Factors That Affect Serum Levels of Ferritin in Australian Adults and Implications for Follow-up (original) (raw)
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Serum Ferritin and Cardiovascular Disease: A 17-Year Follow-up Study in Busselton, Western Australia
American Journal of Epidemiology, 2003
The association between serum ferritin level and coronary heart disease (CHD) and stroke events was evaluated in a long-term Western Australia prospective study in 1981-1998. The cohort consisted of the 1,612 men and women aged 40-89 years who participated in the 1981 Busselton Health Survey and who were free of cardiovascular disease at that time. Serum ferritin levels were obtained from serum samples stored frozen since 1981. The outcomes of interest were time to first CHD event (hospital admission or death) and time to first stroke event. Case-cohort sampling was used to reduce costs and preserve serum but still allow efficient analysis. Ferritin assays were performed for 217 CHD cases, 118 stroke cases, and a random sample of 450 of the total cohort. Proportional hazards regression models were used to obtain age-adjusted and multivariate-adjusted hazard ratios for ferritin level in relation to CHD and stroke. The hazard ratio for the highest tertile group compared with the lowest group was 0.96 (95% confidence interval: 0.60, 1.53) for CHD and 1.43 (95% confidence interval: 0.78, 2.64) for stroke. Little or no evidence was found that ferritin level was a risk factor for cardiovascular disease.
BMC Nephrology, 2023
Background Ferritin levels are used to make decisions on therapy of iron deficiency in patients with chronic kidney disease (CKD). Hyperferritinaemia, common among patients with CKD from the Northern Territory (NT) of Australia, makes use of ferritin levels as per clinical guidelines challenging. No gold standard assay exists for measuring ferritin levels. Significant variability between results from different assays creates challenges for clinical decision-making regarding iron therapy. In the NT, different laboratories use different methods. In 2018, Territory Pathology changed the assay from Abbott ARCHITECT i1000 (AA) to Ortho-Clinical Diagnostics Vitros 7600 (OCD). This was during the planning of the INtravenous iron polymaltose for First Nations Australian patients with high FERRitin levels on haemodialysis (INFERR) clinical trial. The trial design was based on AA assay ferritin levels. We compared the two assays' level of agreement in measuring ferritin levels in CKD patients. Methods Samples from INFERR clinical trial participants were analysed. Other samples from patients whose testing were completed the same day on OCD analyzers and run within 24 h on AA analyzers were added to ensure wide range of ferritin levels, adding statistical strength to the comparison. Ferritin levels from both assays were compared using Pearson's correlation, Bland-Altman, Deming and Passing-Bablok regression analyses. Differences between sample types, plasma and serum were assessed. Results Sixty-eight and 111 (179) samples from different patients from Central Australia and Top End of Australia, respectively, were analyzed separately and in combination. The ferritin levels ranged from 3.1 µg/L to 3354 µg/L and 3 µg/L to 2170 µg/L for AA and OCD assays respectively. Using Bland-Altman, Deming and Passing-Bablok regression methods for comparison, ferritin results were consistently 36% to 44% higher with AA than OCD assays. The bias was up to 49%. AA ferritin results were the same in serum and plasma. However, OCD ferritin results were 5% higher in serum than plasma.
PloS one, 2018
Different laboratory methods are used to quantify ferritin concentrations as a marker of iron status. A systematic review was undertaken to assess the accuracy and comparability of the most used methods for ferritin detection. National and regional databases were searched for prospective, retrospective, sectional, longitudinal and case-control studies containing the characteristics and performance of at least one method for serum/plasma ferritin determinations in humans published to date. The analysis included the comparison between at least 2 methods detailing: sensitivity, precision, accuracy, predictive values, inter-methods adjustment, and use of international reference materials. Pooled method performance was analyzed for each method and across methods. Search strategy identified 11893 records. After de-duplication and screening 252 studies were assessed, including 187 studies in the qualitative analysis and 148 in the meta-analysis. The most used methods included radiometric, ...
Clinical Importance of Determining Serum Ferritin. Establishing Reference Values
The diagnosis of iron deficiency anemia is based on the determination of serum hemoglobin (iron in red blood cells), serum iron (iron in circulation) and ferritin (iron in storage). For an accurate interpretation of laboratory test results and their qualification as normal or pathological, it is essential that each laboratory should establish its own reference intervals for the population it serves. This study defines reference intervals for serum ferritin in children and teenagers using ferritin determinations on a significant number of patients (hospitalized or outpatients). Materials and methods: The study was conducted in the Sibiu Clinical Pediatric Hospital using electronic laboratory data archive from January-December 2010. Serum ferritin measurements have been made on a sample of 600 patients by means of the MiniVidas, Biomerieux analyzer. Data analysis has been performed with the SPSS program using robust method to get 2.5 and 97.5 percentiles. Results and conclusions: The ...
Indian journal of clinical biochemistry : IJCB, 2006
A sample study of biological variation of plasma ferritin in healthy adult males 19-25 years of age (n=6) in the Indian population was determined. Venous blood was collected on 3 non-consecutive days during a 3 week period. Plasma ferritin was measured using enzyme linked immunoassay in an automated immunoassay system. Analytical and Biological variation was calculated. We found a mean biological variation of 21.64%. Thus, our results indicate that biological variation contributed most to the intraindividual variation.
