A study of association of serum ferritin as a prognostic marker in acute cerebrovascular accident

Cerebrovascular disease (CVD) is the third leading cause of death in developed countries and is now emerging as the commonest preventable life-threatening neurological problem worldwide. It makes an important contribution to morbidity and mortality in developed as well as developing countries. The prognosis of acute stroke is determined by a series of factors some of which may be used in the early stages of stroke to predict prognosis and mortality. However, the role of inflammatory markers in predicting functional outcome in stroke remains controversial, Iron and ferritin are known to have an important role in stroke as well as in other disorders. Serum ferritin which is considered as an acute phase reactant has also been used for assessing the severity and prognosis of stroke. Therefore, testing of serum ferritin is useful in identifying high risk patients.1: To study the effect of level of serum ferritin with early neurological deterioration and the outcome in patients of acute stroke. 2: Association of serum ferritin in ischemic and haemorrhagic stroke.50 patients with acute stroke were selected based on inclusion and exclusion criteria. Appropriate questionnaire was used to collect the data of patients. Diagnosis of stroke was confirmed by CT or MRI scan of brain and examination was done by Canadian stroke scale at the time of admission. About 5ml of venous blood Sample from cubital vein was collected for measuring serum ferritin levels, it was performed within 48hrs of onset of symptoms by using CLIA method. Neurological assessment was repeated on the day of discharge to assess the clinical improvement and prognosis of the stroke patients.Totally 50 patients of acute stroke were included in our study, majority of the patients are males 35 (70%), and females are 15(30%). Approximately 36% were in the age group of 51-60 years. In this study ischemic stroke was seen in 45 (90%) of the patients and 5 (10%) had hemorrhagic stroke. The serum ferritin levels are normal in 41(82%) and high in 9(18%) of the patients. Canadian stroke scale interpretation on the day of discharge showed 20% of the patient are deteriorated, 66% are in the same status and 14% of the patients are improved clinically. The patients with haemorrhagic stroke had high serum ferritin level 60.0% and ischemic stroke are 13.3%. Those patients with high serum ferritin levels had higher deterioration in Canadian stroke scale (p<0.001). The mean serum ferritin levels are higher in deteriorated patients 199.29% when compared to other status group in Canadian stroke scale.High levels of serum ferritin correlates well with early neurological deterioration of stroke patients. Based on this study finding, that high serum ferritin level within 48 hours after the onset of symptoms of stroke helps to predict the early prognosis. Therefore, testing of serum ferritin is useful in identifying high risk patients.

Association of Body mass index and serum ferritin level in pediatrics with Beta-thalassemia major disease

Background: Beta-thalassemia major is a type of inherited blood disease that results in variable outcomes such as severe anemia due to haemoglobin chains. Recurrent and lifelong blood transfusions as a treatment in beta-thalassemia major disease lead to iron deposition in various organs and cause the failure of multiple organs. Failure of affected organs leads to Body mass index (BMI) abnormality. This study aimed to evaluate the association between BMI and serum ferritin level as a marker for iron overload. Materials and Methods: A cross-sectional study designed and conducted with total number of 740 paediatrics, with mean age about 14.2±8.7 years old and with beta-thalassemia major requiring recurrent blood transfusion. Patient information, including demographics, serum ferritin level and percentage of BMI, was recorded and analysed by SPSS 25.0 and the statistical significant level, considered as 0.05. Results: A total number of 740 paediatrics with beta-thalassemia major disease (mean age about 14.2±8.7 years) were included to study to examine the association between serum ferritin level and their BMI. The total mean serum level of ferritin calculated about 3326 ± 3859 Nanogram/mililitter (ng/ml). Totally, 447 (60.4%) case of them had BMI percentile less than 5%, 274 (37.02%), 16 (2.16%) and 3 (0.4%) had BMI percentile 5%-85%, 85%-95% and more than 95%. There was no relation between gender and serum ferritin levels. The relationship between age and BMI has been positive (P=0.002). Finally, it resulted that there was a negative relationship between the BMI percentile and mean serum ferritin levels in paediatrics with beta-thalassemia major (P=0.031). Conclusion: Frequent Blood transfusion is associated with elevated serum ferritin level in paediatrics with beta-thalassemia major disease and experiencing lower percentiles of BMI in these patients.

