Study of serum ferritin as diagnostic and prognostic biomarker for severity of sepsis: a hospital-based study

Background: The objective of the study was to evaluate serum ferritin levels to define it as a diagnostic and prognostic biomarker for severity of sepsis.Methods: In this hospital-based descriptive type of observational study, conducted at the Department of Pediatrics, NIMS Medical College; 80 children of age group 6 months to 18 years with diagnosis of pediatric sepsis were included. Children were divided into grades of sepsis (sepsis, severe sepsis, septic shock, MODS). Progress of sepsis, severe sepsis, septic shock, and sepsis with MODS was followed with serum ferritin levels on day 1, day 3, day 7, or more than 7 days and one week post recovery.Results: Pneumonia was identified as the most common source of infection. The blood culture positivity rate was 32.5%. E. coli was the most common organism grown on blood culture. Median serum ferritin levels increased as sepsis severity worsened. A significant association was discovered between sepsis severity and CRP levels at the time of admission.Conclusions: There is a consistent pattern of Serum ferritin levels with increasing severity of pediatric sepsis. Routine use of serum ferritin levels in diagnosis and prognostication is both feasible and simple. CRP level correlate well with serum ferritin level for diagnosis of sepsis.

Serum ferritin levels in children of simple febrile seizures in tertiary institute

Background: Seizure onset is impacted by a number of variables, including genetics, diet, geography, concurrent illnesses, metabolic state, history of head trauma, and blood levels of particular minerals. Due to the fact that iron is required for the proper functioning of a number of enzymes and neurotransmitters in the central nervous system, low blood ferritin levels may lower the seizure threshold. The aim of the study was to determine the association between serum ferritin levels and simple febrile seizures.Methods: The present observational study was conducted in department of pediatrics of a tertiary institute and included a total of 200 study subjects who visited to pediatric OPD/emergency room with febrile illness. The data was collected with the help of a structured clinical proforma. The collected data was recorded in Microsoft Excel sheet and statistical analysis was done with the help of SPSS version 21.0.Results: In our study, the maximum number of the study subjects were between 13 and 24 months (35%) with male to female ratio 1.2:1. In patients with simple febrile seizure the mean Hb level was 9.1�4 gm/dl, the mean MCV was 72.6�4 f1, mean MCH was 23.73�2 pg and mean serum ferritin was 13.4�5 ng/ml as compared to those patients with febrile illness without seizure the mean Hb level was 11.5�2 gm/dl, mean MCV was 82.1�5 f1, mean MCH was 29.6�9 pg and mean serum ferritin was 33.6�.2 ng/ml.Conclusions: It is concluded that the low serum ferritin level is a risk factor of simple febrile seizure.

Role of inflammatory markers in predicting mortality and outcome of acute encephalitis syndrome in children of Eastern Uttar Pradesh India

Background: The present study was performed to study the role of inflammatory markers viz. C-reactive protein, procalcitonin, serum ferritin and serum lactate dehydrogenase in predicting the mortality and outcome in patients with acute encephalitis syndrome admitted to pediatrics ICU, BRD medical college, Gorakhpur.Methods: 140 patients/children of the age group ranging from 1 year to 16 years admitted in the acute encephalitis syndrome unit of BRDMC during 1 August 2021 to 31 July 2022 were analyzed with the prospective observational study.Results: Vaccination status (p<0.001) and socioeconomic status (p=0.020) were associated with mortality outcome in AES patients. Serum procalcitonin levels with cut off value >0.10 mg/dl and serum LDH levels with cut off value of 480u/L have shown a positive association with the mortality in AES patients. (p=0.041 and p=0.038, and strength of association is 0.67 and 0.65, respectively. C-reactive protein with a cut-off value 10 mg/dl and serum ferritin with a cut-off value 140 ng/ml have shown no association with mortality with p values of 0.143 and 0.267, respectively. The Area under the ROC curve is maximum for serum procalcitonin (0.937) with a cut-off value 0.10 ng/dl with 100% sensitivity and 75.8% specificity (confidence interval 95%: 0.894-0.980). The negative predictive value is 100% and PPV is 13.7%. Similarly, the area under the ROC curve for CRP with a cut-off 10mg/dl is 0.900 (confidence interval 95%: 0.841-0.959) with 100% sensitivity of and 64.8%. specificity. Consequently, the negative predictive value is 100 % and the positive predictive value of 11.1%.Conclusions: For predicting the mortality in AES patients 2 prognostic markers viz. C reactive protein and procalcitonin can prove to be promising prognostic screening tests, and therefore, both the tests are advised consecutively.

