Elevated serum ferritin levels are associated with severity and prognosis of severe acute pancreatitis: a preliminary cohort study

Abstract

Background Serum ferritin (SF), as an acute-phase response protein, is used to reflect the degree of oxidative stress and systemic inflammatory responses. This study was designed to assess the effect of elevated SF levels on the severity of acute pancreatitis (AP). Methods From January 2013 to December 2020, 200 consecutive patients with AP were retrospectively reviewed to analyze the relationships among the etiologies of pancreatitis, the severity of the disease and SF levels. The receiver operating characteristic (ROC) curve and logistic regression analysis were used to assess whether elevated SF levels could predict the onset of organ failure in AP. Results 92 (46%) had high SF levels (> 275 ng/ml). SF levels were not associated with the etiology of AP disease. Among patients with high SF levels, there was a significant increase in the proportion of patients with severe AP (23.1% vs. 76.9%) and a higher proportion of systemic inflammatory response scores (25.9% vs. 44.6%) in comparison to patients with normal SF levels. The area under the ROC curve for SF in predicting persistent organ failure was 0.812 [95% confidence interval 0.721–0.904]. Conclusions F concentrations were positively correlated with the severity of AP, and quantitative assessment of SF can predict disease severity and organ failure in patients with AP.

Ferritin and Ferritin-to-Hemoglobin Ratio as Promising Prognostic Biomarkers of Severity in Acute Pancreatitis—A Cohort Study

“…In univariate analysis, SF and FHR were associated with OF, MSAP, and mortality (Table 4). This is consistent with recently published study data showing that patients with higher ferritin levels had a more severe AP [13]. Moreover, in our research, FHR was remarked as an independent variable for MSAP and continued to be significant in multivariate analysis.…”

“…NF-κB is involved in the M1 polarization of macrophages that modulates a pro-inflammatory cytokine over-response. Also, NF-κB up-regulates the expression of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) and, consequently, of pro-inflammatory interleukin-6 (IL-6) that promotes the release of acute-phase proteins such as CRP and ferritin [13][14][15].…”

“…Multiple research studies mentioned the association of the ferritin status with adverse outcomes in patients with various conditions. However, there are limited clinical data regarding the relationship between acute pancreatitis and the serum ferritin status [6,12,13].…”

SARS-CoV-2 Altered Hemorheological and Hematological Parameters during One-Month Observation Period in Critically Ill COVID-19 Patients

“…Virus-driven inflammation as an explanation is in line with our approximately six-fold increased ferritin and nine-fold increased CRP levels compared to clinical reference values [ 20 , 21 ], indicating a severe pro-inflammatory status in aCOV. While CRP is an established marker for acute inflammation and severity in COVID-19 and other diseases [ 53 , 54 ], ferritin can also be regarded as an acute phase protein besides its main function of iron storing and releasing [ 55 ]. Whereas CRP is decreasing over time in aCOV, ferritin levels are still elevated at T30, suggesting that it can be regarded as a longer-lasting marker for disease progression [ 56 ], subsequently negatively affecting hemorheological properties [ 57 ].…”

The relationship between serum ferritin level and clinical outcomes in sepsis based on a large public database

“…In serum, ferritin level is usually regulated by various factors including iron imbalance, hormones and inflammatory cytokines 3 . Researches showed that serum ferritin not only could be an indicator for differentiating anemia 4 , but also was associated with numerous other diseases including malignant tumor 5 , metabolic syndrome 6 , digestive disease 7 and even COVID-19 8 .…”