Iron and ferritin effects on intensive care unit mortality:A metaanalysis

BACKGROUND The effect of serum iron or ferritin parameters on mortality among critically ill patients is not well characterized.AIM To determine the association between serum iron or ferritin parameters and mortality among critically ill patients.METHODS Web of Science,Embase,PubMed,and Cochrane Library databases were searched for studies on serum iron or ferritin parameters and mortality among critically ill patients.Two reviewers independently assessed,selected,and abstracted data from studies reporting on serum iron or ferritin parameters and mortality among critically ill patients.Data on serum iron or ferritin levels,mortality,and demographics were extracted.RESULTS Nineteen studies comprising 125490 patients were eligible for inclusion.We observed a slight negative effect of serum ferritin on mortality in the United States population[relative risk(RR)1.002;95%CI:1.002-1.004].In patients with sepsis,serum iron had a significant negative effect on mortality(RR=1.567;95%CI:1.208-1.925).CONCLUSION This systematic review presents evidence of a negative correlation between serum iron levels and mortality among patients with sepsis.Furthermore,it reveals a minor yet adverse impact of serum ferritin on mortality among the United States population.

Effect of Glycosylation on the Physicochemical Properties,Structure and Iron Bioavailability of Ferritin Extracted from Tegillarca granosa

Iron deficiency anemia(IDA)is a major global health problem.Tegillarca granosa has been considered as an excellent source of iron given its high content of iron-binding protein,ferritin.The aim of the present study was to determine the physicochemical properties,protein structures,and iron uptake of ferritin extracted from T.granosa,and to evaluate the potential impacts of chitosan glycosylation on these characteristics.Based on Box-Behnken design and response surface methodology,the optimal conditions for glycosylation included a ferritin/chitosan mass ratio of 4:1,a pH of 5.5,a reaction time of 10 min,and a reaction temperature of 50℃.Glycosylation caused decreased surface hydrophobicity and elevated water-holding capacity of ferritin due to the introduction of hydrophilic groups.Additionally,glycosylation improved antioxidant capacity of ferritin by 20.69%–189.66%,likely owing to the protons donated by saccharide moiety to terminate free radical chain reaction.The in vitro digestibility of ferritin was elevated by 22.56%–104.85%after glycosylation,which could be associated with lessβ-sheet content in secondary structure that made the glycosylated protein less resistant to enzymatic digestion.The results of the iron bioavailability in Caco-2 cells revealed that ferritin(78.85–231.77 ngmg^(−1))exhibited better iron bioavailability than FeSO4(51.48–114.37 ngmg^(−1))and the values were further elevated by glycosylation with chitosan(296.23–358.20 ngmg^(−1)),which may be related to the physicochemical properties of ferritin via glycosylation modification.These results provide a basis for the development of T.granosa derived ferritin and its glycosylated products,and can promote the utilization of aquatic resources.

Caveolin‑1 is critical for hepatic iron storage capacity in the development of nonalcoholic fatty liver disease

Background:Nonalcoholic fatty liver disease(NAFLD)is associated with disordered lipid and iron metabolism.Our previous study has substantiated the pivotal role of Caveolin-1(Cav-1)in protecting hepatocytes and mediating iron metabolism in the liver.This study aimed to explore the specific mechanisms underlying the regulation of iron metabolism by Cav-1 in NAFLD.Methods:Hepatocyte-specific Cav-1 overexpression mice and knockout mice were used in this study.Cav-1-knockdown of RAW264.7 cells and mouse primary hepatocytes were performed to verify the changes in vitro.Moreover,a high-fat diet and palmitic acid plus oleic acid treatment were utilized to construct a NAFLD model in vivo and in vitro,respectively,while a high-iron diet was used to construct an in vivo iron overload model.Besides,iron concentration,the expression of Cav-1 and iron metabolism-related proteins in liver tissue or serum were detected using iron assay kit,Prussian blue staining,Western blotting,immunofluorescence staining,immunohistochemical staining and ELISA.The related indicators of lipid metabolism and oxidative stress were evaluated by the corresponding reagent kit and staining.Results:Significant disorder of lipid and iron metabolism occurred in NAFLD.The expression of Cav-1 was decreased in NAFLD hepatocytes(P<0.05),accompanied by iron metabolism disorder.Cav-1 enhanced the iron storage capacity of hepatocytes by activating the ferritin light chain/ferritin heavy chain pathway in NAFLD,subsequently alleviating the oxidative stress induced by excess ferrous ions in the liver.Further,CD68^(+) CD163^(+) macrophages expressing Cav-1 were found to accelerate iron accumulation in the liver,which was contrary to the effect of Cav-1 in hepatocytes.Positive correlations were also observed between the serum Cav-1 concentration and the serum iron-related protein levels in NAFLD patients and healthy volunteers(P<0.05).Conclusions:These findings confirm that Cav-1 is an essential target protein that regulates iron and lipid metabolic homeostasis.It is a pivotal molecule for predicting and protecting against the development of NAFLD.