The association of serum ferritin with preeclampsia and its severity

Background: Preeclampsia, a pregnancy-related condition with heightened blood pressure and organ damage after 20 weeks, prompts concern. Serum ferritin, an iron-storing protein, gauged by blood tests, mirrors iron levels. Investigating link before conception between serum ferritin and preeclampsia could impact how we identify, manage, and treat this condition during pregnancy. Study aimed to assess the association of serum ferritin with preeclampsia and its severity.Methods: This case-control study was conducted in Bangabandhu Sheikh Mujib medical university hospital and Dhaka medical college hospital, Dhaka, Bangladesh from July 2011 to June 2012. A total of 100 pregnant women, comprising 50 cases (Preeclamptic) and 50 controls (Normal pregnant women), were purposively included as study subjects. Data analysis was performed using SPSS version 23.0.Results: In the case group, 64% were with mild and 36% with severe preeclampsia. Mean serum ferritin was significantly higher in cases than in controls (p<0.001); 76% of cases had elevated serum ferritin, compared to 44% in controls (p=0.001). Severe preeclampsia group had a mean serum ferritin of 192.8, mild preeclampsia group had 86.1, and normal pregnant women had 21.7 ng/ml, indicating higher serum ferritin with preeclampsia severity (p<0.001).Conclusions: Preeclamptic cases exhibit significantly elevated serum ferritin levels, with a fourfold increased likelihood compared to normal pregnancies. Furthermore, the severity of preeclampsia is associated with higher serum ferritin concentrations in comparison to uncomplicated pregnancies.

Impact of use of iron fortified iodised salt beyond 12 months on haemoglobin levels

Background: Use of iron fortified iodised salt (IS) for 12 months, resulted in improvement in haemoglobin (Hb) in women, children and men. There is no published data on impact of DFS use beyond 12 months on Hb levels. Methods: A community based open randomised study to assess impact of use of DFS on Hb was discontinued after 12 months due to COVID 19 related lockdown. These families used IS for six months during lockdown; they were willing to continue using the salt provided for further one year. These families were re-randomized into three groups and given the assigned salt for further 12 months and Hb, ferritin and C-reactive protein (CRP) were estimated at 12 months. Results: Improvement in the mean Hb was 0.5 g/dl in women who had used IS earlier and DFS under second randomisation and 0.3 g/dl in those who had used DFS under first and second randomisation. Mean Hb at 30 months was higher in those who had used DFS for 24 months as compared to those who had used IS for 18 months and DFS for 12 months. The deterioration in mean Hb following discontinuation of DFS for 6 and 18 months was small. Conclusions: DFS use for the second year resulted in a further increase in Hb in those who had used DFS earlier. The relatively small deterioration in mean Hb following discontinuation of DFS might at least be in part due to the impact of nutrition and health education and access to health and nutrition services.

Is Iron Overload Associated with Worse Outcomes in Patients with Chronic Liver Disease Undergoing Liver Transplantation?

