Serum ferritin and changes in pulmonary functions in Egyptian smokers

Document Type : Original Article

Authors

1 Chest diseases department, Faculty of Medicine, Beni-Suef University, Beni-Suef 62511, Egypt

2 Clinical and Chemical Pathology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt

Abstract

Background: Ferritin is a crucial regulator of iron homeostasis and can contribute to oxidative tissue damage. Elevated ferritin levels may indicate inflammatory processes. Tobaccocan affect ferritin concentrations, potentially causing airway inflammation. High ferritin levels in smokers may be linked to emphysema and lung cancer. Objectives: This study aimed to investigate the possible relationship between serum ferritin and changes in pulmonary function in Egyptian cigarette smokers.  Methods: This Cross-sectional prospective study was conducted in Beni-Suef university hospital, department of chest diseases from September 2022 to March 2023.  Results: The study found significant positive correlations between ferritin levels, age, smoking years, daily cigarette consumption, height, BMI, Hb, and TLC. Conclusion: we identified significant positive correlations between Ferritin levels and Age, Smoking years, number of cigarettes per day, Smoking Index, BMI, Hb and TLC. In contrast, there were significant negative correlations between Ferritin and FEV1, FVC, FEV1/FVC ratio, FEF25-75, and SO2. Weight and Hct did not exhibit any significant correlations with Ferritin.