Hepcidin levels in hereditary hyperferritinemia:Insights into the iron-sensing mechanism in hepatocytes

AIM:To study the role of hepcidin in hereditary hyperferritinemia cataract syndrome(HHCS). METHODS:Six patients from two families with HHCS, confirmed by genetic analysis showing A to G mutation at position+40 in the L-ferritin gene,were recruited to undergo serum hepcidin and prohepcidin measurements using radioimmunoassay and enzyme linked immunoassay,respectively,and measurements were compared with levels in serum from 25 healthy volunteers(14 females),mean age 36±11.9 years.RESULTS:The serum hepcidin and prohepcidin levels in patients with HHCS were 19.1±18.6 and 187± 120.9 ng/mL,respectively.Serum ferritin was 1716.3± 376μg/L.Liver biopsy in one patient did not show any evidence of iron overload.Serum hepcidin and prohepcidin values in healthy controls(HCs)were 15.30±15.71 and 236.88±83.68 ng/mL,respectively,while serum ferritin was 110±128.08μg/L.There was no statistical difference in serum hepcidin level between the two cohorts(19.1±18.6 ng/mL vs 15.30±15.71 ng/mL,P= 0.612)using two-tailed t-test. CONCLUSION:Serum hepcidin levels in HHCS patients is similar to that in HCs.Our study suggests that circulating ferritin is not a factor influencing hepcidin synthesis and does not have a role in the iron-sensing mechanism in hepatocytes.

Evaluation and Application of Two High-Iron Transgenic Rice Lines Expressing a Pea Ferritin Gene

A total of 105 transgenic dce lines independently transformed with a pea ferritin gene （Fer） were previously obtained. After seven generations of selfing and β-glucuronidase （GUS） assisted selection, 82 transgenic lines with stable agronomic traits were got. Among the 82 transgenic lines, two high-iron transgenic rice lines Fer34 and Fer65, with the iron contents in the milled rice being 4.82 and 3.46 times of that of the wild type Xiushui 11, respectively were identified. In the two transgenic lines, the exogenous Fer gene was highly expressed, and inherited as a single locus. The transgene had no negative effect on the agronomic traits of rice plant, other mineral nutritional components, appearance quality and eating quality of the milled rice, indicating that these two lines were elite high-iron breeding lines. Furthermore, the practical application and further studies facilitating utilization of the two elite breeding lines were discussed.

A randomized trial of iron depletion in patients with nonalcoholic fatty liver disease and hyperferritinemia

AIM:To compare iron depletion to lifestyle changes alone in patients with severe nonalcoholic fatty liver disease(NAFLD)and hyperferritinemia,a frequent feature associated with more severe liver damage,despite at least 6 mo of lifestyle changes.METHODS:Eligible subjects had to be 18-75 years old who underwent liver biopsy for ultrasonographically detected liver steatosis and hyperferritinemia,ferritin levels≥250 ng/mL,and NAFLD activity score>1.Iron depletion had to be achieved by removing 350 cc of blood every 10-15 d according to baseline hemoglobin values and venesection tolerance,until ferritin<30 ng/mL and/or transferrin saturation(TS)<25%.Thirty-eight patients were randomized 1:1 to phlebotomy(n=21)or lifestyle changes alone(n=17).The main outcome of the study was improvement in liver damage according to the NAFLD activity score at 2 years,secondary outcomes were improvements in liver enzymes[alanine aminotransferases(ALT),aspartate aminotransferase(AST),and gamma-glutamyl-transferases(GGT)].RESULTS:Phlebotomy was associated with normalization of iron parameters without adverse events.In the21 patients compliant to the study protocol,the rate of histological improvement was higher in iron depleted vs control subjects(8/12,67%vs 2/9,22%,P=0.039).There was a better improvement in steatosis grade in iron depleted vs control patients(P=0.02).In patients followed-up at two years(n=35),ALT,AST,and GGT levels were lower in iron-depleted than in control patients(P<0.05).The prevalence of subjects with improvement in histological damage or,in the absence of liver biopsy,ALT decrease≥20%(associated with histological improvement in biopsied patients)was higher in the phlebotomy than in the control arm(P=0.022).The effect of iron depletion on liver damage improvement as assessed by histology or ALT decrease≥20%was independent of baseline AST/ALT ratio and insulin resistance(P=0.0001).CONCLUSION:Iron depletion by phlebotomy is likely associated with a higher rate of improvement of histological liver damage than lifestyle changes alone in patients with NAFLD and hyperferritinemia,and with amelioration of liver enzymes.