ABSTRACT Background: Iron overload is frequent in patients with chronic liver disease, associated with shorter survival after liver transplantation in patients with hereditary hemochromatosis. Its effect on patients without hereditary hemochromatosis is unclear. The aim of the study was to study the clinical impact of iron overload in patients who underwent liver transplantation at an academic tertiary referral center. Methods: We performed a retrospective cohort study including all patients without hereditary hemochromatosis who underwent liver transplantation from 2015 to 2017 at an academic tertiary referral center in Mexico City. Explant liver biopsies were reprocessed to obtain the histochemical hepatic iron index, considering a score ≥ 0.15 as iron overload. Baseline characteristics were compared between patients with and without iron overload. Survival was estimated using the Kaplan-Meier method, compared with the log-rank test and the Cox proportional hazards model. Results: Of 105 patients included, 45% had iron overload. Viral and metabolic etiologies, alcohol consumption, and obesity were more frequent in patients with iron overload than in those without iron overload (43% vs. 21%, 32% vs. 22%, p = 0.011; 34% vs. 9%, p = 0.001; and 32% vs. 12%, p = 0.013, respectively). Eight patients died within 90 days after liver transplantation (one with iron overload). Complication rate was higher in patients with iron overload versus those without iron overload (223 vs. 93 events/100 person-months; median time to any complication of 2 vs. 3 days, p = 0.043), without differences in complication type. Fatality rate was lower in patients with iron overload versus those without iron overload (0.7 vs. 4.5 deaths/100 person-months, p = 0.055). Conclusion: Detecting iron overload might identify patients at risk of early complications after liver transplantation. Further studies are required to understand the role of iron overload in survival.

Role of serum hepcidin as a marker of iron overload in beta thalassemia major

Background: Beta thalassemia major (BTM) is the most common hemolytic anemia. Regular blood transfusion is a basic treatment modality, recurrent blood transfusion which leads to iron overload and its complications. Hepcidin hormone is found to be a key regulator of iron homeostasis and is significantly increased in children of BTM with iron overload. The main objective of the study is to find out the role of serum hepcidin as a potential marker of iron overload in children with BTM, and to correlate the relationship between serum hepcidin and serum ferritin level in BTM children.Methods: This was a hospital based prospective observational study conducted at Indira Gandhi institute of child health for 12 months from January 2019 to December 2019. Included 100 children between age group of 2 months to 18 years diagnosed with BTM on blood transfusion and 50 age and sex matched healthy controls.Results: In the study group 70% children had >5 transfusions. The median serum hepcidin level (2.354 ng/ml) was significantly higher among those with higher number of total transfusions (>5 transfusions). In addition, hepcidin level showed good positive correlation with total number of transfusions (r=0.608, p<0.001). Also, serum hepcidin showed positive correlation with serum ferritin levels with 87% sensitivity and 88% specificity which was statistically significant (r=0.749, p<0.001).Conclusions: In the present study, BTM children who received >5 transfusions serum hepcidin level was significantly elevated and serum hepcidin showed positive correlation with serum ferritin levels. Thus, hepcidin can be considered as a potential marker of iron overload in patients with BTM.

Deficiencia de ferritina en gestantes colombianas y factores sociodemográficos asociados / Ferritin deficiency in colombian pregnant women and associated sociodemographic factors / Deficiencia de ferritina en gestantes colombianas y factores sociodemográficos asociados

Objetivo: la ferritina es importante en el almacenamiento de hierro intracelular, en una forma soluble no tóxica. Sus niveles en la gestación se la relacionan con la salud de la madre y con su descendencia. El objetivo es escribir los niveles séricos de ferritina y prevalencia de déficit de ferritina, así como los factores sociodemográficos asociados en gestantes de Colombia. Metodología: estudio transversal; análisis secundario de la Encuesta de Situación Nutricional de Colombia, 2015. Se evaluaron en 1.234 embarazadas con edades entre 12 y 48 años: sus características sociodemográficas y antropométricas, la distribución de los niveles séricos y la prevalencia de déficit de ferritina. Para estimar la asociación entre las diferentes variables sociodemográficas y los niveles séricos, o la prevalencia de déficit de ferritina, se utilizaron modelos de regresión multivariables. Resultados: la prevalencia de deficiencia de ferritina fue de 44.5 % (IC 95 % 40.1 % a 49.0 %), los niveles séricos de ferritina oscilaron entre 4 µg/L y 295,7 µg/L, con un promedio de 29.3 µg/L (IC 95 % 26,5 µg/L-32.2 µg/L). Las gestantes del segundo (OR (OR 2.19 IC 95 % 1.50 a 3.19) y tercer trimestre (OR 3.84 IC 95 % 2.68 a 5.50), aquellas que residen en la región Atlántica (OR 2.18 IC 95 % 1.25 a 3.82) y en la región Orinoquia (OR 2.41 IC 95 %1.19 a 4.88), mostraron asociación con el déficit de ferritina. Conclusión: se halló alta prevalencia en el déficit de ferritina en gestantes colombianas.

