scholarly journals Serum ferritin levels are associated with carotid atherosclerosis in Chinese postmenopausal women: the Shanghai Changfeng Study

2015 ◽  
Vol 114 (7) ◽  
pp. 1064-1071 ◽  
Author(s):  
Hui Ma ◽  
Huandong Lin ◽  
Yu Hu ◽  
Xiaoming Li ◽  
Wanyuan He ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Serum Ferritin ◽  
Carotid Atherosclerosis ◽  
Ferritin Level ◽  
Oral Glucose ◽  
Model Assessment ◽  
Cvd Risk ◽  
Carotid Plaques ◽  
Increased Risk ◽  
Fourth Quartile

Postmenopausal women are at increased risk of CVD: the increased serum ferritin level may be involved in the pathogenesis. The aim of the present study is to investigate the relationship of ferritin and carotid atherosclerosis in postmenopausal women. A total of 1178 postmenopausal women (mean age, 60·8 years) were enrolled from the Changfeng Study. A standard interview, anthropometric measurements and laboratory analyses were performed for each participant. Bilateral CIMT (carotid intima–media thickness) were measured using ultrasonography, and the presence of carotid plaques was assessed. Serum ferritin was measured using electrochemiluminescence immunoassay. The results showed that serum ferritin was 181·9 (sd 65·8) ng/ml in the postmenopausal women. Multivariate, linear, stepwise regression analysis demonstrated that age (standardised β = 0·233, P< 0·001), alanine transaminase (standardised β = 0·194, P< 0·001), log homeostasis model assessment index for insulin resistance (standardised β = 0·181, P< 0·001), TAG (standardised β = 0·083, P= 0·003), Hb (standardised β = 0·080, P= 0·004) and PPG (2-h glucose levels following a 75-g oral glucose challenge) (standardised β = 0·079, P= 0·004) were independently associated with serum ferritin. Compared with the ferritin level of subjects in the first quartile, that in the fourth quartile had greater CIMT, and higher prevalence of carotid plaque. After adjusting for conventional CVD risk factors, Hb, leucocytes, log urine albumin:creatinine ratio and liver function, the ferritin level of postmenopausal women in the fourth quartile had a 1·587-fold increased risk of carotid plaques relative to those in the lowest quartile. In conclusion, these results suggest that serum ferritin is independently and positively associated with carotid atherosclerosis in postmenopausal women and that ferritin may be implicated in atherosclerosis.

scholarly journals Circulating Irisin in Relation to Insulin Resistance and the Metabolic Syndrome

2013 ◽  
Vol 98 (12) ◽  
pp. 4899-4907 ◽  
Author(s):  
Kyung Hee Park ◽  
Lesya Zaichenko ◽  
Mary Brinkoetter ◽  
Bindiya Thakkar ◽  
Ayse Sahin-Efe ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Body Mass Index ◽  
Body Mass ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Cvd Risk ◽  
Baseline Serum ◽  
The Metabolic Syndrome ◽  
Increased Risk

Context: Irisin, a recently identified hormone, has been proposed to regulate energy homeostasis and obesity in mice. Whether irisin levels are associated with risk of the metabolic syndrome (MetS), cardiometabolic variables, and cardiovascular disease (CVD) risk in humans remains unknown. Objective: Our objective was to assess the associations between baseline serum irisin levels and MetS, cardiometabolic variables, and CVD risk. Design, Setting, and Subjects: We conducted a comparative cross-sectional evaluation of baseline circulating levels of the novel hormone irisin and the established adipokine adiponectin with MetS, cardiometabolic variables, and CVD risk in a sample of 151 subjects. Results: Baseline irisin levels were significantly higher in subjects with MetS than in subjects without MetS. Irisin was associated negatively with adiponectin (r = −0.4, P &lt; .001) and positively with body mass index (r = 0.22, P = .008), systolic (r = 0.17, P = .04) and diastolic (r = 0.27, P = .001) blood pressure, fasting glucose (r = 0.25, P = .002), triglycerides (r = 0.25, P = .003), and homeostasis model assessment for insulin resistance (r = 0.33, P &lt; .001). After adjustment for potential confounders, including body mass index, subjects in the highest tertile of irisin levels were more likely to have MetS (odds ratio [OR] = 9.44, 95% confidence interval [CI] = 2.66–33.44), elevated fasting blood glucose (OR = 5.80, 95% CI = 1.72–19.60), high triglycerides (OR = 3.89, 95% CI = 1.16–13.03), and low high-density lipoprotein cholesterol (OR = 3.30, 95% CI = 1.18–9.20). Irisin was independently associated with homeostasis model assessment for insulin resistance and general Framingham risk profile in multiple linear regression analyses after adjustment for confounders. Adiponectin demonstrated the expected associations with outcomes. Conclusions: Irisin is associated with increased risk of MetS, cardiometabolic variables, and CVD in humans, indicating either increased secretion by adipose/muscle tissue and/or a compensatory increase of irisin to overcome an underlying irisin resistance in these subjects.