Iron Nutrition <i>vis-à-vis</i>Aconitase Activity and Ferritin Accumulation in Tropical <i>Indica</i>Rice Cultivars Differing in Grain Iron Concentration

Effect of Fe nutrition on Fe acquisition, aconitase enzyme activity and assimilation of the element in ferritin protein was studied in two indica rice cultivars viz. Sharbati and Lalat having contrasting grain Fe concentration. Young rice seedlings were grown in hydroponics with different levels of Fe. For comparison, the two cultivars were also grown in the field under natural conditions of rice culture. Iron accumulation, aconitase activity and ferritin level were higher in the high Fe containing cultivar, Sharbati than that in the low Fe containing cultivar, Lalat. While aconitase activity increased consistently with the increase in concentration of Fe in the growing medium, the same was not found to be true for accumulation of ferritin protein. The leaf ferritin level increased up to a certain level of Fe in the growing medium and declined thereafter. Levels of Fe in the growing medium giving maximum ferritin synthesis were found to be different in the two rice cultivars. In both cultivars, aconitase activity attained maximum level after 20 days of panicle emergence (heading). Pattern of Fe accumulation in the leaves in response to increasing Fe level in the nutrient solution paralleled with that of the aconitase activity indicating a positive correlation. It was concluded that accumulation of both ferritin protein and aconitase enzyme were influenced not only by the Fe level in the growing medium but also by the internal Fe concentration of the two cultivars.

Reabsorption of iron into acutely damaged rat liver:A role for ferritins

AIM To studied iron metabolism in liver, spleen, and serum after acute liver-damage, in relation to surrogate markers for liver-damage and repair.METHODS Rats received intraperitoneal injection of the hepatotoxin thioacetamide(TAA), and were sacrificed regularly between 1 and 96 h thereafter. Serum levels of transaminases and iron were measured using conventional laboratory assays. Liver tissue was used for conventional histology, immunohistology, and iron staining. The expression of acute-phase cytokines, ferritin light chain(FTL), and ferritin heavy chain(FTH)was investigated in the liver by q RT-PCR. Western blotting was used to investigate FTL and FTH in liver tissue and serum. Liver and spleen tissue was also used to determine iron concentrations.RESULTS After a short initial decrease, iron serum concentrations increased in parallel with serum transaminase(aspartate aminotransferase and alanine aminotransferase) levels, which reached a maximum at 48 h, and decreased thereafter. Similarly, after 48 h a significant increase in FTL, and after 72 h in FTH was detected in serum. While earliest morphological signs of inflammation in liver were visible after 6 h, increased expression of the two acute-phase cytokines IFN-γ(1 h) and IL-1β(3 h) was detectable earlier, with maximum values after 12-24 h. Iron concentrations in liver tissue increased steadily between 1 h and 48 h, and remained high at 96 h. In contrast, spleen iron concentrations remained unchanged until 48 h, and increased mildly thereafter(96 h). Although tissue iron staining was negative, hepatic FTL and FTH protein levels were strongly elevated. Our results reveal effects on hepatic iron concentrations after direct liver injury by TAA. The increase of liver iron concentrations may be due to the uptake of a significant proportion of the metal by healthy hepatocytes, and only to a minor extent by macrophages, as spleen iron concentrations do not increase in parallel. The temporary increase of iron, FTH and transaminases in serum is obviously due to their release by damaged hepatocytes.CONCLUSION Increased liver iron levels may be the consequence of hepatocyte damage. Iron released into serum by damaged hepatocytes is obviously transported back and stored via ferritins.

