients with a TSAT over 40% had significantly lower expression of monocytic FTH (P=0.003). This suggests that either excessive iron can lead to FHC downregulation in monocytes, or that a decrease in monocytic ferritin ferroxidase activity in some SCA patients may impair safe iron storage in ferritin and contribute to the development of higher TSAT, independently from ferritin levels. Our data support that human monocyte regulation of ferritin chains in SCA patients mirrors what has been described in hepatic cells in a sickle cell mouse model. Patients with increased TSAT may be relatively deprived of the cytoprotective ferroxidase activity of FHC, and a relationship between FHC deficiency and complications in SCA remains to be investigated. Further studies should also address whether FHC in monocytes influences cell adhesion, thus supporting an important role for iron trafficking in cells involved in sickle cell vaso-occlusion, and corroborating other studies associating organ damage in SCA with iron metabolism dysregulation. Disclosures No relevant conflicts of interest to declare.

scholarly journals Ferritin Is a Marker of Inflammation rather than Iron Deficiency in Overweight and Obese People

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Abidullah Khan ◽  
Wazir Muhammad Khan ◽  
Maimoona Ayub ◽  
Mohammad Humayun ◽  
Mohammad Haroon
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Binding Capacity ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Strong Positive Correlation ◽  
Obese People ◽  
Strong Negative Correlation ◽  
Reactive Protein ◽  
Group A

Background. In clinical practice, serum ferritin is used as a screening tool to detect iron deficiency. However, its reliability in obesity has been questioned. Objectives. To investigate the role of ferritin in overweight and obese people, either as a marker of inflammation or iron deficiency. Methods. On the basis of body mass index (BMI), 150 participants were divided into three equal groups: A: BMI 18.5–25 kg/m2, B: BMI 25–30 kg/m2, and C: BMI>30 kg/m2. Serum iron, total iron binding capacity (TIBC), transferrin saturation, ferritin, C-reactive protein, and hemoglobin (Hb) were measured for each participant and analyzed through SPSS version 16. One-way ANOVA and Pearson’s correlation tests were applied. Results. Ferritin was the highest in group C (M=163.48±2.23, P<0.001) and the lowest in group A, (M=152.78±1.81, P<0.001). Contrarily to ferritin, transferrin was the lowest in group C, (M=30.65±1.39, P<0.001) and the highest in group A, (M=38.66±2.14, P<0.001). Ferritin had a strong positive correlation with both BMI (r=0.86, P<0.001) and CRP (r=0.87, P<0.001) and strong negative correlation with Hb, iron, TIBC, and transferrin saturation (P<0.001). Conclusion. Ferritin is a marker of inflammation rather than iron status in overweight and obese people. Complete iron profile including transferrin, rather than serum ferritin alone, can truly predict iron deficiency in such people.

scholarly journals Influence of dry weight reduction on anemia in patients undergoing hemodialysis

2019 ◽  
Vol 47 (11) ◽  
pp. 5536-5547
Author(s):  
Yinghui Deng ◽  
Hua Liu ◽  
Na Lin ◽  
Lina Ma ◽  
Wenjing Fu
Keyword(s):  
Serum Ferritin ◽  
Weight Reduction ◽  
Transferrin Saturation ◽  
Dry Weight ◽  
Renal Anemia ◽  
Controlled Study ◽  
Control Group ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Volume Load

Objective Volume load in patients undergoing hemodialysis correlates with renal anemia, with reductions in volume load significantly improving hemoglobin levels. We performed a prospective controlled study to assess the effect of post-dialysis dry weight reduction, resulting from the gradual enhancement of ultrafiltration, on renal anemia in this patient population. Methods Sixty-four patients with renal anemia on maintenance hemodialysis were randomized to an ultrafiltration group, in which dry weight was gradually reduced by slightly increasing the ultrafiltration volume while maintaining routine hemodialysis, and a control group, in which patients underwent conventional dialysis while routine ultrafiltration was maintained. After 28 weeks, post-dialysis weight and levels of hematocrit, hemoglobin, C-reactive protein, serum albumin, serum ferritin, and transferrin saturation were compared. Results All parameters were similar at baseline between the two groups and remained unchanged at week 28 in the control group compared with baseline. In contrast, the ultrafiltration group showed a significant reduction in post-dialysis weight and C-reactive protein concentration and a significant increase in hematocrit, hemoglobin, albumin, serum ferritin, and transferrin saturation. Conclusions Dry weight reduction resulting from enhanced ultrafiltration may improve renal anemia in patients undergoing hemodialysis.