scholarly journals Serum ferritin levels are associated with insulin resistance in Chinese men and post-menopausal women: the Shanghai Changfeng study

2018 ◽  
Vol 120 (8) ◽  
pp. 863-871 ◽  
Author(s):  
Hui Ma ◽  
Huandong Lin ◽  
Yu Hu ◽  
Xiaoming Li ◽  
Wanyuan He ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Serum Ferritin ◽  
Cell Function ◽  
Ferritin Level ◽  
Menopausal Status ◽  
Elevated Serum ◽  
Model Assessment ◽  
Menopausal Women ◽  
Post Menopausal

AbstractAssociations between ferritin and insulin sensitivity have been described in recent studies. The possible association showed conflicting results by sex and menopausal status. We aimed to investigate the cross-sectional association of ferritin levels with insulin resistance and β-cell function. A total of 2518 participants (1033 men, 235 pre-menopausal women and 1250 post-menopausal women) were enrolled from the Changfeng Study. A standard interview was conducted, as well as anthropometric measurements and laboratory analyses, for each participant. The serum ferritin level was measured using electrochemiluminescence immunoassay. Insulin resistance and β-cell function indices were derived from a homeostasis model assessment. The results showed that the serum ferritin levels were 250·4 (sd 165·2), 94·6 (sd 82·0) and 179·8 (sd 126·6) ng/ml in the men, pre-menopausal and post-menopausal women, respectively. In fully adjusted models (adjusting for age, current smoking, BMI, waist:hip ratio, systolic blood pressure, diastolic blood pressure, TAG, HDL-cholesterol, LDL-cholesterol, log urine albumin:creatinine ratio, leucocytes, alanine aminotransferase, aspartate aminotransferase and γ-glutamyl transpeptidase), serum ferritin concentrations are significantly associated with insulin resistance in men and post-menopausal females, and the null association was observed in pre-menopausal females. Interestingly, an increased β-cell function associated with higher ferritin was observed in post-menopausal participants, but not in male participants. In conclusion, these results suggested that elevated serum ferritin levels were associated with surrogate measures of insulin resistance among the middle-aged and elderly male and post-menopausal women, but not in pre-menopausal women.

scholarly journals Studies of insulin resistance in patients with clinical and subclinical hypothyroidism

2009 ◽  
Vol 160 (5) ◽  
pp. 785-790 ◽  
Author(s):  
Eirini Maratou ◽  
Dimitrios J Hadjidakis ◽  
Anastasios Kollias ◽  
Katerina Tsegka ◽  
Melpomeni Peppa ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Plasma Membrane ◽  
Glucose Transport ◽  
Subclinical Hypothyroidism ◽  
Tolerance Test ◽  
Oral Glucose ◽  
Model Assessment ◽  
Increased Risk

ObjectiveAlthough clinical hypothyroidism (HO) is associated with insulin resistance, there is no information on insulin action in subclinical hypothyroidism (SHO).Design and methodsTo investigate this, we assessed the sensitivity of glucose metabolism to insulin both in vivo (by an oral glucose tolerance test) and in vitro (by measuring insulin-stimulated rates of glucose transport in isolated monocytes with flow cytometry) in 21 euthyroid subjects (EU), 12 patients with HO, and 13 patients with SHO.ResultsAll three groups had comparable plasma glucose levels, with the HO and SHO having higher plasma insulin than the EU (P<0.05). Homeostasis model assessment index was increased in HO (1.97±0.22) and SHO (1.99±0.13) versus EU (1.27±0.16, P<0.05), while Matsuda index was decreased in HO (3.89±0.36) and SHO (4.26±0.48) versus EU (7.76±0.87, P<0.001), suggesting insulin resistance in both fasting and post-glucose state. At 100 μU/ml insulin: i) GLUT4 levels on the monocyte plasma membrane were decreased in both HO (215±19 mean fluorescence intensity, MFI) and SHO (218±24 MFI) versus EU (270±25 MFI, P=0.03 and 0.04 respectively), and ii) glucose transport rates in monocytes from HO (481±30 MFI) and SHO (462±19 MFI) were decreased versus EU (571±15 MFI, P=0.04 and 0.004 respectively).ConclusionsIn patients with HO and SHO: i) insulin resistance was comparable; ii) insulin-stimulated rates of glucose transport in isolated monocytes were decreased due to impaired translocation of GLUT4 glucose transporters on the plasma membrane; iii) these findings could justify the increased risk for insulin resistance-associated disorders, such as cardiovascular disease, observed in patients with HO or SHO.