Identification of iron-loaded ferritin as an essential mitogen for cell proliferation and postembryonic development in Drosophila

动物细胞为生长，增长和幸存要求外来的暗示。例如，在 vitro 的果蝇想象的圆盘房间的繁殖要求苍蝇摘录，其作文仍然保持大部分未定义的补充。这里，我作为为支持克隆 8 想象的圆盘房间的生长被要求的苍蝇摘录的活跃成分报导装载铁的 ferritin 的生物化学的纯化。与为在有教养的细胞的装载铁的 ferritin 的一个必要角色一致， ferritin 的 overexpression 或铁在的增加一本滋养穷人的食谱增加动物生存能力和身体重量，支持细胞增长，并且弄短 postembryonic 开发的持续时间。相反地，主导否定的 ferritin 的 overexpression 或铁 chelator 的增加引起相反的效果。Ferritin 变异的苍蝇与在饥饿的幼虫看那暗示的严重饥饿显型在第一中间形态的幼虫的阶段逮捕开发。我断定装载铁的 ferritin 由维持铁动态平衡并且反对饥饿反应在果蝇为房间增长和 postembryonic 开发充当必要 mitogen。

The Potential Clinical Significance of the Serum Iron and Ferritin Status in Lung Cancer Patients

Background An increasing number of studies have shown that iron,one of the indispensable trace elements in the human body,is closely related to the occurrence and development of cancer.However,few studies have clearly demonstrated the role of the iron levels in lung cancer patients,or the potential effects of inflammation on iron levels.Methods The clinical data for lung cancer patients and non-lung cancer participants were retrospectively analyzed.The serum iron and ferritin levels were measured and compared using a rank-sum test.The correlation between the serum iron/ferritin and C-reactive protein(CRP)was analyzed by rank correlation.The cut-off values for continuous variables were obtained by the receiver operating characteristic curve(ROC)method.An analysis of potential prognostic factors in lung cancer patients was conducted by univariate and multivariate survival analyses.Results The serum iron levels in patients with extensive small-cell lung cancer(SCLC)were lower than those with limited-stage SCLC,and the levels of serum ferritin and CRP in those with extensive SCLC were higher than those with limited-stage SCLC.Similarly,the serum iron levels in patients with stage IV non-small cell lung cancer(NSCLC)were lower than those of patients with stageⅠ-Ⅲdisease,and the levels of serum ferritin and CRP in those with stage IV NSCLC were higher than those in stagesⅠ-Ⅲ.The serum iron level was negatively correlated with the level of CRP,while the serum ferritin level was positively correlated with CRP.The stage of lung cancer,but not the serum iron/ferritin level,was an independent prognostic factor in lung cancer patients.Conclusions The serum iron and ferritin levels are associated with the staging of lung cancer.The later stages of lung cancer are associated with a lower serum iron level,a higher serum ferritin level,and a higher CRP level.Inflammation may play an important role in regulating the serum iron and ferritin levels in lung cancer patients.