Introduction: Ferritin is important in the storage of intracellular iron, in a non-toxic soluble form. Its levels during pregnancy are related to the health of the mother and her offspring. Objective: To describe the serum ferritin levels and the prevalence of ferritin deficiency, and the associated sociodemographic factors in pregnant women in Colombia. Methodology: Cross-sectional study; secondary analysis of the Nutritional Situation Survey of Colombia, 2015. The following were evaluated in 1,234 pregnant women aged between 12 and 48 years: their sociodemographic and anthropometric characteristics, the distribution of serum levels, and the prevalence of ferritin deficiency. To estimate the association between the different sociodemographic variables and serum levels, or the prevalence of ferritin deficiency, multivariate regression models were used. Results: The prevalence of ferritin deficiency was 44.5% (95% CI 40.1% to 49.0%), serum ferritin levels ranged from 4 µg/L to 295.7 µg/L, with a average of 29.3 µg/L (95% CI 26.5 µg/L - 32.2 µg/L). Pregnant women in the second (OR (OR 2.19 95% CI 1.50 to 3.19) and third trimester (OR 3.84 95% CI 2.68 to 5.50), those residing in the Atlantic region ( OR 2.18 95% CI 1.25 to 3.82) and in the Orinoquia region (OR 2.41 95% CI 1.19 to 4.88), showed an association with ferritin deficiency. Conclusion: A high prevalence of ferritin deficiency was found in Colombian pregnant women.

Study on the Distribution of Traditional Chinese Medicine Constitution in Pregnant Women with Iron Deficiency Anemia and Its Influencing Factors / 广州中医药大学学报

Objective To investigate the distribution of traditional Chinese medicine(TCM)constitution in pregnant women with iron deficiency anemia(IDA)and its related influencing factors,so as to provide a reference for the TCM prevention and treatment of IDA in pregnancy.Methods A total of 109 eligible patients with IDA during pregnancy were included in the study.The general data of pregnant women,the TCM constitution types and relevant laboratory indicators including serum ferritin(Fer),hemoglobin(Hb)and mean corpuscular volume(MCV)were collected.Statistical analyses were conducted on the distribution of TCM constitution types of IDA pregnant women and its related influencing factors as well as the pregnancy outcomes.Results(1)The 109 IDA pregnant women were predominated by biased constitution types,accounted for 60 cases(55.05％).The distribution of the constitution types of 109 IDA pregnant women was as follows:balanced constitution(49 cases,44.95％)>damp-heat constitution(13 cases,11.93％)>yang deficiency constitution(12 cases,11.01％)>yin deficiency constitution(11 cases,10.09％)>qi deficiency constitution(10 cases,9.17％)>qi stagnation constitution(9 cases,8.26％)>blood stasis constitution(3 cases,2.75％)>phlegm-damp constitution(2 cases,1.83％).(2)Comparison of Hb and MCV levels in IDA pregnant women with various constitution types showed no statistically significant differences(P>0.05),but Fer level in IDA pregnant women with damp-heat constitution was significantly higher than that in IDA pregnant women with balanced constitution(P<0.01),and the probability of occurrence of amniotic opacity in IDA pregnant women with damp-heat constitution was significantly higher than that in IDA pregnant women with balanced constitution and other biased constitution types(P<0.05).Conclusion Damp-heat constitution is the most common TCM constitution type in pregnant women with IDA,followed by yang deficiency constitution,yin deficiency constitution and qi deficiency constitution.The damp-heat constitution may be the susceptible constitution of pregnant women with IDA,and IDA pregnant women with damp-heat constitution have significantly higher Fer level than those with balanced constitution,and also have the higher probability of occurrence of amniotic opacity than those with balanced constitution and other biased constitution types.