scholarly journals Depression and cardiovascular risk—association among Beck Depression Inventory, PCSK9 levels and insulin resistance

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
C. Macchi ◽  
C. Favero ◽  
A. Ceresa ◽  
L. Vigna ◽  
D. M. Conti ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Risk Factor ◽  
Beck Depression Inventory ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Model Assessment ◽  
Cvd Risk ◽  
Assessment Index ◽  
Increased Risk ◽  
Homeostatic Model Assessment

Abstract Background Depression and cardiovascular disease (CVD) are among the most common causes of disability in high-income countries, depression being associated with a 30% increased risk of future CV events. Depression is twice as common in people with diabetes and is associated with a 60% rise in the incidence of type 2 diabetes, an independent CVD risk factor. Proprotein convertase subtilisin/kexin type 9 (PCSK9), a key regulator of low-density lipoprotein cholesterol, has been related to a large number of CV risk factors, including insulin resistance. Aim of this study was to investigate whether the presence of depression could affect PCSK9 levels in a population of obese subjects susceptible to depressive symptoms and how these changes may mediate a pre-diabetic risk. Results In 389 obese individuals, the Beck Depression Inventory (BDI-II) was significantly associated with PCSK9 levels. For every one-unit increment in BDI-II score, PCSK9 rose by 1.85 ng/mL. Depression was associated also with the HOMA-IR (homeostatic model assessment index of insulin resistance), 11% of this effect operating indirectly via PCSK9. Conclusions This study indicates a possible mechanism linking depression and insulin resistance, a well-known CV risk factor, providing evidence for a significant role of PCSK9.

scholarly journals Association between Serum Mg2+ Concentrations and Cardiovascular Organ Damage in a Cohort of Adult Subjects

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1264 ◽  
Author(s):  
Elettra Mancuso ◽  
Maria Perticone ◽  
Rosangela Spiga ◽  
Carolina Averta ◽  
Mariangela Rubino ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Intima Media Thickness ◽  
Multivariate Regression Analysis ◽  
Organ Damage ◽  
Tolerance Test ◽  
Cardiovascular Complications ◽  
Left Ventricular ◽  
Oral Glucose ◽  
Model Assessment ◽  
Increased Risk

Magnesium (Mg2+) levels are associated with insulin resistance, hypertension, atherosclerosis, and type 2 diabetes (T2DM). We evaluated the clinical utility of physiological Mg2+ in assessing subclinical cardiovascular organ damage including increased carotid artery intima- media thickness (c-IMT) and left ventricular mass index (LVMI) in a cohort of well-characterized adult non-diabetic individuals. Age- and gender-adjusted correlations between Mg2+ and metabolic parameters showed that Mg2+ circulating levels were correlated negatively with body mass index (BMI), fasting glucose, and 2h-oral glucose tolerance test (OGTT) glucose. Similarly, Mg2+ levels were significantly and negatively related to c-IMT and LVMI. A multivariate regression analysis revealed that age (β = 0.440; p < 0.0001), BMI (β = 0.225; p < 0.0001), and Mg2+ concentration (β = −0.122; p < 0.01) were independently associated with c-IMT. Age (β = 0.244; p = 0.012), Mg2+ (β = −0.177; p = 0.019), and diastolic blood pressure (β = 0.184; p = 0.038) were significantly associated with LVMI in women, while age (β = 0.211; p = 0.019), Mg2+ (β = −0.171; p = 0.038) and the homeostasis model assessment index of insulin resistance (HOMA-IR) (β = −0.211; p = 0.041) were the sole variables associated with LVMI in men. In conclusion, our data support the hypothesis that the assessment of Mg2+ as part of the initial work-up might help unravel the presence of subclinical organ damage in subjects at increased risk of cardiovascular complications.