葡萄铁蛋白基因Ferritin的鉴定、克隆及其在果实发育不同时期对氨基酸铁复合肥喷施的响应

【目的】铁蛋白Ferritin在植物生长发育过程中发挥重要作用,其在果树中的生物学功能尚未见报道。克隆葡萄Ferritin家族基因并揭示其在果实发育不同时期的表达模式及其对叶面喷施氨基酸-铁(Fe)复合肥处理的响应差异,可为研究果树铁素营养与代谢的分子机制提供理论依据。【方法】通过同源克隆法从‘马瑟兰’中克隆Ferritin家族基因,利用生物信息学手段分析葡萄Ferritin及其编码蛋白的详细特征;设置叶面喷施氨基酸-Fe复合肥处理,利用荧光实时定量PCR技术分析Ferritin在葡萄果实发育不同时期的表达特征及其对叶面喷施处理的差异响应。【结果】在葡萄基因组中检索并克隆获得4个Ferritin家族基因,命名为VvFer1—VvFer4,分布于第6、8和13号三条染色体上,均含有7个长度不一的内含子,且主要定位于叶绿体和细胞核。本文所选16种植物Ferritin蛋白序列的一致性高达61.48%,系统发育树分析表明同一属的Ferritin同源蛋白如十字花科的拟南芥和芜菁,茄科的烟草和马铃薯,豆科的大豆、落花生和鹰嘴豆,大戟科的橡胶树、木薯和蓖麻,蔷薇科的苹果、桃和草莓,遗传进化关系较近,葡萄VvFer3和茄科同源蛋白遗传关系最近。葡萄VvFer基因在五年生‘马瑟兰’果实发育不同时期、不同组织中的表达水平差异较大,其中,VvFer3在不同组织中的表达量均最高,最大值出现在硬核期至成熟期的果实中,其次是VvFer2和VvFer4。‘马瑟兰’葡萄发育不同时期果实中的Fe含量略有差异,从幼果期开始逐渐增加,并在转色期果实中达到最高值,从转色期到成熟期略有下降,但仍高于幼果期和硬核期果实中的Fe含量,叶面喷施处理显著提高了成熟期果实中的Fe含量、乌头酸酶ACO(aconitase)、硝酸还原酶NIR(nitrite reductase)和琥珀酸脱氢酶SDH(succinate dehydrogenase)的酶活性。VvFer2—4在转录水平易受叶面喷施铁肥的诱导而显著增强,且与葡萄组织/器官分布和果实发育的不同时期密切相关,VvFer2在葡萄发育整个周期仅在果实中对叶面喷施铁肥处理比较敏感,VvFer3在所有组织中仅从幼果期至转色期对叶面喷施铁肥有响应,VvFer4在葡萄发育整个周期的韧皮部和叶片中持续受叶面喷施铁肥的诱导,而在果实中仅从幼果期至转色期对叶面喷施铁肥有响应;VvFer1在本文所选组织中的表达量相对较低,但很均匀,且在转录水平对叶面喷施铁肥没有响应。【结论】从葡萄中克隆并鉴定了4个铁蛋白基因Ferritin,其在葡萄发育不同时期、不同组织中的表达水平差异较大,并在转录水平易受叶面喷施铁肥的诱导;VvFer3在葡萄所有组织中的整体表达量最高(特别是果实中最为突出),且在幼果期至转色期易受铁肥叶面喷施的调控。

孕康口服液对缺铁性贫血孕鼠产后恢复及子代质量的影响

目的 探究孕康口服液对缺铁性贫血(IDA)孕鼠产后恢复及子代质量的影响。方法 采用饲喂缺铁饲料联合放血法建立缺铁性贫血孕鼠模型,造模成功后,在妊娠第7天同期灌胃给予琥珀酸亚铁片(52 mg/kg)及孕康口服液(9、6、4 mL/kg),每天1次,直至产后6周。结束后,检测小鼠相关体征指标(自主活动、抓力、背温、爪色)、脏器系数(心脏、脾、胸腺系数)、外周血指标(RBC、HGB、HCT、MCH、MCHC)、铁代谢相关血清因子指标(EPO、FEP、SF、sTfR、TFR1),免疫组化法检测肝组织FPN、Tf蛋白表达,免疫荧光法检测肝组织TFR1、Hepcidin蛋白表达,RT-qPCR检测肝组织Hepcidin、FPN、Tf、TFR1 mRNA表达,测定子代相关情况(存活率、自主活动、抓力、爪色、心脏系数、脾脏系数、体长、外周血象指标)。结果 孕康口服液可提高IDA孕鼠产后的自主活动次数、抓力、背温、爪色(P<0.05,P<0.01),降低心脏和脾脏系数(P<0.01),提高全血RBC、HGB、HCT、MCH、MCHC水平(P<0.05,P<0.01),降低血清EPO、FEP、TFR1、sTfR水平(P<0.05,P<0.01),升高SF水平(P<0.05,P<0.01),提高肝组织Hepcidin、FPN mRNA及蛋白表达(P<0.05,P<0.01),降低Tf、TFR1 mRNA及蛋白表达(P<0.05,P<0.01)。与模型组比较,孕康口服液各剂量组子代存活率、自主活动次数、抓力提高(P<0.05,P<0.01),心脏系数、脾脏系数降低(P<0.05,P<0.01),体长增加(P<0.05,P<0.01),全血RBC、HGB、HCT水平升高(P<0.01)。结论 孕康口服液可改善IDA孕鼠的贫血状况,促进其产后恢复,并提高子代质量。