Analysis of micronutrient elements in female patients with diffuse hair loss / 基础医学与临床

Objective To analyze micronutrient levels in three types of female patients with diffuse hair loss.Methods The clinical data of 299 female patients with diffuse alopecia from January 2018 to June 2021 in the Department of Dermatology of Daping Hospital were analyzed retrospectively.Results The level of serum 25-hydroxyvitamin D in patients with diffuse alopecia was significantly lower than that in the control group,and had no impact to the type of diffuse alopecia.The concentration of serum zinc in patients with diffuse alopecia areata was also significantly lower than that in the control group.When ferritin≤50 ng/mol was taken as the threshold of iron deficiency and 25-hydroxyvitamin D≤20 ng/mol,as the indicator level of serum 25-hydroxyvitamin D deficiency,the proportion of serum 25-hydroxyvitamin D and serum ferritin deficiency in all the three types of diffuse hair loss patients was higher than that in the control group(P＜0.05).So,lack of iron and serum 25-hydroxyvitamin D were belived to be related to the occurrence of diffuse alopecia of women.Conclusions Iron metabolism disorder and se-rum 25-hydroxyvitamin D level play a key role in female diffuse alopecia,while the effects of copper and zinc on hair growth and hair loss cycle are not well identified yet.

Role of ferritinophagy in the pathogenesis of diabetes and its complications:A review of literature / 实用医学杂志

Diabetes mellitus(DM)is a common metabolic disease,and its hyperglycemia can induce many complications and even threaten human health and life.Ferritinophagy,currently a research focus,has been proven to be related to the occurrence and development of DM and its complications.Ferritinophagy,which is cell-selective,is mediated by nuclear receptor coactivator 4(NCOA4),which degrades ferritin in autophagosomes and releases excessive iron ions so that irons are overloaded and ROS are accumulated.This process contributes to the upstream ferroptosis.This article reviews the mechanism of ferritinophagy and its pathogenesis in DM and its complications,and further analyzes the effects of regulated ferritinophagy on DM and its complications,pro-viding new insight into the prevention and treatment of DM and its complications.

Correlation of serum 25-(OH)D3, albumin, ferritin with STAMP score and their predictive value for clinical outcome of preschool children with malnutrition / 中国儿童保健杂志

【Objective】 To investigate the correlation of serum 25-hydroxyvitamin D3 [25-(OH)D3], albumin (ALB) and ferritin (SF) with Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) score in preschool children with malnutrition, and to analyze the predictive value of these factors on clinical outcomes, so as to provide reference for improving clinical outcomes. 【Methods】 Totally 90 preschoolers with malnutrition in Fuzhou Children′s Hospital from August 2021 to August 2022 were selected as the observation group, and 60 healthy preschool children during the same period were selected as the control group. Nutritional guidance was provided to the preschoolers for a consecutive 3-month period, followed by monitoring and recording the incidence of malnutrition and iron deficiency anemia within 3 months after treatment. 【Results】 The levels of serum 25-(OH)D3, ALB and SF were lower in the observation group compared to the control group, while the STAMP score was higher in the observation group (t=9.700, 6.047, 4.771, 26.976, P<0.05). The levels of serum 25-(OH)D3, ALB and SF in preschool children with malnutrition showed a negative correlation with the STAMP score (r=-0.813, -0.792, -0.829, P < 0.05). After 3 months of treatment, the levels of serum 25-(OH)D3, ALB and SF, as well as the difference between pre- and post-treatment levels, were lower in children with adverse clinical outcomes compared to those with good clinical outcomes (t=3.622, 2.189, 2.163, 8.704, 4.354, 5.296, P< 0.05). When the difference in serum 25-(OH)D3, ALB and SF before and after treatment was small, preschool children with malnutrition had a higher risk of adverse clinical outcomes [25-(OH)D3:OR=7.250, 95%CI: 3.008 - 17.476; ALB: OR=9.167, 95%CI: 2.954 - 28.444; SF: OR=5.730, 95%CI: 2.364 - 13.890]. The combined predictive value of serum 25-(OH)D3, ALB and SF before and after treatment had an AUC value of 0.927, higher than that of any single index. The decision curve analysis (DCA) showed that the combined prediction scheme of these factors had a clinical net benefit in predicting the clinical outcome of preschool children with malnutrition. 【Conclusions】 Low serum levels of 25-(OH)D3, ALB and SF are indicative of a higher risk of adverse clinical outcomes. Utilizing the combined prediction of these factors before and after treatment shows high accuracy in predicting clinical outcomes.