Prognostic Impact of Elevated Serum Ferritin at Diagnosis of Diffuse Large B-Cell Lymphoma Treated In the Rituximab Era

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 5080-5080
Author(s):  
Herve Ghesquieres ◽  
Ferlay Céline ◽  
Lachenal Florence ◽  
Nicolas-Virlizier Emmanuelle ◽  
Domnisoru Izabella-Irina ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Initial Treatment ◽  
Iron Homeostasis ◽  
Cell Lymphoma ◽  
Ferritin Level ◽  
B Cell Lymphoma ◽  
Prognostic Impact ◽  
Large B Cell Lymphoma ◽  
Fourth Quartile

Abstract Abstract 5080 Background: Combination of rituximab (R) and anthracyclin-based chemotherapy (CT) regimens had greatly improved the overall survival (OS) of Diffuse Large B-Cell Lymphoma (DLBCL). It is challenging to identify more accurately patients who will progress during therapy or relapse after initial treatment. Currently, International Prognostic Index (IPI) is the better tool in daily practice to define at diagnosis the prognostic of DLBCL patients. New biological parameters in relation with the pathogenesis of DLBCL were developed but were not routinely used. In this context, iron homeostasis was not well explored in the pathogenesis of DLBCL and the markers of iron metabolism had not been analysed as prognostic markers for DLBCL patients treated with R-CT. Patients and Methods: In this study, we assessed the prognostic role of serum ferritin on complete response (CR) after initial treatment, OS and Progression Free Survival (PFS) in a cohort of DLBCL patients treated by R-CT in first line therapy. Between March 2005 and December 2008, 87 DLBCL patients could have at diagnosis a serum ferritin dosage. Outcomes were estimated using the Kaplan-Meier method and compared between patients with or without elevated ferritin and in each quartile of ferritin dosage using the log-rank test. Results: The median age of patients was 67 years old (range, 23 – 96). Initial characteristics of whole series were as follow: male gender, 41%, stage III-IV 69%, elevated LDH 84%, number of extra-nodal sites >1 24%, Performance Status (PS) >1 22% and 69% of patients had an age-adjusted IPI (aaIPI) 2–3. Median ferritin was 268μ g/l (range, 27 – 3343), 45 patients (52%) had an elevated ferritin level. Ferritin level had no prognostic impact on CR at the end of initial treatment whether patients were compared with or without elevated ferritin or by quartile groups. The 2-year OS was 69% (95% confidence interval (CI) 53–81) for patients with elevated ferritin and 88% (CI 74 – 95) for patients with normal ferritin (p=0.04). The 2-year PFS was 58% (CI 43–73) for patients with elevated ferritin and 75% (CI 59 – 86) for patients with normal ferritin (p=0.09). The 2-year OS for patients in the first quartile (27-115 μ g/l) was 86% (CI 67–95); in the second quartile (116-267 μ g/l) 94% (CI 74–99), in the third quartile (268-465 μ g/l) 74% (CI 51–89) and in the fourth quartile (≥ 466 μ g/l) 58% (CI 38–76) (p=0.02). The 2-year PFS for patients in the first quartile was 72% (CI 51–87); in the second quartile 82% (CI 56–94), in the third quartile 58% (CI 36–77) and in the fourth quartile 54% (CI 34–73) (p=0.14). Patients could be classified using the fourth quartile (≥ 466 μ g/l) versus the lower 3 quartiles. The 2-year OS was 85% (CI 74–92) for patients with low ferritin (<466 μ g/l) and 58% (CI 38–76) for patients with elevated ferritin (≥ 466 μ g/l) (p=0.01). The 2-year PFS was 71% (CI 58–81) for patients with low ferritin (<466 μ g/l) and 54% (CI 34–73) for patients with elevated ferritin (≥ 466 μ g/l) (p=0.09). Interestingly, median age, sex, Ann Arbor stage, LDH level, PS, aaIPI, number of extra-nodal sites >1, CRP level (normal vs. abnormal) distribution were not statistically different between patients with low and elevated ferritin. Three prognostic classes integrated the aaIPI could be proposed: Low ferritin (<466 μ g/l) and aaIPI 0–1 (Group 1, 20 patients), Low ferritin and aaIPI 2–3 or high ferritin (≥ 466 μ g/l) and aaIPI 0–1 (Group 2, 52 patients), high ferritin and aaIPI 2–3 (Group 3, 15 patients) with respectively a 2-year OS of 100%, 77% (CI 63–87) and 53% (CI 30–75) (p=0.003) and a 2-year PFS of 90% (CI 70–97), 63% (CI 48–76), 47% (25-70) (p=0.03). Conclusion: This exploratory study identifies a subgroup of patients with high aaIPI 2–3 and a high ferritin (≥ 466 μ g/l) who presented an immediate poor outcome. These results need to be confirmed in a large prospective series of DLBCL to know if serum ferritin could add prognostic information to IPI. These results also incline to decipher the role of iron homeostasis in the pathogenesis of DLBCL. Disclosures: No relevant conflicts of interest to declare.