Increased Serum Ferritin Levels in Type 2 Diabetes Mellitus Patients: A Hospital Based Cross-Sectional Study

INTRODUCTION: Type 2 diabetes mellitus is a metabolic disorder of multiple etiology characterized by chronic hyperglycemia with a derangement in carbohydrate, fat and protein metabolism resulting from defects in insulin secretion and action. Ferritin is a ubiquitous intracellular protein complex that reflects the iron stores of the body. Studies have shown that the increased body iron stores are associated with the development of glucose intolerance often leading to metabolic syndrome and type 2 diabetes (T2DM). The objective of the study was to find out association of serum ferritin level with T2DM and assess the correlation between serum ferritin and HbA1c. MATERIAL AND METHODS: A hospital based comparative cross-sectional study was conducted in 43 diabetic patients and 42 age and sex matched healthy controls. Fasting blood glucose (FBG), postprandial blood glucose (PBG), Glycated hemoglobin (HbA1c) and serum ferritin were estimated in cobas c311 autoanalyser using standard protocol. RESULTS: Mean age of healthy control and T2DM were found 54.83 ± 6.48 and 55.95±10.92 years respectively. Mean FBG (mg/dL) (170.41 ± 71.7 v/s 98.38 ± 9.7), PBG (mg/dL) (266.16 ± 110.09 v/s 123.20 ± 17.0), HbA1c (%) (8.17 ± 1.83 v/s 4.9 ± 0.29 and median ferritin (μg/L) 207.90 (138, 306.0) v/s 127.95 (85.75, 210.25) were significantly higher in T2DM compared to the healthy controls. Spearman’s correlation depicted that ferritin level was positively correlated with HbA1c level but the correlation was statistically insignificant. CONCLUSION: Serum ferritin level was found significantly higher in T2DM compared to healthy age and sex matched controls in our study.

Setting for “Normal” Serum Ferritin Levels in Patients with Transfusion-Dependent Thalassemia: Our Current Strategy

This cross-sectional study aimed to establish the association between serum ferritin levels and organ iron overload (IO) and overall morbidity in transfusion-dependent thalassemia (TDT) patients. One hundred and three TDT patients (40.03 ± 9.15 years; 57.3% females) with serum ferritin < 2500 ng/mL were included. IO was assessed by T2* magnetic resonance imaging. Three groups were identified based on mean serum ferritin levels: <500 ng/mL (group 0; N = 32), 500–1000 ng/mL (group 1; N = 43), and 1000–2500 ng/mL (group 2; N = 28). All demographic and biochemical parameters were comparable among the three groups, with the exception of the triglycerides being significantly lower in group 0 than in group 2. No difference was found in the frequency of hepatic, endocrine, and cardiac complications. Hepatic IO was significantly less frequent in group 0 versus both groups 1 and 2. No patient with a serum ferritin level < 500 ng/mL had significant myocardial IO and alterations in the main hematological parameters. No difference in the distribution of the different chelation regimens was found. Serum ferritin < 500 ng/mL appears to be achievable and safe for several TDT patients. This target is associated with the absence of significant cardiac iron and significantly lower hepatic IO and triglycerides that are well-demonstrated markers for cardiac and liver complications.

Androgenic Alopecia and its Correlation with Serum Ferritin Level

Background: Serum ferritin is a good indicator of quantifying the risk of hair loss among women. Iron lead to low serum ferritin level; therefore, a low serum ferritin level can precisely point toward iron deficiency. Objectives: To determine the mean serum ferritin levels in female patients with androgenetic alopecia. Study Design: Descriptive cross-sectional study Place and Duration of Study: Department of Dermatology, Fauji Foundation Hospital, Rawalpindi from 2nd October 2018 to 1st April 2019. Methodology: One hundred female patients with androgenic alopecia of all ages after puberty were included. Patients with scarring and other non-scarring alopecia, who had taken iron, vitamin B12, folic acid or multivitamin supplements, anticoagulants, anti-thyroid drugs, antimitotic drugs and oral contraceptives were excluded. After aseptic measures,5 ml of venous blood was drawn, into sterile and disposable plastic syringes. Serum ferritin was measured by enzyme immunoassay (EIA) test, based on sandwich ELISA. Results: Mean age was 33.94±6.29 years and 65 (65.0%) of patients ranged from 36 to 50 years. Average duration of disease was 6.25±2.43 months. Mean weight was 58.77±9.17 kg. Mean serum ferritin levels in female patients with androgenetic alopecia was 33.10±42.99ng/ml. Conclusion: Serum ferritin levels in female patients with androgenetic alopecia are low. Keywords: Androgenic alopecia, Serum ferritin levels

Relationship of Menstrual Patterns with Serum Ferritin Levels in Brides-to-Be in Padang City