Association of elevated plasma ferritin and triglyceride concentrations in early pregnancy and the risk of gestational diabetes mellitus / 公共卫生与预防医学

Objective To investigate the relationship between combined plasma ferritin and triglyceride (TG) concentrations in early pregnancy and the risk of gestational diabetes mellitus (GDM). Methods A total of 1 000 pregnant women who had antenatal care at the Sixth Hospital of Wuhan from January 2021 to January 2023 were selected as the research subjects. The cut-offs of ferritin and TG were analyzed by using unrestricted cube splines. All participants were divided into 4 groups according to the cut‐off values of ferritin and TG. Associations between combined ferritin and TG concentrations and GDM risk were estimated using multivariable logistic regression models. Results A total of 158 (15.8%) participants were diagnosed with GDM. The ferritin and TG levels in early pregnancy of pregnant women in the GDM group were significantly higher than those in the non-GDM group (P<0.05). After adjusting for potential confounders, the OR for the risk of developing GDM after combining ferritin with TG was 2.35 (1.65, 3.35). Couclusion The increase in plasma ferritin and TG concentrations in early pregnancy is positively correlated with the increased risk of GDM. Pregnant women with high plasma ferritin (˃65.7 ng/mL) and high TG (˃1.9mmoL/L) have the greatest risk of GDM.

Nomogram including serum ferritin to predict the occurrence of diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

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.

Progress in mechanism and detection methods of ferrinophagy-mediated ferroptosis / 中国病理生理杂志

Ferroptosis is an iron-dependent form of regulated cell death,which is distinct from apoptosis,ne-crosis,and pyroptosis.Recent studies have found that activators of ferroptosis,such as Erastin,can activate autophagy-re-lated proteins,induce the formation of autophagosomes,and ultimately release ferric ions to mediate ferroptosis.This pro-cess,called ferritinophagy,is initiated by the binding of an autophagic cargo receptor protein,nuclear receptor coactivator 4(NCOA4),to iron-laden ferritin.The transfer of NCOA4-ferritin to the lysosome by ferritinophagy results in the proteoly-sis of ferritin,and,in turn,the release of its iron content and lipid-reactive oxygen species(ROS)accumulation.Ferritin-ophagy has been closely associated with central nervous system disorders,circulatory system diseases,and cancer.Fur-thermore,the regulation mechanism of ferritinophagy is also a hot topic in the study of iron-dependent cell death process.With the in-depth study of ferritinophagy,great progress has been made in the study of key components of ferritinophagy as well as its molecular mechanisms and processes.However,a comprehensive summary of the methods for detecting ferritin-ophagy is still unclear.To further deepen the understanding of ferritinophagy and its detection methods,this review focus-es on the concept,characteristics,methods,and precautions during detection of ferritinophagy.This review provided ex-perimental reference for subsequent researchers and promoting the progress of research related to ferritinophagy.

Expression and prognostic value of serum VitD,FRT and HB-EGF in sep-sis patients / 中国感染控制杂志