Keywords

Main Subjects


  1. Emerit J, Beaumont C, and Trivin F. Iron metabolism, free radicals, and oxidative injury. Biomedicine & pharmacotherapy. 2001 Jul 1;55(6):333-9.
  2. Philippot Q, Deslée G, Adair-Kirk TL, Woods JC, Byers D, Conradi S et al. Increased iron sequestration in alveolar macrophages in chronic obtructive pulmonary disease. PloS one. 2014 May 1;9(5):e96285.
  3. Nelson ME, O'Brien-Ladner AR, and Wesselius LJ. Regional variation in iron and iron-binding proteins within the lungs of smokers. American journal of respiratory and critical care medicine. 1996 Apr;153(4):1353-8.
  4. Lee CH, Goag EK, Lee SH, Chung KS, Jung JY, Park MS et al. Association of serum ferritin levels with smoking and lung function in the Korean adult population: analysis of the fourth and fifth Korean National Health and Nutrition Examination Survey. International journal of chronic obstructive pulmonary disease. 2016 Nov 29:3001-6.
  5. Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, et al. 2000 CDC Growth Charts for the United States: methods and development. Vital and Health statistics. Series 11, Data From the National Health Survey. 2002 May 1(246):1-90.
  6. Miller MR, Hankinson JA, Brusasco V, Burgos F, Casaburi R, Coates A et al . Standardisation of spirometry. European respiratory journal. 2005 Aug 1;26(2):319-38.
  7. Brown K, Blake RS, and Dennany L. Electrochemiluminescence within veterinary Science: A review. Bioelectrochemistry. 2022 Aug 1;146:108156.
  8. Koorts AM, and Viljoen M. Ferritin and ferritin isoforms I: Structure–function relationships, synthesis, degradation and secretion. Archives of physiology and biochemistry. 2007 Jan 1;113(1):30-54.
  9. Arosio P, Elia L, and Poli M. Ferritin, cellular iron storage and regulation. IUBMB life. 2017 Jun;69(6):414-22.
  10. Venkataramani V. Iron homeostasis and metabolism: two sides of a coin. Ferroptosis: Mechanism and Diseases. 2021 Aug 10:25-40.
  11. Anderson GJ, and Frazer DM. Current understanding of iron homeostasis. The American journal of clinical nutrition. 2017 Dec 1;106:1559S-66S.
  12. Moreira AC, Mesquita G, and Gomes MS. Ferritin: an inflammatory player keeping iron at the core of pathogen-host interactions. Microorganisms. 2020 Apr 18;8(4):589.
  13. Kell DB, and Pretorius E. Serum ferritin is an important inflammatory disease marker, as it is mainly a leakage product from damaged cells. Metallomics. 2014 Apr;6(4):748-73.
  14. Cloonan SM, Mumby S, Adcock IM, Choi AM, Chung KF, Quinlan GJ. The “iron”-y of iron overload and iron deficiency in chronic obstructive pulmonary disease. American journal of respiratory and critical care medicine. 2017 Nov 1;196(9):1103-12.
  15. Malenica M, Prnjavorac B, Bego T, Dujic T, Semiz S, Skrbo S et al. Effect of cigarette smoking on haematological parameters in healthy population. Medical Archives. 2017 Apr;71(2):132.
  16. Sankar V, and Villa A. Hematologic diseases. Burket's Oral Medicine. 2021 Aug 30:627-64.
  17. Sadreameli SC, Kopp BT, Creary SE, Eakin MN, McGrath-Morrow S, and Strouse JJ. Secondhand smoke is an important modifiable risk factor in sickle cell disease: a review of the current literature and areas for future research. International journal of environmental research and public health. 2016 Nov;13(11):1131.
  18. Cohen RT, Strunk RC, Field JJ, Rosen CL, Kirkham FJ, Redline S, et al. Environmental tobacco smoke and airway obstruction in children with sickle cell anemia. Chest. 2013 Oct 1;144(4):1323-9.
  19. Lee J, Park HK, Kwon MJ, Ham SY, Kim JM, Lim SY et al. Decreased lung function is associated with elevated ferritin but not iron or transferrin saturation in 42,927 healthy Korean men: A cross-sectional study. PLoS One. 2020 Apr 2;15(4):e0231057.
  20. Gothwal SK, Palsaniya V, Barjatiya HC, Banseria R, Sharma P, Goyal PK et al. Study of lung function test in association with laboratory findings of serum iron in patients with chronic obstructive pulmonary disease. Clinical Epidemiology and Global Health. 2022 Jul 1;16:101091.
  21. Shibata Y, Inoue S, Igarashi A, Yamauchi K, Abe S, Aida Y et al. Elevated serum iron is a potent biomarker for spirometric resistance to cigarette smoke among Japanese males: the Takahata study. PloS one. 2013 Sep 9;8(9):e74020.
  22. Ghio AJ, and Hilborn ED. Indices of iron homeostasis correlate with airway obstruction in an NHANES III cohort. International journal of chronic obstructive pulmonary disease. 2017 Jul 18:2075-84.
  23. Kim SY, Lee SH, Lee IS, Kim SB, Moon CS, Jung SM et al. The Relationship between Serum Ferritin Concentrations, Smoking and Lung Function in Korean. Tuberculosis and Respiratory Diseases. 2012 Feb 1;72(2):163-8.
  24. Brigham EP, McCormack MC, Takemoto CM, and Matsui EC. Iron status is associated with asthma and lung function in US women. PloS one. 2015 Feb 17;10(2):e0117545.
  25. Inal B, Hacıbekiroglu T, Cavus B, Musaoglu Z, Demir H, and Karadag B. Effects of smoking on healthy young men’s hematologic parameters. Northern clinics of Istanbul. 2014;1(1):19.
  26. Cankurtaran M, Yavuz BB, Halil M, Ulger Z, Haznedaroğlu IC, and Arıoğul S. Increased ferritin levels could reflect ongoing aging-associated inflammation and may obscure underlying iron deficiency in the geriatric population. European Geriatric Medicine. 2012 Oct 1;3(5):277-80.
  27. Lencel P, and Magne D. Inflammaging: the driving force in osteoporosis?. Medical hypotheses. 2011 Mar 1;76(3):317-21.
  28. Ryan JD, Chin JL, and Crowe J. Ferritin in decompensated cirrhosis: Iron or inflammation?. Journal of Hepatology. 2015 Feb 1;62(2):499-500.
  29. McKeever TM, Lewis SA, Smit HA, Burney P, Cassano PA, and Britton J. A multivariate analysis of serum nutrient levels and lung function. Respiratory research. 2008 Dec;9:1-0
  30. Ghio AJ, and Hilborn ED. Indices of iron homeostasis correlate with airway obstruction in an NHANES III cohort. International journal of chronic obstructive pulmonary disease. 2017 Jul 18:2075-84.