Association Between Serum Ferritin Levels and Low Bone Mineral Density in Postmenopausal Osteoporosis Women

2020 ◽  
Author(s):  
Lama ALjeshi ◽  
Shaden Haddad
Keyword(s):  
Bone Mineral Density ◽  
Postmenopausal Women ◽  
Postmenopausal Osteoporosis ◽  
Bone Mineral ◽  
Serum Ferritin ◽  
Serum Ferritin Level ◽  
Ferritin Level ◽  
Mineral Density ◽  
Low Bone Mineral Density ◽  
Femur Neck

As women go through menopause, serum estrogen decreases, and ferritin increases. Ferritin is an essential component of the body, but many studies have stated that ferritin, which exceeds the normal physiological range, may potentially cause health problems in women. The aim of this study is to investigate the relationship between bone mineral density and serum ferritin levels in post-menopausal women and to evaluate serum ferritin levels as a potential biomarker for postmenopausal osteoporosis. Serum ferritin levels were measured in 62 postmenopausal women with low bone mineral density, and in 18 postmenopausal healthy control women using a standardized Enzyme-Linked Immune Sorbent Assay (ELISA) kit. Bone mineral density BMD was assessed at the lumbar spine and femoral neck. The mean serum ferritin level was significantly higher in the postmenopausal women with low BMD group (group 1) than in the normal control group (group 2), respectively (mean=262.69 vs. 181.44 ng/ml, (P<0.05), and serum ferritin level was negatively correlated with BMD among low BMD postmenopausal women's group (R= -0.628, P=0.0001), and in the healthy postmenopausal group (R= -0.052, P=0.838). A comparison of the BMD between spine and femur neck sites shows that the frequency of low BMD in the spine site is higher than the femur neck site. Our findings show that increased serum ferritin levels were associated with low bone mineral density in postmenopausal osteoporosis.

scholarly journals Reduced atherogenic indices in prepubertal girls with precocious adrenarche born appropriate for gestational age in relation to the conundrum of DHEAS

2013 ◽  
Vol 2 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Ahmet Uçar ◽  
Nurçin Saka ◽  
Firdevs Baş ◽  
Nihal Hatipoğlu ◽  
Rüveyde Bundak ◽  
...  
Keyword(s):  
Gestational Age ◽  
Plasma Lipids ◽  
University Hospital ◽  
Atherogenic Index ◽  
Oral Glucose ◽  
Model Assessment ◽  
Metabolic Complications ◽  
Increased Risk ◽  
Precocious Adrenarche ◽  
Appropriate For Gestational Age

Context An association between low birth weight, insulin resistance (IR), dyslipidemia, and atherogenesis has been shown in girls with precocious adrenarche (PA). Objective To evaluate whether girls with PA born appropriate for gestational age (AGA) have increased risk for metabolic complications at initial evaluation. Design/methods We conducted a cross-sectional study on 69 AGA born girls with PA (mean (±s.d.) age 7.1±1 years) and 45 body mass index (BMI)- and waist circumference (WC)-matched prepubertal peers born AGA (mean (±s.d.) 7.5±1.9 years). A standard 2-h oral glucose tolerance test with insulin sampling was performed. Fasting plasma lipids and high-sensitivity C-reactive protein were analyzed, and blood pressure was recorded. Insulin sensitivity (IS) index (ISIcomp), homeostasis model assessment of IR, and atherogenic index (AI) (triglycerides/high-density lipoprotein cholesterol) were calculated. Setting The study was performed at University Hospital. Results AI was significantly lower in girls with PA than in controls (P<0.001), and it was correlated with BMI SDS (r=0.44, P=0.001) and WC (r=0.39, P=0.001). The significant correlation of AI with ISIcomp (r=−0.38, P=0.001) disappeared after correcting for BMI (r=−0.185, P=0.16). Multivariate regression analysis revealed that DHEAS was the only significant parameter influencing AI in girls with born AGA (R 2=0.475 β=−0.018, P=0.0001). Conclusions Metabolic screening in prepubertal AGA born girls with PA may yield favorable lipid profiles. AI in girls with PA is increased in relation to decreasing IS and increasing BMI and WC. DHEAS seems to have the most significant effect on AI.