Objective To explore and analyze the expression and prognostic value of serum vitamin D(VitD),fer-ritin(FRT)and heparin-binding epidermal growth factor(HB-EGF)in sepsis patients.Methods 86 sepsis patients who were admitted to the intensive care unit(ICU)of a hospital from January 2021 to January 2022 were selected as the case group,and 60 non-sepsis patients in the ICU were selected as the control group.According to the prognosis of sepsis patients one month later,patients were divided into survival group and death group.Patient's serum upon admission was taken,levels of serum VitD,FRT and HB-EGF were detected,the correlation with the prognosis of sepsis patients was analyzed,and the prognostic value was evaluated by area under curve(AUC)of receiver opera-ting characteristic curve.Results Levels of white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-1β and FRT of case group were all higher than those of non-sepsis patients in the control group,while the VitD and HB-EGF levels were lower than those of non-sepsis patients in the control group,differences were all statistically significant(all P＜0.05).One month follow-up on the prognosis of sepsis patients showed that 55 patients survived and 31 died.Acute physiology and chronic health evaluationⅡ(APACHE IⅡ)score,sequential organ failure assessment(SOFA)score,PCT,TNF-α,L-1βand FRT score in patients in the death group were all higher than those in patients in the survival group,while VitD and HB-EGF were lower than patients in the survival group,differences were all statistically significant(all P＜0.05).The Pearson correlation analysis results showed that VitD were negatively correlated with APACHE Ⅱ score,SOFA score,WBC,CRP,PCT and TNF-α(all P＜0.05),HB-EGF was negatively correlected with APACHE Ⅱ,score,CRP,PCT,TNF-α,IL-6 and IL-1β(all P＜0.05);while FRT was positively correlated with APACHE Ⅱscores,CRP,PCT,TNF-α,IL-6 and IL-1β(all P＜0.05).The AUC,sensitivity,and specificity of combined de-tection of serum VitD,FRT and HB-EGF in predicting the prognosis of sepsis patients were 0.82(95％CI:0.72-0.86),84.39％,and 69.35％,respectively.Conclusion Serum levels of VitD and HB-EGF are lower and FRT is higher in sepsis patients,their expression levels are closely related to patient prognosis,and have good predictive value for predicting the prognosis of sepsis patients.

Effect of Liuwei Dihuang Tang on ferroptosis pathway in retinal tissue of aging model rats / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the effects of Liuwei Dihuang Tang on the expression levels of ferritin, recombinant solute carrier family 7 member 11(SLC7A11), glutathione(GSH), and glutathione peroxidase 4(GPX4)in retinal of aging model rats.METHODS: A total of 45 SD rats were randomly divided into a blank group, a model group, and a traditional Chinese medicine(TCM)group, with 15 rats in each group. The blank group was intraperitoneally injected with physiological saline, while the model group and TCM group were intraperitoneally injected with D-galactose [500 mg/(kg·d)]. At the same time, the TCM group was orally administered with Liuwei Dihuang Tang [6.75 g/(kg·d)], while the blank group and model group were orally administered with equal volume of physiological saline for 8 consecutive wk. The expression levels of ferritin, SLC7A11, GSH, and GPX4 in the retinal tissues of rats in each group were detected.RESULTS: The expression of ferritin in the retinal tissue of the model group was increased compared to the blank group(P&#x003C;0.05), while the expression of GSH, SLC7A11, and GPX4 was reduced(P&#x003C;0.05). The expression of GSH, SLC7A11, and GPX4 in the retina tissue of rats in the TCM group was higher than that in the model group(P&#x003C;0.05).CONCLUSIONS: Liuwei Dihuang Tang may exert a delaying effect on retinal aging by regulating the ferroptosis pathway.

Reduced HDL-cholesterol in long COVID-19: A key metabolic risk factor tied to disease severity

Abstract This controlled study investigated metabolic changes in non-vaccinated individuals with Long-COVID-19, along with their connection to the severity of the disease. The study involved 88 patients who experienced varying levels of initial disease severity (mild, moderate, and severe), and a control group of 29 healthy individuals. Metabolic risk markers from fasting blood samples were analyzed, and data regarding disease severity indicators were collected. Findings indicated significant metabolic shifts in severe Long-COVID-19 cases, mainly a marked drop in HDL-C levels and a doubled increase in ferritin levels and insulin resistance compared to the mild cases and controls. HDL-C and ferritin were identified as the leading factors predicted by disease severity. In conclusion, the decline in HDL-C levels and rise in ferritin levels seen in Long-COVID-19 individuals, largely influenced by the severity of the initial infection, could potentially play a role in the persistence and progression of Long-COVID-19. Hence, these markers could be considered as possible therapeutic targets, and help shape preventive strategies to reduce the long-term impacts of the disease.