Should ferritin tests be added to routine screening: An integrative literature review
2018
The purpose of this analysis was to explore the possible benefits of a blood screening to be coupled with the annual routine check-up. Blood screenings are only administered upon reasonable suspicion of pathology. Upon the examination of current research concerning ferritin levels within the blood, one can speculate the existence of strong correlations between ferritin levels, inflammatory disease and early morality. Cause for concern stems from the fact that the ferritin levels of the vast majority of people in the US are completely unknown. Ferritin levels are the most accurate marker for measuring the amount of iron being stored in the human body. Ferritin levels measured higher than 300 mcg/L for men and 200 mcg/L for women represent chronic iron toxicity (Schrier & Bacon, 2017). Although iron toxicity has been studied much less then iron deficiency, there has been some experimentation performed. This literature review will gather relevant works and will use the RE-AIM Framework...
Clinica Chimica Acta, 1985
The effects of biological (age, sex, weight) and patho~o~c~ factors on plasma ferritin concentrations were documented in 776 unselected elderly patients aged 80.9 f 9.7 yr. A marked shift towards high values (159 + 142 pg/l) was observed in this elderly population together with the persistence of the well-known sex-related difference in ferritin levels (higher levels in men). Twenty-five percent of the population had high levels of ferritin (2 220 pg/l) but 75% of these high values (i.e. 18.5% of the population) could be readily explained by their known association with a particular pathology (inflammatory syndrome, renal failure, cardiovascular diseases, alcoholism). Only 6% of the population had unexplained high ferritin concentrations. Therefore, our data strongly suggest that the repeatedly reported increase of ferritin in the aged population is merely related to an age-associated pathology and may not be a normal physiolo~c~ event occurring during the process of aging. OGO9-8981/85/$03.30 0 1985 Elsevier Science Publishers B.V. (Biomedical Division)
Measurement of ferritin in serum: Application in Diagnostic use
Clinical Biochemistry, 1984
A sandwich-type radioimmunoassay for serum ferritin was developed using iron-rich human liver ferritin and evaluated for its clinical usefulness. In young healthy males and females, the mean serum ferritin concentrations were 44 ~g/L (range 7-158) and 16 p.g/L (range 4-56), respectively. In anemic patients lower serum ferritin concentrations were found, while in most patients with iron overload serum ferritin concentrations well above 1000 ~g/L were measured. Comparison of our method with a commercially available radioimmunoassay kit revealed a good correlation, except for sera with very low ferritin concentrations. Comparison with serum iron and transferrin parameters in patients with iron deficiency demonstrated that serum ferritin concentrations might be subnormal in a majority of patients with otherwise normal iron indices. Up to 70% of the ferritin in serum of normal subjects could bind to concanavalin A-Sepharose, indicating its glycoprotein nature. It is concluded that our serum ferritin radioimmunoassay gave reliable results and was useful in the laboratory diagnosis of latent iron-deficiency and in the analysis of the heterogeneity of serum ferritin.
Background: Spot ferritin assay on dried serum spot (DSS) samples provides reliable and accurate assessment. Standard DSS preparations, however, involve precise serum aliquots and require some skill and training of field personnel. Objective: We evaluated the validity of the spot ferritin assay on DSS samples prepared by simplified approaches and standard technique in Guatemala City. Design: Venous blood (5 mL) was obtained from 104 subjects aged 24 Ȁ 15 y (x Ȁ SD) and transferred into nonheparin-containing (2 plain and 2 self-sealing) capillary blood collection tubes. Three DSS samples were prepared: A (standard, 20 L serum), B (blot, Ȃ30 -35 mm serum column), and C (dispenser, 20 L serum pushed directly from self-sealing capillary tubes with a dispenser). Spots were airdried and placed in hermetic plastic bags with a desiccant. Two weeks later, entire spots for DSS A and C samples and a circle in the center for DSS B samples were analyzed. Results: DSS ferritin A, B, and C correlated strongly with traditional ferritin (r ҃ 0.71-0.88, P 0.001). The geometric mean (Ҁ1 SD and ѿ1 SD) values for the DSS A, B, and C and traditional ferritin methods were 27.5 (12.6, 60.2), 32.4 (13.5, 77.6), 27.5 (11.7, 64.6), and 30.2 (13.8, 66.1) g/L, respectively, and did not differ significantly. The difference in ferritin values by various DSS approaches compared with the traditional approach was small (4 g/L; P 0.05). Conclusions: Simplified and standard DSS methods provide accurate iron-status assessment in population studies. The simplified DSS approaches for serum ferritin measurement need to be evaluated further in populations in whom iron deficiency is prevalent.
Background: Nutritional surveys use acute phase protein (APP) biomarkers such as C-reactive protein (CRP) and ␣ 1 -acid glycoprotein (AGP) to identify the influence of inflammation on the distribution of iron status biomarkers. Few, however, have examined which biomarker better identifies persons with spurious elevations in iron status markers. Objective: We explored the relations of APP biomarkers to ironstatus biomarkers in infants and school-age children. Design: In screening surveys, we identified a sample of African American infants (n ҃ 351) and Guatemalan school-age children (n ҃ 375). We used a common set of APP and iron-status biomarkers to examine the association between the 2 sets of markers (laboratory variables). Results: The overall prevalence of either inflammation or iron deficiency was 10% in both samples. The log AGP and CRP values were significantly correlated (r ҃ 0.70), but the unexplained variance still was 50%. Serum ferritin-but not transferrin receptor, transferrin receptor index, or serum iron-was related to APP concentrations, but poor positive predictive value (72%) and low kappa scores were found. Ferritin concentrations 1 geometric SD above the geometric mean were poorly predicted by either elevated AGP or CRP. Qualitative CRP analysis was not effective in identifying persons who had other indications of mild inflammation. Conclusions: These analyses show that a low prevalence of inflammation has little influence on the distribution of ferritin, and 2 common indicators of inflammation do not perform equally well in identifying persons who may have elevations in ferritin due to inflammation.