细胞质及线粒体ferritin与铁代谢

铁是机体代谢所必需的微量元素之一。近年来,铁在机体内的代谢越来越受到人们的重视。维持体内铁的平衡,对保证机体的正常生理功能显得极为重要。胞质铁蛋白(cytosolic ferritin,CFt)是细胞内重要的调节铁平衡的因子之一。而近年发现的线粒体铁蛋白(mitochondrial ferritin,MtFt)是一种定位在线粒上、和铁代谢密切相关的蛋白,具有组织受限性表达的特点,它在结构和功能上与胞质铁蛋白相比有一定的相似性,但是由于其mRNA上没有铁调控元件,它的表达不直接受铁调节蛋白调控,所以其确切功能及表达机制还未完全明了,因此,近年来有不少人开展了这方面的研究。对线粒体铁蛋白的深入研究将极大地丰富人们对铁在亚细胞水平上的代谢机制和功能的认识。文章介绍了细胞质铁蛋白的调控机制以及线粒体铁蛋白的结构、功能、表达及与铁代谢的关系。

血清铁蛋白、红细胞参数及红细胞形态在孕妇缺铁性贫血病情评估中的应用

目的 探究血清铁蛋白(Serum Ferritin,SF)、红细胞参数及红细胞形态在评估孕妇缺铁性贫血中的作用。方法 回顾性选取2022年1—12月泗水县人民医院收治的76例贫血孕妇的临床资料,以其贫血类型分为缺铁性贫血组(37例)、非缺血性贫血(39例),选同期42例常规筛查孕妇(无贫血)作为健康组;比较3组SF、红细胞参数水平[红细胞平均体积(Mean Corpuscular Volume,MCV)、红细胞平均血红蛋白量(Mean Corpuscular Hemoglobin,MCH)、红细胞(Red Blood Cell,RBC)、红细胞体积分布宽度(Red Blood Cell Volume Distribution Width,RDW)、血红蛋白(Hemoglobin,Hb)、红细胞比容(Hematocrit,HCT)]及显微镜下红细胞形态。结果 缺铁性贫血组患者SF、MCV、MCH水平均较健康组低,RBC、RDW均较健康组高,差异有统计学意义(P均<0.05);缺铁性贫血患者MCV、MCH、SF水平较非缺铁性贫血组低,RBC、RDW水平较非缺铁性贫血组高,差异有统计学意义(P均<0.05)。非缺铁性贫血组Hb、HCT水平与缺铁性贫血组对比,差异无统计学意义(P均>0.05)。缺铁性贫血组异常形态红细胞占比为(9.62±2.03)%,较非缺铁性贫血组(67.19±6.78)%低,差异有统计学意义(t=49.570,P<0.05)。缺铁性贫血组中,轻度、中度、重度患者,其MCV、Hb、SF水平逐渐降低,差异有统计学意义(P<0.05);MCV、Hb、SF水平与缺铁性贫血程度负相关(r=-0.587、-0.591、-0.756,P均<0.001)。结论 贫血孕妇中,缺铁性贫血孕妇会出现红细胞参数、红细胞形态学及SF水平变化,且随缺铁性贫血加重,MCV、Hb、SF水平随之下降,考虑可将其作为患者病情评估指标。

线粒体铁蛋白在神经系统疾病的研究进展

线粒体铁蛋白(FtMt)是一种无内含子基因编码的铁蛋白,能通过调控细胞氧化应激、胞质铁的平衡,进而影响线粒体铁含量、线粒体功能、活性氧的产生和细胞GSH含量等。越来越多的证据表明FtMt参与神经退行性病变、缺血性脑卒中、创伤性脑损伤、不安腿综合征以及脑胶质瘤的发生、发展,本文总结了FtMt在多种神经系统疾病中发挥的不同作用,为探索多种神经系统疾病的机制研究提供参考。

