Shrivastava Aadarsh, Kumari Suchitra, Mohapatra Sonali
Biochemistry, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND.
Hematology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND.
Cureus. 2024 Aug 12;16(8):e66695. doi: 10.7759/cureus.66695. eCollection 2024 Aug.
Background and objective Serum ferritin concentration and transferrin saturation are commonly employed to estimate body iron but are non-specific to iron overload. Glycosylated ferritin may be primarily elevated in cases of iron overload in patients undergoing regular blood transfusions. In this study, we aimed to estimate glycosylated ferritin and determine its cutoff values for iron overload in patients receiving blood transfusions regularly. We also endeavored to the examine correlation between serum ferritin and glycosylated ferritin in patients receiving regular blood transfusions. Methods We conducted a cross-sectional study involving 17 patients undergoing regular blood transfusions in the Department of Medical Oncology/Hematology, who had already received ≥10 transfusions without any iron chelation therapy or acute inflammation. All participants were evaluated based on a questionnaire to gather relevant medical details. Serum iron, ferritin, glycosylated ferritin, and unsaturated iron-binding capacity (UIBC) were estimated. Total iron-binding capacity (TIBC) and transferrin saturation were also calculated. Results Participants were divided into two groups based on transferrin saturation (≥50% as a reference for iron overload). The group with transferrin saturation ≥50% had significantly higher levels of serum ferritin, glycosylated ferritin, and iron, compared to the group with transferrin saturation <50%. Glycosylated ferritin showed a positive correlation with ferritin (rho=0.80) and transferrin saturation (rho=0.64), which was statistically significant. UIBC and TIBC showed a negative association with glycosylated ferritin. The correlation of glycosylated ferritin with units of blood transfusion (Spearman's rho=0.60) was found to be better than that of serum ferritin (Spearman's rho=0.52). Conclusions Based on our findings, glycosylated ferritin could be a potential marker for transfusion-related iron overload. The optimal cutoff value for iron overload using serum glycosylated ferritin level was >587.55 ng/mL. Further extensive studies with larger sample sizes will substantiate the role of glycosylated ferritin in predicting post-transfusion iron overload.
血清铁蛋白浓度和转铁蛋白饱和度常用于评估机体铁含量，但对铁过载不具有特异性。糖基化铁蛋白可能在接受定期输血的患者发生铁过载时主要升高。在本研究中，我们旨在评估糖基化铁蛋白，并确定其在定期输血患者中铁过载的临界值。我们还努力研究定期输血患者血清铁蛋白与糖基化铁蛋白之间的相关性。方法：我们进行了一项横断面研究，纳入了医学肿瘤学/血液学科室17例接受定期输血的患者，这些患者已接受≥10次输血，且未接受任何铁螯合治疗或急性炎症。所有参与者均通过问卷调查进行评估，以收集相关医学细节。评估血清铁、铁蛋白、糖基化铁蛋白和不饱和铁结合能力（UIBC）。还计算了总铁结合能力（TIBC）和转铁蛋白饱和度。结果：根据转铁蛋白饱和度（≥50%作为铁过载参考）将参与者分为两组。与转铁蛋白饱和度<50%的组相比，转铁蛋白饱和度≥50%的组血清铁蛋白、糖基化铁蛋白和铁水平显著更高。糖基化铁蛋白与铁蛋白（rho=0.80）和转铁蛋白饱和度（rho=0.64）呈正相关，具有统计学意义。UIBC和TIBC与糖基化铁蛋白呈负相关。发现糖基化铁蛋白与输血单位的相关性（Spearman秩相关系数rho=0.60）优于血清铁蛋白（Spearman秩相关系数rho=0.52）。结论：基于我们的研究结果，糖基化铁蛋白可能是输血相关铁过载的潜在标志物。使用血清糖基化铁蛋白水平诊断铁过载的最佳临界值>587.55 ng/mL。进一步开展更大样本量的广泛研究将证实糖基化铁蛋白在预测输血后铁过载中的作用。