A meta-analysis of ferric carboxymaltose versus other intravenous iron preparations for the management of iron deficiency anemia during pregnancy

Abstract Objective: We conducted a meta-analysis of randomized clinical trials evaluating the clinical effects of ferric carboxymaltose therapy compared to other intravenous iron in improving hemoglobin and serum ferritin in pregnant women. We also assessed the safety of ferric carboxymaltose vs. other intravenous iron. Data source: EMBASE, PubMed, and Web of Science were searched for trials related to ferric carboxymaltose in pregnant women, published between 2005 and 2021. We also reviewed articles from google scholar. The keywords "ferric carboxymaltose," "FCM," "intravenous," "randomized," "pregnancy," "quality of life," and "neonatal outcomes" were used to search the literature. The search was limited to pregnant women. Selection of studies: Studies related to ferric carboxymaltose in pregnancy were scanned. Observational studies, review articles, and case reports were excluded. Randomized studies in pregnant women involving ferric carboxymaltose and other intravenous iron formulations were shortlisted. Of 256 studies, nine randomized control trials were selected. Data collection: Two reviewers independently extracted data from nine selected trials Data synthesis: The final effect size for increase in hemoglobin after treatment was significant for ferric carboxymaltose vs. iron sucrose/iron polymaltose (standard mean difference 0.89g/dl [95% confidence interval 0.27,1.51]). The final effect size for the increase in ferritin after treatment was more for ferric carboxymaltose vs. iron sucrose/iron polymaltose (standard mean difference 22.53µg/L [-7.26, 52.33]). No serious adverse events were reported with ferric carboxymaltose or other intravenous iron. Conclusion: Ferric carboxymaltose demonstrated better efficacy than other intravenous iron in increasing hemoglobin and ferritin levels in treating iron deficiency anemia in pregnant women.

Association between nonalcoholic steatohepatitis and high serum ferritin levels in type 2 diabetes mellitus

SUMMARY OBJECTIVE: The aim of this study was to assess the role of elevated serum ferritin levels in the onset, pathological progression and prognosis of nonalcoholic fatty liver disease. Nonalcoholic fatty liver disease has been rapidly increasing worldwide. Despite extensive research on the pathogenesis of nonalcoholic fatty liver disease, a lack of sufficient clinical research on the relationship between nonalcoholic fatty liver disease and serum ferritin levels remains. METHODS: We analysed 968 patients with type 2 diabetes mellitus who underwent liver ultrasound examination and had their serum ferritin levels measured. The presence of nonalcoholic fatty liver disease and advanced liver fibrosis was determined through abdominal ultrasound examination and the nonalcoholic fatty liver disease fibrosis score. RESULTS: Compared to that in the non-nonalcoholic fatty liver disease group, the presence of hyperferritinemia was significantly more common in the nonalcoholic fatty liver disease group (83.3 vs. 56.3%, p=0.005). When patients with nonalcoholic fatty liver disease were stratified by the nonalcoholic fatty liver disease fibrosis score, those with advanced liver fibrosis exhibited a higher prevalence of hyperferritinemia (56.3, 78.9, and 88.9% for none, simple steatosis, and advanced fibrosis, respectively; p for trend=0.002). In multivariate logistic regression, liver fibrosis was independently associated with hyperferritinemia (odds ratio [OR] 1.45; 95% confidence interval [CI] 1.18-2.02; p=0.014), and this association remained significant in male patients after adjusting for other risk factors (OR 2.66; 95% CI 1.43-5.48; p=0.026). CONCLUSION: Identifying nonalcoholic fatty liver disease patients at a risk of developing nonalcoholic steatohepatitis and advanced fibrosis is crucial for implementing timely interventions and improving patient outcomes. This study highlights the potential utility of serum ferritin levels as a serum biomarker for identifying nonalcoholic steatohepatitis patients and those at a risk of late-stage fibrosis, particularly in male patients with nonalcoholic fatty liver disease.