血清铁调素及MCV、MCH等红细胞参数在不同严重程度缺铁性贫血患者中的比较研究

目的探讨血清铁调素、平均红细胞体积(MCV)、平均红细胞血红蛋白(MCH)等红细胞参数在不同严重程度缺铁性贫血(IDA)患者中的差异及与疾病严重程度的相关性。方法回顾性分析2021年10月—2023年3月新疆维吾尔自治区妇幼保健院内科诊治的IDA患者102例的临床资料。根据患者病情严重程度分为轻中度IDA组(n=64)和重度IDA组(n=38)。收集2组临床资料,检测并比较血清铁调素、血清铁蛋白(SF)及总铁结合力(TIBC)等铁代谢指标;MCV、MCH及红细胞分布宽度(RDW)等红细胞参数;网织红细胞(RET)计数、RET百分比及RET血红蛋白含量(RET-He)等网织红细胞参数。分析不同预后患者间各指标的差异,通过Spearman相关性分析及多因素Logistic回归分析筛选IDA患者病情严重的危险因素。结果重度IDA组患者的血清铁调素、SF、MCV、MCH、RET百分比及RET-He均低于轻中度IDA组患者(t/P=5.091/<0.001,5.513/<0.001,3.191/0.002,5.338/<0.001,5.244/<0.001,5.745/<0.001),血清TIBC水平、RDW、RET计数均高于轻中度IDA组患者(t/P=4.215/<0.001,5.770/<0.001,3.874/<0.001);IDA患者严重程度与患者血清TIBC、RDW及RET计数呈正相关(r/P=0.390/<0.001,0.496/<0.001,0.386/<0.001),与血清铁调素、SF、MCV、MCH、RET百分比及RET-He呈负相关(r/P=-0.477/<0.001,-0.506/<0.001,-0.302/0.002,-0.475/<0.001,-0.466/<0.001,-0.500/<0.001);多因素Logistic回归分析表明,IDA患者铁调素升高、MCH水平升高均是病情严重的保护因素[OR(95%CI)=0.780(0.631~0.965),0.556(0.328~0.941)]。结论不同严重程度的IDA患者铁代谢、红细胞参数及网织红细胞参数存在较大差异,其中铁调素、MCH水平降低可能提示IDA患者病情较严重,监测相关指标有助于更准确地评估IDA患者病情。

电离辐射对鼻咽癌中铁死亡驱动因子SOCS1与抑制因子FTH1表达水平的影响

目的 探索铁死亡驱动因子细胞因子信号转导抑制蛋白1(SOCS1)与抑制因子铁蛋白重链1(FTH1)在鼻咽癌中的表达水平及电离辐射对其的影响。方法 分析来自GEO数据库的鼻咽癌数据集GSE53819(18个鼻咽癌样本和18份鼻咽正常组织样本)和GSE12452(31个鼻咽癌样本和10份鼻咽正常组织样本)中SOCS1与FTH1的表达水平,并联合GSE62328(30个鼻咽癌样本)分析不同肿瘤分期、淋巴结转移状态与原发-复发类型中SOCS1和FTH1表达水平;利用GSE48501数据集中放射抵抗性鼻咽癌CNE2-IR细胞和放射敏感性鼻咽癌CNE2细胞中m RNA表达数据,分析SOCS1与FTH1在放射抵抗性和放射敏感性鼻咽癌细胞株中的表达水平;以经2 Gy电离辐射照射后的鼻咽癌C666-1细胞为实验组,0 Gy电离辐射照射的鼻咽癌C666-1细胞为对照组,应用RT-q PCR法分别检测其中SOCS1与FTH1的表达水平。结果 GEO数据库分析显示,鼻咽癌组织中SOCS1与FTH1表达水平高于正常鼻咽组织(P<0.05)。与伴淋巴结转移的鼻咽癌样本比较,无淋巴结转移的鼻咽癌样本中SOCS1与FTH1表达水平较高(P<0.05)。SOCS1与FTH1在放射抵抗性和放射敏感性鼻咽癌细胞株中的表达水平比较,差异无统计学意义(P>0.05)。RT-PCR结果提示,实验组C666-1细胞中SOCS1表达水平高于对照组,FTH1表达水平低于对照组(P<0.05)。结论 铁死亡驱动因子SOCS1与抑制因子FTH1在鼻咽癌中差异表达且可作为鼻咽癌放射治疗潜在靶点。