Background: Among the causes of high Maternal Mortality Rate (MMR) in Indonesia is anemia. Iron deficiency anemia, the most common type of anemia, frequently occurs in women of childbearing age because they experience menstruation each month. To diagnose iron deficiency, serum ferritin level could be used as one of the indicators. This study aims to know whether there is an association between menstruation patterns and serum ferritin level in brides-to-be in Padang. Method: This study was conducted using an analytic observational method with a cross-sectional design. A Total of seventy samples of brides-to-be aged 20-30 years were gathered using a consecutive sampling technique. This study was conducted from November 2019 until April 2020. Data on menstruation patterns were collected through a questionnaire. Data of serum ferritin levels were acquired from venous blood sampling and measurement of serum ferritin levels with The Electro Chemiluminescence Immuno Assay (ECLIA) method. Bivariate analysis of this study used Independent T-test. Results: This study showed sixty-eight point six percent of respondents were experiencing abnormal menstruation patterns while the mean of serum ferritin levels was normal (sixty-two point zero seven ± thirty-nine point forty-five ng/ml). The Independent T-test showed p-value = 0,921. Conclusion: There was no significant association between menstruation pattern and serum ferritin level in brides-to-be in Padang. Keywords: iron deficiency anemia, women of childbearing age, menstruation patterns, serum ferritin levels.

Serum ferritin level of transfusion dependent thalassaemia patients- A Single Centre Study

The aim of the study was to determine serum ferritin level in transfusion dependent thalassaemia patients. A total of 64 transfusion dependent thalassaemia (TDT) patients was included in this cross sectional study from April, 2018 to September, 2019 according to selection criteria. Body iron load was estimated by serum ferritin level. The study sample consisted of 43 male and 21 female TDT patients, with a mean age of 25.5 years. Most of the patients (43.8%) patients had serum ferritin level in between 1000-2500 ng/ml. 12 patients (18.7%) had serum ferritin level >5000 ng/ml and 3 patients (4.7%) had serum ferritin in between 2501-5000 ng/ml. The mean serum ferritin was found 2462.6 ± 2792.7ng/ml with range from 207.0 -11891.2ng/m.

Cardiac Dysfunction and Serum Ferritin Level as Early Prognostic Markers in Children with Sepsis: A Cross-Sectional Study

Background: Sepsis still causes morbidity and mortality in children admitted to the pediatric intensive care unit (PICU). Sepsis induces myocardial dysfunction and causes a reversible decline in ejection fraction (EF) of ventricles. Many biomarkers have been described for diagnosing sepsis, including serum ferritin and C-reactive protein (CRP). Objectives: This study was conducted to assess the relationship of cardiac dysfunction evaluated using echocardiogram, ferritin, and CRP with negative outcomes of sepsis in the PICU. Methods: A cross-sectional study was conducted on 80 patients aged between one month and six years who fulfilled the following criteria: (1) confirmed diagnosis of sepsis according to the American College of Critical Care Medicine; (2) receiving ventilation for 48 h and/or vasoactive medicines. The CRP and ferritin levels were recorded on the first day (D1) and third day (D3) of hospitalization in the PICU. Participants underwent an echocardiography study to investigate the ejection fraction on D1 and D3. All outcomes were evaluated. Results: Our results showed a highly statistically significant difference between D1 and D3 in ejection fraction (P = 0.001). The serum ferritin level and CRP enhanced significantly from D1 to D3 (P < 0.001). Low left ventricular ejection fraction, and high serum ferritin were associated with unfavorable outcomes (P values < 0.001 and 0.021, respectively), but there was no significant difference in the outcomes regarding CRP. Conclusions: Cardiac dysfunction and high serum ferritin were associated with unfavorable outcomes in children with sepsis admitted to the PICU.

A COMPARATIVE STUDY OF THE ASSOCIATION OF SERUM FERRITIN LEVEL WITH GESTATIONAL DIABETES MELLITUS IN THE DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY AT SMS MEDICAL COLLEGE & ATTACHED GROUP OF HOSPITALS, JAIPUR

Background: The present study aimed to study the association of Serum Ferritin level with gestational diabetes mellitus Methods: All Pregnant Females in Gestational age of 16 to 32 weeks presenting to the Ante natal clinic of Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur. Based on Oral Glucose tolerance test, study participants were divided into two groups, Pregnant female with Gestational Diabetes (GDM group) and Pregnant female without Gestational Diabetes (Controls) Results: Mean ferritin level was significantly higher in GDM group (33.51 ng/ml)) as compared to control group (24.97 ng/ml). This difference in mean ferritin level among the two groups was found to be statistically significant (p<0.001). This indicates that higher ferritin level is significantly associated with risk of GDM. Conclusion: Serum ferritin in this study had a significant correlation with development of GDM. High ferritin range was found in females with GDM. Routine use of monitoring of serum ferritin levels, during the antenatal visit in the mid trimester should be carried out, for early prediction of developing GDM. Keywords: GDM, Serum ferrtin, Metabolic conditions.