High Ferritin Level and Malnutrition Predict High Risk of Infection-Related Hospitalization in Incident Dialysis Patients: A Japanese Prospective Cohort Study

2016 ◽  
Vol 42 (1) ◽  
pp. 56-63 ◽  
Author(s):  
Sawako Kato ◽  
Bengt Lindholm ◽  
Yukio Yuzawa ◽  
Yoshinari Tsuruta ◽  
Kana Nakauchi ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Hospital Admissions ◽  
Ferritin Level ◽  
Nutrition Status ◽  
Rank Test ◽  
Risk Of Infection ◽  
Dialysis Patients ◽  
Clinical Biomarkers ◽  
Kaplan Meier ◽  
Increased Risk

Aims: The aim of the study was to clarify the relationship between serum ferritin and infectious risks. Methods: We evaluated all hospital admissions due to infections, clinical biomarkers and nutrition status in 129 incident Japanese dialysis patients during a median follow-up of 38 months. Results: Kaplan-Meier analysis revealed that the period without infections requiring hospitalization was significantly shorter in ferritin > median (82.0 ng/ml) group than in the ferritin < median group (log-rank test 4.44, p = 0.035). High ferritin was associated with significantly increased relative risk of hospitalization for infection (Cox hazard model 1.52, 95% CI 1.06-2.17). The number of hospitalization days was gradually longer in patients with high ferritin levels and malnutrition. Conclusion: Although serum ferritin levels were low, and doses of iron administered to dialysis patients in Japan are generally lower than in Western countries, an elevated ferritin level was associated with increased risk of infection, particularly in patients with poor nutritional status.

scholarly journals Systemic inflammation modulates the ability of serum ferritin to predict all-cause and cardiovascular mortality in peritoneal dialysis patients

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Sha Fu ◽  
Junzhe Chen ◽  
Bo Liu ◽  
Peifen Liang ◽  
Yuchun Zeng ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Serum Ferritin ◽  
Systemic Inflammation ◽  
Cardiovascular Mortality ◽  
Serum Ferritin Level ◽  
Cox Regression ◽  
Ferritin Level ◽  
Ferritin Concentration ◽  
Cox Regression Analysis ◽  
Increased Risk

Abstract Background This study aimed to ascertain whether the correlation of high serum ferritin with mortality is affected by systemic inflammation and to investigate the optimal serum ferritin level for predicting death when inflammation is considered in peritoneal dialysis (PD) patients. Methods We classified 221 patients into four groups according to serum ferritin concentration (100 μg/L) and high-sensitivity CRP (hs-CRP) level (3 mg/L), and followed them regularly from the date of catheterization to Dec 31, 2016, at Sun Yat-Sen Memorial Hospital, China. Clinical and biochemical data were collected at baseline, and clinical outcomes such as all-cause and cardiovascular mortality were assessed. Results During a median follow-up of 35 months (3 ~ 109 months), 50 (22.6%) deaths occurred. Cardiovascular disease (46.0%) was the most common cause of death, followed by infection (10.0%). The Kaplan–Meier survival analysis and log-rank test revealed significantly worse survival accumulation among PD patients with higher serum ferritin (≥100 μg/L) under elevated hsCRP levels (> 3 mg/L) (P = 0.022). A multivariate Cox regression analysis revealed that an increased serum ferritin level was independently associated with a higher risk of all-cause and cardiovascular mortality in PD patients (HR = 3.114, P = 0.021; and HR = 9.382, P = 0.032) with hsCRP above 3 mg/L after adjusting for relevant confounding factors. Conclusion Higher serum ferritin levels were associated with an increased risk of all-cause and cardiovascular mortality in patients undergoing PD only in the presence of elevated hsCRP levels. The correlation of serum ferritin with poor outcome should take into consideration systemic inflammation.

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