缺铁性贫血患者血清铁蛋白、血红蛋白与血清甲状腺激素相关性分析

目的探讨缺铁性贫血(iron deficiency anemia,IDA)患者的血清铁蛋白(serum ferritin,SF)、血红蛋白(Hemoglobin,HB)和血清甲状腺激素水平之间的关系。方法回顾性分析190例确诊的IDA患者,按贫血程度分为轻度、中度、重度组,按甲状腺功能分甲状腺功能亢进组、亚临床甲状腺功能亢进组、临床甲状腺功能减退组、亚临床甲状腺功能减退组及甲状腺功能正常组,所有研究对象均行血常规、血清铁蛋白、甲状腺激素水平测定。结果IDA伴甲状腺功能异常占43.2%,IDA合并亚临床甲减占45.1%、甲状腺毒症占29.3%、临床甲减占15.9%、亚临床甲亢占9.8%,IDA与甲状腺疾病的患病率有统计学意义(P<0.01)。轻度、中度、重度IDA合并甲状腺功能异常的分别占47.4%、33.3%、60%;其中轻度IDA患者合并临床甲亢、亚临床甲亢、甲减、亚临床甲减的患病率分别为75%、75%,38%,43.2%,中度:20.80%、12.50%、30.80%和40.50%,重度:4.20%、12.50%、30.80%和16.20%,IDA的严重程度与甲状腺疾病的患病率有统计学意义(P<0.05)。相关性分析显示,在IDA患者合并甲减、亚临床甲减时,HB与游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、促甲状腺素(TSH)均有相关性(P<0.01),SF仅与TSH有相关性(P<0.05)。在IDA患者合并临床甲亢和亚临床甲亢时,SF、HB分别与FT_(3)、TSH有相关性(P<0.05),与FT_(4)无相关(P>0.05)。甲状腺功能正常的IDA患者,SF与FT_(3)、FT_(4)和TSH有相关性(P<0.01),HB仅与FT_(4)有相关性(P<0.01)。结论IDA可以导致甲状腺激素的变化,SF、HB与FT_(3)、FT_(4)、TSH之间存在相关性;IDA伴亚临床甲减患病率更高,以轻、中度贫血较多见,血红蛋白相较于铁蛋白能更好地反应IDA合并亚临床甲减的指标。

血清铁蛋白、转铁蛋白联合25-羟基维生素D指标检测对婴幼儿缺铁性贫血的预测价值

目的:探究血清铁蛋白(serum ferritin,SF)、转铁蛋白(transferrin,TF)联合25-羟基维生素D[25-hydroxyvitamin D,25(OH)D]指标对婴幼儿缺铁性贫血的预测价值。方法:选取2020年10月—2023年9月在上海市浦东新区南汇新城镇社区卫生服务中心就诊的缺铁性贫血婴幼儿60例,并按病例对照1∶4的比例选取具有可比性的240例非缺铁性贫血婴幼儿作为非缺铁性贫血组,另选取同期健康体检儿童100例作为健康对照组,收集3组受试儿童的临床资料,并检测其血清SF、TF、25(OH)D等水平。结果:3组受试儿童SF、25(OH)D、TF水平比较,差异均有统计学意义(Z/F值分别为296.290、408.959、1008.023,P<0.05),其中,非缺铁性贫血组与缺铁性贫血组SF、25(OH)D水平明显低于健康对照组,缺铁性贫血组TF水平高于非缺铁性贫血组和健康对照组。logistic回归分析结果显示,SF、25(OH)D、TF水平与婴幼儿缺铁性贫血发生风险因素呈正相关。以SF、25(OH)D、TF指标作为检验变量,将缺铁性贫血组和非缺铁性贫血组作为参考标准,制作ROC曲线,其中,SF、25(OH)D、TF的AUC分别为0.613,0.713,0.628,而3个指标联合预测概率AUC为0.848,相较于每个指标均显著提升。结论:SF、25(OH)D、TF联合检测对婴幼儿缺铁性贫血诊断有较高的价值,能够为婴幼儿缺铁性贫血的临床诊断及预后提供借鉴。

红细胞输注疗效和铁过载对再生障碍性贫血患者T淋巴细胞亚群的影响

目的 浅析红细胞输注疗效和铁过载再生障碍性贫血患者对T淋巴细胞亚群的影响,以便为日后临床提供参考。方法 选取2022年1—12月北大医疗鲁中医院收入的再生障碍性贫血患者68例为研究对象,依据输注是否有效分为输注有效组与输注无效组,每组34例,分析两组患者的T淋巴细胞亚群的结果。结果 两组患者T淋巴细胞检验结果指标相比,差异无统计学意义(P>0.05);输血有效组及输血无效组患者非铁过载患者CD3+指标均高于铁过载,差异有统计学意义(P<0.05)。结论 患者长期依靠红细胞输注会造成铁过载,而铁过载会对CD3+T淋巴细胞产生影响,特别是在红细胞输注是有效的情况下。