scholarly journals Proinflammatory state, hepcidin, and anemia in older persons

Blood ◽  
2010 ◽  
Vol 115 (18) ◽  
pp. 3810-3816 ◽  
Author(s):  
Luigi Ferrucci ◽  
Richard D. Semba ◽  
Jack M. Guralnik ◽  
William B. Ershler ◽  
Stefania Bandinelli ◽  
...  
Keyword(s):  
Older Persons ◽  
Inflammatory Diseases ◽  
Iron Status ◽  
Population Based ◽  
C Reactive Protein ◽  
Population Based Study ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Factor Α ◽  
Necrosis Factor

Abstract In patients with overt inflammatory diseases, up-regulated hepcidin impairs iron absorption and macrophage release, causing anemia. Whether the mild proinflammatory state of aging is associated with increased hepcidin is unknown. We characterized the relationships between urinary hepcidin, iron status, anemia, and inflammation in 582 patients 65 years or older participating in the InCHIANTI (Invecchiare in Chianti, “Aging in the Chianti Area”) study, a population-based study of aging in Tuscany, Italy. Compared with nonanemic persons, urinary hepcidin (nanograms/milligram of urinary creatinine) was significantly lower in iron deficiency and inflammation anemia compared with no anemia or other anemia types. Urinary hepcidin was positively correlated with log(ferritin) and negatively correlated with the soluble transferrin receptor/log(ferritin) ratio but not correlated with markers of inflammation: interleukin-6 (IL-6), IL-1β, tumor necrosis factor-α, and C-reactive protein (CRP). Lower iron was significantly correlated with higher IL-6 and CRP. Adjusting for confounders, IL-6 and CRP remained significantly associated with serum iron, with no evidence that such a relationship was accounted for by variability in urinary hepcidin. In conclusion, elevated proinflammatory markers were associated with anemia and low iron status, but not with higher urinary hepcidin. Future studies should test whether hepcidin production becomes up-regulated only in situations of overt inflammation.

Reliability of biomarkers of iron status, blood lipids, oxidative stress, vitamin D, C-reactive protein and fructosamine in two Dutch cohorts

Biomarkers ◽  
2006 ◽  
Vol 11 (4) ◽  
pp. 370-382 ◽  
Author(s):  
W. K. Al-Delaimy ◽  
E. H. J. M. Jansen ◽  
P. H. M. Peeters ◽  
J. D. van der Laan ◽  
P. A. H. van Noord ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Vitamin D ◽  
Blood Lipids ◽  
Iron Status ◽  
C Reactive Protein ◽  
Reactive Protein

639 RISK OF PROSTATE CANCER IS NOT ASSOCIATED WITH LEVELS OF C-REACTIVE PROTEIN AND OTHER COMMONLY USED MARKERS OF INFLAMMATION

2011 ◽  
Vol 10 (2) ◽  
pp. 207
Author(s):  
Hemelrijck M.J.J. Van ◽  
I. Jugner ◽  
G. Walldius ◽  
H. Garmo ◽  
E. Binda ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Markers Of Inflammation

MO477SERUM C-REACTIVE PROTEIN AND PROCALCITONIN LEVELS IN HEMODIALYSIS AND INTRADIALYTIC ALTERATIONS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Makrouhi Sonikian ◽  
Aggeliki Barbatsi ◽  
Eugenia Karakou ◽  
Theodoros Chiras ◽  
Jacob Skarakis ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Control Group ◽  
Healthy Controls ◽  
C Reactive Protein ◽  
Polysulfone Membrane ◽  
Reactive Protein ◽  
Markers Of Inflammation ◽  
Dialysate Flow Rate ◽  
Significant Difference ◽  
Serum Crp

Abstract Introduction C-reactive protein (CRP) and procalcitonin (PCT) are widely used as markers of inflammation and infection in general population and in chronic hemodialysis (HD) as well. However, in dialysis (D) patients, serum CRP and PCT levels may be elevated even in the absence of inflammatory or infectious disease and diagnostic process is a challenge in such cases. We studied HD patients' laboratory profile concerning CRP and PCT. Subjects and Methods We studied 25 stable HD patients, M/F=22/3, aged 68(44-89) years, dialyzed thrice weekly for 55(6-274) months with a dialysate flow rate of 700 ml/min, with a residual daily diuresis less than 200 ml, Kt/V values of 1,44±0,3 and no signs of infection. Patients were classified in two groups. Group A included 10 patients on pre-dilution online hemodiafiltration (HDF). Group B consisted of 15 patients on conventional HD with low-flux polysulfone membrane. Twenty healthy subjects formed a control group C. Serum CRP and PCT levels were measured in duplicate in A and B groups before and at the end of mid-week dialysis sessions and also in C group. Results Pre-D serum CRP values in the total of patients were higher than those in healthy controls (10,89±19,29 vs 2,54±1,28 mg/L-p=0,004). Compared with group C, pre-D CRP values were higher only in B group (15,98±24,54 mg/L-p=0,001) but not in A group (4,09±3,33 mg/L-p=NS). There was a significant difference in pre-D serum CRP values between A and B groups (p=0,028). At the end of D session serum CRP values showed a tendency to increase in both groups A (5,16±4,81 mg/L) and B (17,00±27,00 mg/L) but differences were not significant. Pre-D serum PCT values in the total of patients were higher than those in healthy controls (0,82±0,9 vs 0,29±0,55 ng/ml-p&lt;0,001). Compared with group C, pre-D PCT values were higher in both A group (0,52±0,15 ng/ml-p&lt;0,001) and B group (1,01±1,13 ng/ml-p=0,006). There was no significant difference in pre-D serum PCT values between A and B groups (p=0,261). At the end of D session serum PCT values decreased in A group (0,32±0,11 ng/ml-p&lt;0,001) and increased in B group (1,12±1,21 ng/ml-p=0,014). Conclusions In patients on both conventional low-flux HD and online HDF pre-D serum CRP and PCT levels were higher than those in healthy subjects. Dialysis modality and membrane flux did not affect post-D serum CRP values, but post-PCT values decreased in online HDF. PCT usefulness might be limited in dialysis with high-flux membranes. Cut-off values have to be established for both markers to eliminate confusion in diagnosis of inflammatory and infectious diseases in hemodialyzed patients.

scholarly journals Association between central obesity indices and iron status indicators among Qatari adults

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250759
Author(s):  
Abdelhamid Kerkadi ◽  
Reem Mohsen Ali ◽  
Alaa A. H. Shehada ◽  
Eman Abdelnasser AbouHassanein ◽  
Joyce Moawad ◽  
...  
Keyword(s):  
Waist Circumference ◽  
Iron Deficiency ◽  
Central Obesity ◽  
Iron Status ◽  
C Reactive Protein ◽  
Ferritin Concentration ◽  
Reactive Protein ◽  
Android Fat ◽  
Gynoid Fat ◽  
Obesity Indices

Co-existence of iron deficiency and obesity in adults has been reported in many countries. However, little is known on the association between obesity and iron deficiency in Qatar. This study aimed to investigate the link between abdominal obesity indices and iron status among adults in Qatar. A random sample of 1000 healthy Qatari adults, aged 20–50 years, was obtained from Qatar Biobank study. Body weight, waist circumference, dual x-ray absorptiometry (DXA) parameters and iron status indicators were measured using standard techniques. Multiple regression analysis was used to examine the associations. The prevalence of iron deficiency and anaemia were 35.4 and 25%, respectively. Of the participants with a large waist circumference, 31.7% had anaemia. Ferritin significantly increased with the increase in the android fat to gynoid fat ratio and visceral fat in both genders. Serum iron and transferring saturation decreased significantly with the increase in waist circumference in women. In both genders, C-reactive protein increased with the increase in all obesity indices. Standardized values of waist circumference, android fat, gynoid fat ratio and visceral fat were significantly associated with log transformed ferritin in men and women. Waist circumference was inversely related to serum iron (β:-0.95, 95% CI:-1.50,-0.39) and transferrin saturation (β:-1.45, 95%CI:-2.46, -0.43) in women. In men, waist circumference was positively associated with haemoglobin level (β: 0.16, 95% CI:0.04, 0.29). Central obesity coexists with anaemia among the study population. Elevated central obesity indices were associated with an increase in ferritin concentration. The increased ferritin concentration may be attributed to the increase in inflammatory status as a result of an increase in c-reactive protein concentration associated with central obesity.

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